See article the HIV & AIDS Figures Drop in Zimbabwe

HIV Testing And Counselling - Govt Ponders Way Forward

Financial Gazette (Harare)

NEWS
17 January 2008
Posted to the web 17 January 2008

By Zhean Gwaze
Harare

AFTER notching up some successes in checking the spread of HIV and AIDS, Zimbabwe still has to ponder its progress in the provision of testing and counselling services.

The country recorded a reduction in adult (15 to 49 years) HIV prevalence rates from a peak of 20.1 percent in 2005 to 15.6 percent in 2007.

But questions still remain over how well the country is doing in terms of providing access to treatment and care.

Owen Mugurungi, head of the government's AIDS and TB unit, says although strides had been made in educating people on the scourge, there was a need for an increase in HIV testing and counselling services.

There are 21 voluntary counselling testing (VCT) centres provided by the Health Ministry and Population Services International Zimbabwe (PSI) through the New Start network, but these fall below the needs of a national response to the scourge.

New Start was the first network to offer HIV testing and counselling services in Zimbabwe in 1999.

The network offers on-site and mobile services covering urban and rural areas throughout the country and an estimated 25 000 clients currently receive HIV counselling and testing through the New Start centres every month.

Mugurungi said it was difficult for the government to roll out more VCT centres in the country because resources were limited.

Mugurungi's unit has coined the Provider Initiated Routine Offer of Confidential Counselling and Testing (PITCT) under which all districts and mission hospitals will join the initiative.

There are 61 districts in the country and each has either an established hospital or a semi institution offering medical services.

"We are emphasising this because we believe if we score a success in HIV testing and counselling then we can achieve universal access because this is the primary start in combating the scourge," Mugurungi said.

However, these efforts might come to nought considering the government's poor human resources management record.

The government has been hit by a massive brain drain, particularly in the medical sector.

Last year, Health Minister David Parirenyatwa announced that Zimbabwe would re-hire retired nurses to ease a critical staff shortage in public hospitals caused in part by the exodus of health care workers to the region, Europe and Australia.

A report compiled by the World Health Organisation in 2006, World Health Report 2006 - Working Together for Health, estimated that 34 percent of Zimbabwean nurses were working abroad.

Parirenyatwa announced late last year that the government was working out the modalities of cushioning and retaining health professionals this year.

Health received the largest chunk of the 2008 national budget, a surprise 13 percent, drawing the country close to meeting the terms of the Abuja Declaration.

Zimbabwe is one of many African countries yet to meet the terms of the Abuja Declaration, under which African leaders pledged to allocate 15 percent of their national budgets to health.

However, although the budget seems significant, Zimbabwe is in the grip of a debilitating political and economic crisis that is marked by hyperinflation, a rapidly contracting gross domestic product (GDP) -- the fastest for a country not at war according to the World Bank -- and shortages of foreign currency, food and fuel.

The government still needs to do a lot more to achieve universal access by 2010, as the health sector continues to decline, as evidenced by ageing equipment and infrastructure, incomplete projects, a lack of drugs and the inaccessibility of health services, especially at primary level, and the collapse of the referral system.

Mugurungi said if enough funds were available, the government would increase its antiretroviral drug rollout programme from the current 80 000 recipients to 170 000 by the end of this year.

There are 1.6 million HIV positive Zimbabweans and 300 000 are in need of treatment. It is estimated that at least 2 500 deaths are recorded per week from HIV/Aids related illness.

The Clinton Foundation, Global Fund and the Bill Gates Foundation are among organisations that have shown an interest in funding anti-AIDS programmes in Zimbabwe.

Reducing new infections is the principal aim of the Zimbabwe National HIV and AIDS Strategic Plan 2006-2010 administered by the National Aids Council which also focuses on: treatment and care, mitigation and support and effective management and co-ordination of the national HIV/AIDS response.