By Takunda Mandura
Having been diagnosed with HIV during her first pregnancy 15 years ago, Moud Chinembiri, now a mother of two children, has defied the odds and looked the beast in the eye. Now her child whom she had when she had a positive HIV diagnosis is attending high school and is HIV-negative, a living testimony of the intervention measures against HIV.
Her daughter has been her treatment buddy.
“My daughter has become sort of my alarm to remind me of my medication schedule. I can say she is my treatment buddy,” Moud says.
Around the time Moud gave birth, the documentary “Zimbabwe’s Forgotten Child” was produced, showing the devastating effects of HIV and Aids on Esther, a 9-year-old who lost her mother to the virus and was left to look after her sister Tino.
Years later, children whose parents have managed to take antiretroviral prophylaxis treatment have a different story.
Moud gave birth to her second daughter who is currently in infant school. Her daughter dreams of becoming a police officer to arrest criminals and contribute to a crime-free country, just like the hopes of Zimbabwe to have an HIV and AIDS-free generation.
Moud’s daughters, like millions of other children, benefited from parents who utilized antiretroviral prophylaxis (ARV) treatment as she is negative.
Moud has become a local celebrity in Chitungwiza Unit L where she stays. She has been a role model to members of her community, living positively, who constantly approach her for solace.
Moud’s story tells of the positive impact of being on ART treatment which the government of Zimbabwe and various international organizations have collabarated to make sure there is access to decentrialisation and easy
Chiedza’s Story
In 2002 Chiedza was born positive but currently, she is a mother of three negative children. However, Chiedza is yet to gain the courage to disclose her status publicly as she fears negative blackclash.
“I have been positive all my life but thanks to the free life-saving medications which been taking from childhood I managed to give birth to children who are negative,”
disclosed Chiedza.
“The issue of disclosure is a tricky choice, I would not know how people will react but my partner knows my status,” added Chiedza.
Historical Context:
When PEPFAR began in 2003, HIV/AIDS was devastating Zimbabwe. More than 30% of the adult population was infected with HIV and over 330 people were dying every day, leaving generations of orphans. Two decades on, with the support from PEPFAR and other donors, as well as community and government efforts, Zimbabwe has made significant strides in the fight against HIV, in particular the transmission from mother to child.
Since its national roll-out in 2002, Zimbabwe’s Prevention of Mother-to Child Transmission (PMTCT) program has made progress in preventing mother-to-child transmission of HIV.
Facility coverage of PMTCT programming within antenatal care (ANC )services is moderate (74%). HIV testing among pregnant women increased significantly from 29% in 2005 to 90% in 2010 and, in 2011, 78% of pregnant women living with HIV received ARVs for PMTCT. Between 2009 and 2011, Zimbabwe has seen a 45% decline in the number of new paediatric HIV infections – from 17,700 to 9,7003. Coverage of early infant diagnosis (14%) was still very limited in 2010.In 2013, less than 80% of all HIV-positive pregnant women received ARV treatment.
In 2013, UNAIDS noted that 34,000 women acquired HIV and AIDS but due to the access of of antiretroviral medicines whilst they are pregnant this translated into decreasing rates of HIV transmission from mother to child in which the HIV transmission rate from mother to child at six weeks was at 5%. 
Some of the challenges the country remain with is to ensure that HIV-positive mothers adhere to lifelong ART; that all infants born to HIV-positive women are tested for HIV, and that families receive these test results.
Zimbabwe has made significant progress in eliminating mother-to-child
transmission (MTCT) of HIV, reducing the transmission rate from 30% in 2005 to 6.9% in 2016. However, in 2020, Harare province had an MTCT rate of 11.4%, the highest among all 10 provinces and above the 5% national target. Some of the factors for the high mtct rate were late maternal HIV diagnosis ,non adherence to ART and interruptions to pediatric ART and vertical transmission was high among babies whose mothers were diagnosed of HIV after conception and low among babies whose mothers had a treatment partner
Over the years Zimbabwe has seen a 750% decline in AIDS-related deaths among adults and children, from 130,000 deaths in 2001 to 20,000 in 2021. Currently, a report by the Ministry of Health and Childcare indicate that 3 650 HIV infections among children are acquired from their mothers.
According to the 2022 spectrum estimates over, 1,300 000 people are living with HIV in Zimbabwe.
Out of the 1.3 million people living with HIV in Zimbabwe, 74,587 are children under 14 years old. There are more than 50,000 pregnant women in need of prevention of mother-to-child transmission (PMTCT), and the country needs to work toward achieving that. This is why the MTCT rate remains high at 8.1%, according to the Ministry of Health and Childcare.
According to the UNDP in 2022, 43,570 women living with HIV received antiretroviral therapy (ART) to prevent mother-to-child transmission (PMTCT) of HIV, down from 47,639 in 2021.
Current measures
The Zimbabwe National Strategic Plan 2021-2025 focuses on eliminating mother-to-child transmission of HIV and syphilis. The plan includes district and facility-level tracking to achieve EMTCT status by 2025. Interventions will involve case-based tracking, increased male involvement, and viral load monitoring of HIV-positive pregnant and lactating women.
The government has taken significant steps to ensure the health and well-being of newborns exposed to HIV. To facilitate early diagnosis, clinics and hospitals providing maternity services have been equipped with point-of-care devices for testing infants under 6 months of age. This proactive approach ensures that newborns born to HIV-positive mothers are promptly tested for HIV exposure, either at birth or during their initial review within three to ten days.
Furthermore, if the mother is HIV positive, she is provided with Highly Active Antiretroviral Therapy (HAART), a combination of antiretroviral drugs that is designed to prevent the transmission of HIV from mother to child. Both the mother and the infant receive HAART, significantly reducing the risk of transmission during crucial phases such as pregnancy, labour, and breastfeeding. As part of the regimen, the mother also undergoes antiretroviral therapy during pregnancy to further safeguard the health of both herself and her baby.
Zimbabwe has developed a national triple elimination of mother-to child transmission plan from 2023 to 2026.
The plan targets to attain the Gold Tier on the Path to Elimination by 2026 and this involves reducing the MTCT rate to less than 5% , reduction of new paediatric HIV and congenital syphilis cases to below 250 per 100 000 live births as well as reduction of the hepatitis B surface antigen (HBsAg) prevalence among children aged five years and below to 0,1% or less.
Global-regional-trends
In the last 12 years, the number of infants under six months globally who are exclusively breastfed has increased by more than 10%, benefiting about 48% of infants worldwide and saving hundreds of thousands of babies’ lives.
About 120,000 new HIV infections occurred among children under five in 2023, declining from 300,000 in 2010, representing a 62% decline. Since the start of prevention of mother-to-child transmission programs, 1.9 million deaths and 4 million HIV infections have been averted among pregnant women and children.
UNAIDS (2024) estimates in 2023, around 120,000 children aged 0-14 were newly infected with HIV, bringing the total number of children aged 0-14 living with HIV to 1,370,000
HIV and AIDS Funding in Zimbabwe:
Zimbabwe’s health budget is mainly funded through government revenue ,international aid and donor support. PEPFAR has been contributing nearly US$90 million annually to support 21,700 healthcare workers in Zimbabwe.
The U.S. government has invested over $1.7 billion in Zimbabwe since 2006 to strengthen health systems and support people living with HIV. In 2023 alone, PEPFAR invested more than $200 million to fund HIV/AIDS programs in Zimbabwe. This enabled more than 1.2 million Zimbabweans living with HIV to be on life-saving treatment, and 97% of those on treatment have achieved viral suppression.
This report was made possible by technical support from Media Monitors in partnership with the US Embassy in Harare
