Zimbabwe’s Bumpy Road Towards Eliminating Paediatric HIV

STATISTICS indicate that Zimbabwe is amongst some of the few countries progressing towards attaining the 90-90-90’s. The triple 90s is an ambitious treatment target towards eradicating AIDS by 2020,  that is next year.

By Michael Gwarisa

Under the 90s framework, by 2020, 90% of all people living with HIV will know their HIV status. By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy. By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.

However, for Zimbabwe getting to the first 90 where people should know their HIV status was not an easy call. From the early 80 when HIV was first discovered in Zimbabwe, the notion of getting tested was off the equation for many owing to personal fears, self-stigma and discrimination from fellow members of society.

For children and infants, the bulk of HIV transmission is from Mother to Child. During pregnancy, the foetus is infected by HIV crossing the placenta while during childbirth, the baby is infected by HIV  in the mother’s cervical secretions of blood. If the baby is lucky to escape these two infection channels, HIV will catch up with them at breastfeeding through breast milk or the mother’s blood.

Testing and initiating the young ones on ART is a critic tool towards ensuring Zimbabwe progresses in offering treatment and care to children born with HIV. About 30 years ago, the HIV transmission rate from mother to child was uncontrollable in Zimbabwe due to the lack of proper HIV testing technologies amongst a host of other woes. As a result, millions of children died before their second birthday.

Director for HIV and Tuberculosis |(TB) in the ministry of health and child care (MoHCC), Dr Owen Mgurungi said Zimbabwe had gone through so much hurdles in its quest to avail  affordable and reliable HIV testing, treatment and care services.

“Most of you may actually remember that some 30 years ago, when we had no program for prevention of mother to child transmission of HIV from a pregnant woman to their baby was around a third or 33%.

“We instituted a program to prevent mother to child transmission of HIV in 1999. From those humble beginnings, three sites that we started from, they are now covering more than 1,600 healthcare centres across the country,” said Dr Mgurungi.

To date, Zimbabwe has scaled up efforts towards eliminating MTCT with latest figures indicating that there is an impressive decline in the infection rate.

“Our transmission rate has therefore been reduced from around 28% in 2001, to 5% in 2015. However, the challenges that we did face were those of expectation. The pregnant women wanted to know whether transmission had occurred to their unborn babies or their new infant.”

However diagnosis and technology available then was such that results could only be accessed one and half year later.

“So it was an ordeal, it was a challenge of waiting for 18 months before we could definitely say transmission had occurred or not.

“With improvements in technology, we were then able to have what we have called DNA PCR in which we could determine whether transmission had occurred in six week and of course that was a huge relief for most families,” added Dr Mgurungi.

The technology however did not provide that much relief as it had its own shortfalls which range from its humongous size and the six weeks waiting period was not helping much.

“Still there were challenges, the machines that we had for DNA PCR were big machines that were put in centralised laboratories in Bulawayo, Harare and Mutare. We would  then had to take blood samples to those 1 600 centres which were the redirected to those central laboratories for diagnostics..

“The samples at times were taken and would get to the lab in a condition where it was not even possible to conduct the taste. So we would be forced to repeat and the turnaround time was an average three months. So that continued and that was the challenge.”

Zimbabwe recently received HIV testing machines from Diagnostics of the Real World (DWR) whose turnaround time is just a matter of minutes or a few hours.












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