Country Spotlight: Zimbabwe

Country Overview

Zimbabwe is one of the countries hardest hit by AIDS in sub-Saharan Africa. Nearly 1.4 million people are living with HIV in Zimbabwe, with an estimated 64,000 new infections in 2015 and a mother-to-child HIV transmission rate of 6.7%.

Our Work in Zimbabwe

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) in Zimbabwe brings both clinical HIV expertise and a focus on strengthening data quality and health systems to address the HIV and AIDS epidemic in-country. Since 2001, EGPAF has been a lead partner to Zimbabwe’s Ministry of Health and Child Care, supporting the national prevention of mother-to-child transmission of HIV (PMTCT) and pediatric HIV care and treatment programs. In 2011, the Ministry of Health and Child Care made elimination of pediatric HIV and AIDS a national goal and renewed commitment to decrease the rate of new HIV infections among children to 5% by 2015. The Government of Zimbabwe is in the process of adopting the World Health Organization 2015/2016 antiretroviral therapy guidelines, recommending Treatment for All to increase access to services in an effort to control the HIV epidemic by 2020 and end AIDS by 2030.

EGPAF-Zimbabwe has helped the country work toward its goal of near elimination of new pediatric HIV infections by supporting PMTCT and pediatric programs at the facility, district, provincial, and national level with a primary focus on improving the quality of HIV services in Zimbabwe.  We focus on four major program implementation areas; 1) increasing access to comprehensive and integrated HIV services; 2) strengthening data collection and use for evidence-based programming; 3) community-level programming; and 4) health systems strengthening.

In addition to direct health service delivery support, EGPAF-Zimbabwe advocates for policy development aligned with local community needs focusing on PMTCT, the scale-up of early infant HIV diagnosis (EID), and the specific needs of HIV-positive children and adolescents. We also engage in operations research, which aims to increase access and use of the most effective HIV and AIDS services. Our research has, to date, focused on acceptability of lifelong antiretroviral therapy among HIV-positive pregnant and breastfeeding women; result turnaround time for EID; health worker capacity to manage patients; use and acceptability of recently-adopted client tracking tools (to ensure better retention of clients on treatment); and effects of community-based interventions on increased demand for, access to, and retention in maternal, newborn, and child health (MNCH) and PMTCT services.

Zimbabwe is on track to be one of the first nations in sub-Saharan Africa to virtually eliminate mother-to-child transmission of HIV. This is a remarkable feat, considering that, as of 2009, Zimbabwe had one of the highest burdens of new HIV infections in the world and was experiencing a mother-to-child HIV transmission rate of approximately 30%. Zimbabwe is on track to be one of the first nations in sub-Saharan Africa to virtually eliminate mother-to-child transmission of HIV. This is a remarkable feat, considering that, as of 2009, Zimbabwe had one of the highest burdens of new HIV infections in the world and was experiencing a mother-to-child HIV transmission rate of approximately 30%. This breathtaking progress is a testament to the power of partnerships. Two global health leaders, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and the Children’s Investment Fund Foundation (CIFF), collaborated with the Ministry of Health and Child Care (MOHCC) to turn the tide on this epidemic by focusing on improving maternal, newborn, and child health in Zimbabwe while working hand-in-hand with a country eager to address a widespread HIV epidemic and strengthen child survival.

 

Key Projects in Zimbabwe

Accelerating Elimination of Pediatric HIV in Zimbabwe (cost extension, CIFF)

(2015-2017) In late 2015, CIFF awarded a two-year costed extension to EGPAF for the “Accelerating Elimination of Pediatric HIV” project to support the government of Zimbabwe in sustaining systems and services developed over the past five years which have accelerated the elimination of pediatric AIDS in Zimbabwe. The purpose of the grant is to continue to assist in reducing the incidence of HIV infections in children and, reduce maternal and child mortality through supporting the national PMTCT program in Zimbabwe. This project supports: 13 quality improvement district focal persons in the 26 districts not supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); and technical assistance, guidance and advocacy at the district and national level in support of the elimination of mother-to-child transmission of HIV and accelerated pediatric HIV care and treatment in Zimbabwe.

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ACT Adolescent HIV Project (CIFF)

(2016-2018) The objectives of this two-year project funded by CIFF are to improve identification, initiation, retention and viral load suppression of adolescents in 20 high-burden districts, and to strengthen the knowledge base related to adolescent HIV.

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Optimizing EID through the introduction of POC HIV testing (UNITAID)

(2015-2019) The overarching goal of this project is to increase the number of HIV-positive infants whose HIV status is known in order to facilitate early ART initiation. The specific purpose is to ensure that at-risk infants have timely access to EID through the scale-up of point-of-care (POC) EID technology in nine countries. During the four-year project period (August 2015 – July 2019), EGPAF anticipates testing up to 215,000 infants across all project countries, and identifying 30,960 HIV-positive infants, positioning POC EID to capture 30% of the total EID market.

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AIDSFree (John Snow, Inc./United States Agency for International Development [USAID])

(2015-2017) EGPAF is implementing two projects under the AIDSFree mechanism: one aimed at strengthening quality improvement activities in USAID expansion districts in Zimbabwe, and one aimed at strengthening private sector involvement in PMTCT services.

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The Delivering Technical Assistance Project ([Project DELTA] U.S. Centers for Disease Control and Prevention [CDC])

(2015-2018) EGPAF is implementing two projects under the CDC Project Delta mechanism. One project is aimed at strengthening quality improvement activities at the national, district and site level in select CDC-supported districts in Zimbabwe. The other project is focusing on the implementation of the 2016 Young Adult Survey in Zimbabwe.

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Publications

Country Fact Sheet: Zimbabwe

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Haba Na Haba: Technical Assistance Provision at the Elizabeth Glaser Pediatric AIDS Foundation (2014)

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Journal article: Lessons learned from early implementation of B+: The Elizabeth Glaser Pediatric AIDS Foundation experience (2014)

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Technical Report: Unmet Need for Family Planning, Contraceptive Failure, and Unintended Pregnancy among HIV-Infected and HIV-uninfected Women in Zimbabwe (2014)

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Zimbabwe Program 2012 Annual Report

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Program Brief: Strengthening Antiretroviral Treatment for Women and Children in Maternal, Neonatal, and Child Health Services (2015)

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Program Brief: Supporting Improved Health Outcomes for Mothers and Babies Through the Use of Electronic Database Systems (2015)

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Bringing Rural Sub-Saharan African Communities and the Global Response to the HIV and AIDS Epidemic (2015)

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Technical Report: Accelerating the Elimination of Pediatric HIV and AIDS in Zimbabwe (2015)

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BRIDGING RURAL SUB-SAHARAN AFRICAN COMMUNITIES AND THE GLOBAL RESPONSE TO THE HIV AND AIDS EPIDEMIC

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