By Michael Gwarisa
Over 150,000 men and boys have undergone circumcision under the INTEGRATE-Catalyzing Integrated Sustainable Subnational HIV Biomedical Prevention Program, an initiative aimed at enhancing decentralized biomedical HIV prevention services in Zimbabwe.
The program, implemented by the Ministry of Health and Child Care (MoHCC) with technical support from Population Services International (PSI) and Population Solutions for Health (PSH), was catalyzed by funding from the Gates Foundation.
Launched in November 2020, the INTEGRATE project was designed to run for four years and is set to conclude by the end of November 2024. The initiative focused on fostering locally owned and sustainable HIV prevention services, with a particular emphasis on Voluntary Medical Male Circumcision (VMMC).
The program engaged district healthcare executives and education officials to coordinate VMMC efforts within their communities. Speaking at the program’s closeout event, Dr. Aspect Maunganidze, Permanent Secretary in the Ministry of Health and Child Care, highlighted the program’s significance in Zimbabwe’s fight against HIV and AIDS.
This event represents a very significant milestone in our ongoing efforts to combat HIV and AIDS in Zimbabwe and bring us closer to our goal of ending AIDS by 2030. Over the past few years, we have witnessed remarkable progress in our fight against HIV,” said Dr. Maunganidze.
Zimbabwe has already achieved the 95-95-95 UNAIDS targets, and Dr. Maunganidze emphasized that enhancing biomedical HIV prevention services has been pivotal in the country’s journey toward epidemic control.
The INTEGRATE project was rooted in Zimbabwe’s VMMC Strategic Implementation Plan (2019-2021), which aimed to transition from unsustainable, high-cost scale-up programming to integrated, cost-effective solutions.
“By executing the Sustainability Transition Implementation Plan (STIP), INTEGRATE has made invaluable contributions to integrating the VMMC program into the routine activities of the Ministry of Health and Child Care,” noted Dr. Maunganidze.
He added that decentralizing service delivery to at least 30% of primary healthcare facilities and revising the nursing curriculum to include modules on HIV prevention and treatment will ensure long-term impact. The first cohort of graduates under the revised curriculum is expected in 2025.
The program also enhanced the capacity of district health executives by training them in planning and coordinating VMMC programs. This included financial management, organizational development, and leadership training, which improved efficiency and localized decision-making.
Precious Chakasikwa, PSH Board Chairperson, said “From the inception of this project in November 2020, we aimed to support improved government-led subnational health system performance. Our mission was to facilitate the transition from vertical, partner-led VMMC programming to locally driven, integrated biomedical prevention efforts. I am delighted to say we have surpassed expectations on all fronts.”
She acknowledged the dedication of the PSH team, stating:
“This achievement would not have been possible without our exceptional team’s hard work and resilience. They turned challenges into opportunities and have set a strong foundation for sustained HIV prevention.”
Dr. Karin Hatzold, Director of HIV/TB and Hepatitis at PSI, highlighted some of the program’s critical lessons:
“There is a balance between achieving rapid expansion of VMMC coverage for immediate impact on HIV incidence and building long-term sustainability by integrating services into broader health systems. INTEGRATE has successfully demonstrated how to achieve both.”
Maya Sundaram, Senior Program Officer for HIV Prevention and Testing at the Gates Foundation, commended the program’s innovative approaches, including Results-Based Financing (RBF) and digital solutions, which enhanced efficiency and sustainability.
“The successes of INTEGRATE have not only advanced Zimbabwe’s HIV prevention goals but also demonstrated sustainable models for health systems strengthening,” said Sundaram.
The Gates Foundation has been a global leader in HIV prevention and treatment for over two decades. It has invested heavily in innovative solutions to reduce new infections, improve treatment access, and strengthen health systems. In Zimbabwe, the Foundation has supported multiple initiatives aimed at scaling up prevention strategies such as VMMC, ensuring they are sustainable and locally owned.
