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DR PARIRENYATWA . . . “We are saying let’s continue to concentrate on treatment but at the element of prevention in a very strong manner and we are saying we want to revitalise the issue of prevention to make it more alive”

Last week, Zimbabwe joined over 180 other countries from across the globe at the largest HIV gathering for scientists, policymakers, donors, advocates, community representatives and civil society in Durban, South Africa. Organised by the International Aids Society in partnership with the Government of South Africa, this year’s conference ran under the theme, ‘’Access, equity, rights now”.

Led by Health and Child Care Minister Dr David Parirenyatwa, Zimbabwe had a heavy presence at the conference with over 200 people forming part of the 18 000 delegates who participated.

Zimbabwe is also leading the HIV East and Southern Africa (ESA) HIV prevention agenda to which African Health Ministers have already committed to revitali’se strategies aimed at preventing HIV transmission. Senior Health Reporter Paidamoyo Chipunza (PC) speaks to Dr Parirenyatwa (DP) to discuss this and other key issues that affect Zimbabwe.

PC: Why is this conference important to Zimbabwe?

DP: This is a very important conference; it is an international conference which gathers all ideas that help to fight HIV worldwide. It is all good to do long distance interactions but it is really important to actually meet and share scientific papers and go to the community village and interact with people who are in the field of HIV and you will really benefit quite a lot. It is also a platform, not only to showcase what we are doing but to compare and contrast and learn from others what else we could do in Zimbabwe and this has been extremely instructive for us.

PC: This is the 21st such conference to be held in the world and you must have attended more than one of these during your term as Minister of Health and Child Care, taking stock to the world’s response to the epidemic over the years, what would you say has evolved over the years?

DP: In the past it was just haphazard fighting HIV, now there is a lot of focus on certain areas that had been left behind. I think the key message is that we will not win this war until we take everybody on board, all types of people, to be able to fight HIV. What has really pushed this for us as Zimbabwe is to spearhead the issue of prevention.

PC: Zimbabwe is leading the HIV East and Southern Africa (ESA) HIV prevention agenda to which African Health Ministers have already committed to revitalise strategies aimed at preventing HIV transmission, can you shed more light on this programme?

DP: ESA has taken it upon itself to spearhead what we call revitalising combination prevention. So there are many methods that are being used now to promote prevention and that is really exactly what we are now doing.

So this region, this whole region from Ethiopia right to South Africa, we have said let us put prevention on the agenda.

In the past, it has been 90-90-90 and those three 90s are mostly all on treatment. Although there are elements in each one of them, essentially they have been on treatment so we are advocating for a fourth 90, which is primarily on prevention.

The three 90s are concerned with making at least 90 percent of people with HIV knowing their status, at least 90 percent of those that know their status should be on ARVs and at least 90 percent of those on ARVs should have the level of their viral load suppressed to undetectable levels by 2020.

PC: What has necessitated revitalisation of prevention programmes in the region?

DP: We had forgotten about prevention, we were concentrating too much on treatment. We are saying let’s continue to concentrate on treatment but at the element of prevention in a very strong manner and we are saying we want to revitalise the issue of prevention to make it more alive.

PC: What do you aim to achieve through this agenda and how will it contribute towards achieving the 90-90-90 targets and eventually ending Aids by the year 2030?

DP: So the fourth 90 is really a question of saying we will not win this war if there is a continuation of new infections. As long as there are new infections, we will not win it. I always say if there is a tap that is leaking, you will not be able to scoop out all the water that is flooding the floor so you must be able to prevent new infections particularly in children when mothers are pregnant.

We are looking at the youths and adolescents as you know within the region especially among young girls, this is where the highest incidence of HIV occurs, new infections are occurring in that age group. We must close that tap, we must also close the tap on prison inmates and the long distance truck drivers.

We will look at where new infections are coming from, the border areas – Plumtree, Victoria Falls. We will look at all these areas and see how we can close those taps. I think that will go a long way towards harnessing the implements of fighting HIV and ending Aids by 2030.

PC: Earlier, you made reference to “taking everyone on board” to effectively combat HIV and that same message was coming out strongly in most sessions from this conference how do you intend to achieve this goal in the Zimbabwean environment?

DP: What we are doing ourselves is that as soon as we identify which ones are our key populations and we all agree as a country that these are our key populations, no matter where they are, we will tackle that as a programme. We will not tackle it politically; we will tackle it as a programme.

As you know the prevalence of HIV in our population is 14 percent but in prisons it is 28 percent, so we cannot ignore that. We have to see what is happening in prisons, we have to see what is happening with our commercial sex workers, we must close that tap.

We must even look at our regulations and laws and say how can we ease the situation so that we are able to tackle those key populations and do not leave anything behind.

PC: Another issue that came out strongly throughout the conference is the issue of dwindling financing for HIV and Aids globally. Zimbabwe is one of the developing countries that rely heavily on donor support in its national HIV programmes, what innovations is Government exploring to ensure sustainability of programmes already underway such as the ART programme?

DP: Globally as you know there is now a feeling of fatigue, some donors have got their own problems in Europe their funding is nothing now to really rely on. We will continue to lobby for it, we hope to get the Global Fund monies, but maybe less than what we were getting before but we must all as countries look at our own domestic funding.

We are in a very dire economic situation at home but at least we have our National Aids Trust Fund, also known as the Aids Levy. It is not very much but it is something we can leverage on.

We are going to look particularly at Community Share Ownership Schemes, how that can benefit the health sector and HIV in particular, cancers and also tuberculosis.

I hope we will be able to lobby successfully for the National Health Insurance Scheme because that will give us a primary health approach to everybody so that people can actually access services much more and finally we continue to mobilise the private sector.

We hope those employed in the private sector would be able to subsidise their medical fees in terms of HIV.

PC: What other key issues came out of the conference?

DP: I think the issue of new treatments that are coming up, new third line drugs, how they can be made cheaper. The issue of local manufacturing of the drugs in general, it’s coming out very strongly that as a region we must really manufacture our own drugs.