Kuda Pembere
Zimbabwe made significant gains in its HIV response under the National HIV and AIDS Strategic Plan IV (ZNASP IV 2021–2025), including achieving the 95-95-95 targets for adults and reducing new infections and AIDS-related deaths, but persistent inequalities across age, sex, geography and population groups continue to undermine progress.
This emerged during the ZNASP V validation workshop held on Tuesday.
Presenting the ZNASP IV end-term review, lead consultant Professor Simbarashe Rusakanikwa told stakeholders in the national HIV response that, beyond meeting the adult 95-95-95 targets, Zimbabwe also recorded reductions in HIV incidence and AIDS-related mortality.
However, the review flagged deep and persistent inequalities, with children, adolescents, men and key populations continuing to lag behind despite overall national gains.
“Children, adolescents, and men continued to lag across the testing, treatment, retention, and suppression cascade; MTCT remained above the elimination threshold; and prevention impact was uneven due to inconsistent layering, demand challenges, and geographic heterogeneity.
“Structural barriers, particularly stigma, discrimination, and legal and policy constraints affecting key populations, continued to limit access and service quality, while health system constraints including commodities, human resources for health, laboratory reliability and fragmented strategic information systems, weak shock resilience, and high dependence on external financing posed risks to sustainability and continuity of gains,” Prof Rusakanikwa said.
With preparations underway for ZNASP V, the new strategic plan seeks to close the gaps identified under ZNASP IV.
“ZNASP V responds to the unfinished agenda of ZNASP IV with a precision, equity, and sustainability lens, aiming to end AIDS as a public health threat by 2030 through high-impact, rights-based, and multisectoral action,” Prof Rusakanikwa said.
“The strategy shifts from national averages to precision public health, prioritising high-burden districts, priority populations, and differentiated service delivery models to close the ‘last-mile’ gaps for children, adolescents, men, adolescent girls and young women, and key populations.”
He added that the next strategy would intensify prevention and treatment interventions.
“ZNASP V accelerates combination prevention and EMTCT to drive incidence and MTCT below elimination thresholds; strengthens treatment, care, and integrated TB and HIV and co-morbidity management; and places renewed emphasis on enabling environments through stigma reduction, legal and policy reform, and community leadership.
“Under constrained fiscal conditions, the plan embeds systems strengthening, business-unusual Monitoring, Evaluation and Learning, efficiency, domestic resource mobilisation, and resilience as core pillars to protect gains, improve accountability, and ensure sustainable epidemic control,” Prof Rusakanikwa said.
National AIDS Council chief executive officer Dr Bernard Madzima said one of the key issues highlighted in the ZNASP IV review was funding sustainability.
“So as we move from 2026 to 2030, as we develop our Zimbabwe National AIDS Strategic Plan, these are the areas which we are looking at, how to sustain the gains of the HIV programme, noting that we have already achieved the 95-95-95 targets. So we need to find ways to sustain that momentum.
“And one of the areas which we are looking at is resource mobilisation at the domestic level. We know the funding gaps which have been created by these stopgap measures, and we are looking at mobilising not less than US$200 million per year to ensure that we have adequate supplies of ARVs, laboratory commodities, condoms, sexual and reproductive health commodities. So this is the gap,” he said.
Zimbabwe Community Health Intervention Research director Walter Chikanya said the ZNASP validation exercise was critical for civil society organisations.
“This ZNASP validation meeting is very critical, especially for us as civil society because this really defines and becomes the Bible in terms of when we want to implement our programmes within communities.
“This will guide us as we go forward on what the priority areas are, what the gaps were from ZNASP IV and, even as we start to look at Global Fund GC8, having ZNASP V is going to be very critical because it determines what programmes we can prioritise as a country,” Chikanya said.
He added that improved integration of health services was urgently needed.
“So it is high time we see how we can improve our interventions but, importantly, also address the issue of integration. We cannot continue working in silos. There is a need for layering programmes, intervention services, and integration of services,” he said.
