UNAIDS – NEWSSPACE

“Inspire Inclusion: Combating HIV, Advancing Rights”

**Jane Kalweo – UNAIDS Country Director, Zimbabwe**

BY JANE KALWEO

The world is significantly off course in meeting the gender targets set by the Sustainable Development Goals (SDGs). At the current pace, it will take an estimated 300 years to eradicate child marriage, 140 years to achieve equal representation of women in positions of power and leadership in the workplace, and 47 years to attain equal representation in national parliaments.

As of December 2023, women’s representation in Zimbabwe’s Parliament stood at 34%, falling short of global targets on gender parity in legislative bodies. However, evidence has shown that when women lead, they contribute to more just, equitable, and inclusive societies. Women encounter numerous challenges when running for public office. Addressing legal and policy environments and other barriers that limit women’s political participation is crucial to leveling the playing field. To foster more just and equitable societies, we need to advance the agenda of proportional representation for men and women in parliament. Given that women face a disproportionate burden of HIV, women leadership would significantly contribute to legal and policy reforms that address gaps and barriers in the HIV continuum of care for women and children.

The global debt crisis and pandemics are reducing investment in education, health, and social protection, disproportionately affecting women and girls. Unequal access to education has left 122 million girls out of school, denying them lifesaving information on how to protect themselves from HIV. The unprecedented disruption to education during the height of the COVID-19 pandemic exacerbated inequalities in access to education for girls. School closures and economic hardships increased the risk of child marriages as families sought to alleviate financial burdens. In 2021, during the COVID-19 pandemic, 1174 cases of child marriages were recorded, and 4959 girls became pregnant.

The SDG of ending AIDS by 2030 is also at risk. Every week in 2022, 4000 adolescent girls and young women aged 15-24 became infected with HIV globally, largely due to inequalities in accessing HIV services. When girls’ rights to education and empowerment are realized, their vulnerability to HIV is reduced. In Zimbabwe, HIV incidence among adolescent girls and young women is more than three times higher than among their male counterparts. Many factors increase the vulnerability of girls and young women, including harmful gender norms such as gender-based violence, gender inequalities that exclude them from economic opportunities, and poverty. The Zimbabwean government, through the Zimbabwe National HIV and AIDS Strategic Plan (ZNASP) IV Addendum, has committed to reducing inequalities to less than 10% of women and girls experiencing gender-based inequalities and gender-based violence in efforts to end AIDS as a public health threat by 2030.

Despite many challenges, women in Zimbabwe have been at the forefront of driving change and leading in the HIV response since the beginning of the pandemic. However, funding shortages, capacity gaps, and regulatory environments limit their ability to effectively contribute to the agenda of ending AIDS by 2030. There is a need for sustained investment in independent, autonomous feminist movements. Progress can only be sustained by putting power in the hands of those whose lives are most impacted by the denial of rights.

The health of young women and girls today is too often shaped by gender-based inequalities and gender-based violence, which increases the risk of HIV infection. One in three women worldwide experience sexual or gender-based violence. Gender-based violence remains one of the most pervasive human rights violations affecting women in Zimbabwe. The ZDHS 2015 estimates that one in three women aged between 15 and 49 has experienced physical violence, and one in four women have experienced sexual violence. Addressing gender inequality and gender-based violence is critical to ending AIDS and accelerating progress towards achieving the SDGs.

UNAIDS Commends the Government of Zimbabwe for showing its commitment to ending gender-based violence through the 2023-2030 National Strategy to Prevent and Address Gender-Based Violence. The strategy highlights priority areas for the country and outlines specific actions and strategies for the government and society in their efforts to prevent and respond to GBV in general, and violence against women and girls in particular.

Prevalence rates for child marriages in Zimbabwe remain unacceptably high. An estimated 34% of girls are married before reaching 18 years, and 5% before the age of 15. Ending child marriages and their devastating consequences on the health, development, and well-being of adolescent girls and young women is critical for the advancement of their human rights. The Zimbabwean government has committed to ending child marriages through the Marriages Act and has gazetted the Criminal Laws Amendment (Protection of Children and Young Persons) Bill, 2024. These instruments criminalize the marriage and facilitation of marriage of anyone under the age of 18.

To protect women and girls’ economic and social rights, there is a need to fully invest in women to achieve the 2030 SDGs. This investment is not just about financial resources; it’s about creating an environment where women and girls can thrive, free from violence and discrimination, and where they can realize their full potential.

As we commemorate International Women’s Day, UNAIDS reiterates the need to empower women, combat HIV, advance rights, and position women at the center of HIV response, Human rights, and empowerment.

To protect everyone’s health, protect everyone’s rights

BY JANE KALWEO

This Friday 1 March, is Zero Discrimination Day, established 10 years ago by UNAIDS to protect the rights of everyone and build healthier societies. The evidence is clear: only by protecting everyone’s rights, can we protect everyone’s health.

There is much to celebrate.

Zimbabwe is one of the few countries in sub-Saharan Africa which has reached and surpassed the 95–95–95 targets. The country has reached 95 percent for the number of HIV-positive people knowing their status, 98 percent of HIV-positive people on ART and has reached the target of 95 percent of people taking ARV’s virally suppressed. The number of new HIV infections has also decreased by 78 percent from 78 000 in 2010 to 17 000 in 2022. These results have been achieved through the Government’s commitment to follow the evidence in the implementation of a combination of behavioral, biomedical, and structural prevention interventions targeted at diverse groups based on their needs, as prioritized in national strategic plans.

Although there has been remarkable progress in Zimbabwe towards reaching the global targets, inequalities continue to pose barriers to accessing lifesaving services for marginalized groups such as Key Populations, Adolescent Girls, and Young Women (AGYW) and People Living with HIV (PLHIV). The 2022 People Living with HIV Stigma Index 2.0 for Zimbabwe indicated an increase in stigma and discrimination against PLHIV from 65% in 2014 to 69.7% in 2022. The country, through its Zimbabwe National HIV AIDS Strategic Plan 2021 -2025 (ZNASP 2021- 2025) has identified addressing stigma and discrimination by strengthening community-led reporting mechanisms and developing comprehensive programmes to reduce stigma and discrimination, as a critical enablers towards attaining the goal of eliminating AIDS as a public health threat by 2030.

When marginalized communities are criminalized or stigmatized, their vulnerability to HIV infection increases, and their access to HIV prevention, treatment, care, and support services is obstructed. Laws which criminalize HIV transmission have proven to be ineffective, discriminatory and undermine efforts to reduce new HIV infections UNAIDS is advocating for legal reform aimed at decriminalization in areas such as: HIV exposure, non-disclosure, and transmission; key populations’ sexual relations; and drug possession and use. This ensures access to services and is a crucial step in ending AIDS as a global public health threat.

Every week in 2022, 4000 adolescent girls and young women aged 15-24 became infected with HIV globally, in large part because their rights are not respected. When girls’ rights to education and empowerment are realized, then their vulnerability to HIV is greatly reduced. In Zimbabwe HIV incidence among adolescent girls and young women is more than three times higher than among their male counterparts. The HIV incidence among young women who are 15 -24 years was 0.25 which is 3.6 times higher than their male counterparts 0.07, in Zimbabwe deeply entrenched gender inequalities and discrimination, often combined with significant levels of poverty, increase their risk of HIV infection, among Adolescent Girls and Young Women. It is vital to advance safe societies so that young women can protect their health and wellbeing.

Countries that are beating the AIDS epidemic are doing so by repealing laws and policies that discriminate, by expanding human rights for all and by allowing marginalized communities to lead the response. Progress towards eliminating AIDS as a public health threat has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but instead enable and protect them. It is commendable that in 2022, Parliament of Zimbabwe repealed section 79 of the Criminal Law Code, which criminalized HIV transmission. The rights path strengthens entire societies, making them better equipped to deal with the challenges we face today and those that are emerging.

Public health is undermined when laws, policies, practices, or norms enshrine punishment, discrimination, or stigma for people because they are women, migrants, key populations, (includes sex workers, and people who use drugs). Discrimination obstructs HIV prevention, testing, treatment, and care, and holds back progress towards the end of AIDS.

We have hope, however, from communities on the frontlines. As Dr. Martin Luther King noted, “Social progress never rolls in on wheels of inevitability; it comes through the tireless efforts of people.” It is the communities most affected by discrimination that are leading the pushback against the erosion of their right to health, against the right to life. They are uniting their efforts to protect and advance human rights. They need, and deserve, all our support.

Protecting everyone’s rights is not a favor to any group but is the way that we can protect everyone’s health, end AIDS and create happier societies for all.

Contact

By Jane KALWEO – UNAIDS Country Director, Zimbabwe| tel. +2634338836-41

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

To protect everyone’s health, protect everyone’s rights

BY JANE KALWEO

There is much to celebrate.

Protecting everyone’s rights is not a favor to any group but is the way that we can protect everyone’s health, end AIDS and create happier societies for all.

Contact

By Jane KALWEO – UNAIDS Country Director, Zimbabwe| tel. +2634338836-41

UNAIDS

SADC Helpline Project; a ray of hope for adolescents and young people

**Tatenda Songore, Youth Advocates Executive Director**

BY MUNYARADZI BLESSING DOMA

A SADC helpline project which is being implemented in Zimbabwe, Botswana and Malawi has reached over 22 000 adolescents and young people to access integrated HIV services.

The projected which was piloted in three districts in the three countries, Zvishavane (Zimbabwe), Francistown (Botswana) and Zomba (Malawi) has been famed for improving the wellbeing of youths.

Tatenda Songore, Executive Director of Youth Advocates who are spearheading the project also revealed that they have gone beyond issues to do with HIV prevention or treatment, to include other social support services.

“All of the 22 000 youths have been actually tested for HIV and we have managed to get at least 4 percent of them who were diagnosed HIV positive and they were put on treatment.

“We are very excited also on the fact that 94 percent of young people who were diagnosed HIV positive are on treatment, actually the figure is 96 percent, which means we have surpassed the 95 percent target for the UNAIDS.

“So these are the key achievements and we are looking at scaling up this project.

“The impact of this project has been seen beyond HIV prevention, to address issues of drug and substance, gender based violence to also helping young people to return back to school after they were out of school because of different problems.

“We know that when young people are out of school, they are more vulnerable to risky behaviour and HIV so we have been able to return young people using 393 helpline within the three countries,” said Songore.

Both Malawi and Zimbabwe use 393 toll free helplines while for Botswana it’s 16658, which youths can access and get help on various issues affecting them.

When the youths call the toll free lines, they are helped through ongoing counselling services, information dissemination and referral to services and follow-up on the uptake of such services.

Songore further revealed that those youths who were having challenges with drug and substance abuse, were given mental health support.

“Some of the most interesting achievements of this project also look at how we were also able to look beyond the fact that when young people are on drug and substance abuse, they are more vulnerable to GBV.

“They are more vulnerable to risky behaviour and we have been able to support about 7 000 young people who were showing symptoms of drug and substance use and we have also been able to put them on mental health support beyond the project,” he revealed.

He also revealed that since drug and substance abuse is now a pandemic in the region, they had been able to leverage on the HIV fund from SADC which has seen them addressing several issues that put young people at risk.

Further commenting on the 393 toll free youth helpline, Songore said when any young person in the country uses it, they can make a call or whatsapp or use chat box where they can be educated using written formats, video and audio formats.

He also revealed that the platform has registered tremendous success because over 90 percent of users complete their courses unlike the traditional way of communicating with young people.

“They (youths) are more concentrated, they are more focused, they do it at their own pace and we are able to address multiple issues from HIV.

“We are also able to address mental health, we are also able to address emerging issues like cholera and we also able to respond and educate young people on measles as well,” added Songore.

He also revealed that in Zimbabwe they had piloted the SADC Youth Help Line in Zvishavane “because of high activity of artisanal miners, issues of drug and substance abuse, issues of young people who were dropping out of school and going to do artisanal mining.

“Child marriages are also very rampant, so we explored Zvishavane to try and explore those issues using mobile technology and we have been very effective because in Zvishavane alone, we reached 8 600 young people in a period of two years and in a rural community, this is very much a significant figure.”

Speaking at the same function, Jeremia Manyika, UNAIDS Zimbabwe: Adviser: Equality and Rights for all; said it was commendable to see young people showing leadership, adding that it was resonating well with the last year’s International Conference on AIDS and STIs in Africa (ICASA) theme, “let communities lead”.

“We are really emphasizing the theme of let communities lead, we are very delighted that we see the communities actually leading and when we say communities we are actually talking about the actual people that are affected and infected by HIV.

“And in this case we talking about young people and they are there in their numbers leading the project and we are very elated and happy about that development,” he said.

He added that it was good that partners had collaborated to make this a success for the benefit of young people.

“Again to reiterate our theme let communities lead, the UNAIDS Global AIDS strategy provides guidance to countries towards ending AIDS by 2030 and we are talking about what we call the 30-60-80 and these are targets that are really important if we are to meet them we will be able to end AIDS by 2030.

“We are saying 30 percent of HIV treatment services should be led by communities and when we say communities of young people it is young people who should be leading the services.

“Then 60 percent of programmes to address barriers to HIV care and support should also be led by communities and when we talk of communities, communities of young people should be leading the programmes to end stigma, to end discrimination to address barriers to HIV care and support and 80 percentage of programmes for women, young people and key populations must be led and coordinated by women, young people and the key populations themselves for us to be able to end AIDS within those communities let communities lead.

“So the 30-60-80 targets are a reality when we witness communities taking leadership and ownership of programmes as we see in this intervention, the call line 393.

“Am happy to note that the intervention has contributed significantly to achieving the 95-95-95 targets by increasing uptake of…HIV testing services by young people.

“As we move towards sustainability approaches to the HIV epidemic, we are excited to see communities lead and we are excited to see communities lead initiatives that demonstrate effective engagement of young people in their diversity to ensure that no-one and no place is left behind.

“It is noteworthy that the youth helpline goes beyond HIV prevention and treatment to address broader issues of social protection, mental health, gender based violence substance abuse among other challenges being faced by young people,” added Manyika.

Freeman Dube, Research and Documentation Coordinator at National Aids Council (NAC) said they had endorsed the project which had not only improved the lives of young people but also adults.

“We should celebrate those achievements and we as NAC have even said what is good as the way forward, is we integrate the work of the call centre within existing programmes.

“And by the way the capacity of the line is not only for Zvishavane District although it was the focus of the SADC project, the capacity is national, so our districts as NAC is to integrate promotional activities for the call centre to be utilized across the country,” said Dube.

Thando Madondo, who is one of the beneficiaries of the Youth Advocates project said he was supported in his passion for music, recording three songs.

He also revealed that the empowerment by Youth Advocates had been a good escape for him as some of his peers in his community have fallen to drugs.

“On the issue of drug and substance abuse, I know for a fact that they will ruin one’s life, you won’t make any progress.

“If I look at the community where I live, many youths have fallen to drugs, you will see young people smoking weed, but because of the guidance I get here at Youth Advocates, I just made a I vow that I won’t partake in drug and substance abuse, it destroys my life, so I rather just empower my life.

“I recorded three songs under Youth Advocates, namely, Youth Advocate, which showcases the brand of the organisation as a whole, then there is another one called Zvinodhaka, I sang it after some youths died during the Covid-19 pandemic. Those who died were under the wrong influence, like I remember some would say if they take whiskey, they would not contract covid, but this was wrong. Then I also did a song called Child marriage which really touched on this growing scourge in the country,” added Madondo whose stage name is Firemaster.

Guests from Malawi, Botswana, government ministries, students among others, attended the event which was held at Youth Advocates head office in Chitungwiza.

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Include elderly patients in HIV prevention campaigns

BY MUNYARADZI BLESSING DOMA

There is need to highlight HIV prevention campaigns in elderly patients, as it has been noted that there is an emerging challenge of increasing number of people aged 50 and above living with the virus, an HIV Clinician has revealed.

Doctor Cleophas Chimbetete revealed this on Tuesday during a media science cafe on “HIV and Ageing”, organised by the Health Communicators Forum and the Humanitarian Information Facilitation Centre.

He revealed that over the years, there seems to have been more focus on the younger generation, whilst a lot of issues concerning the elderly patients were emerging.

“There is a realisation that there is an emerging challenge of more and more elderly patients living with HIV in their old age, so in terms of strategies to address this problem number one; we need to highlight HIV prevention even in elderly patients.

“Those of us who are involved in HIV prevention campaigns such as PrEP (Pre Exposure Prophylaxis), such as circumcision, whatever form of HIV prevention campaigns, let’s include the elderly as well.

“Realizing that they remain at risk of new infections,” said Dr Chimbetete.

He further revealed that as elderly patients visit health institutions for any other medical reasons, personnel should offer HIV testing, so that they (elderly patients) are not left behind.

“Number two; when we see elderly patients coming to our hospitals, facilities, for whatever medical reason; let’s offer HIV testing because we have noticed a delay in HIV diagnosis.

“Because some of the symptoms of HIV infections in this age group, they mimic old age and they are just dismissed as part of the ageing process and we don’t want late diagnosis of HIV in this generation of people.

“We also realise that HIV is a risk factor for a number of other conditions, so people living with HIV in old age are more likely to have other conditions such as hypertension, such as diabetes, mental health issues, such as also being at greater risk of cancers such as cervical cancer.

“So us as care providers we must now offer a holistic approach or comprehensive approach to the care of elderly patients.

“We don’t want OI (Opportunistic Infections) clinics that just look at viral loads, without BP machines, without glucometers to test blood sugar.

“We don’t want health care workers who only understand HIV management and not understand our national guidelines in terms of how we manage hypertension, how we manage diabetes, how we screen for common cancers. “So we want a holistic approach, we are offering free services for HIV clients and these services must also mean that we offer free treatment where possible for these common non communicable conditions,” added Dr Chimbetete.

Doctor Trevor Kanyowa, World Health Organisation (WHO) Zimbabwe, Technical Lead Healthier Populations, said the trend of a number of older people living with HIV is being noticed, not only locally but regionally and globally.

“This is mainly because of two reasons; the first reason is that we now have effective anti retroviral medicines of high quality and these medicines are enabling people to live healthier and longer lives.

“So we have people who acquired the HIV virus even before they had aged, managing to grow into the older age groups still living with the virus but living healthy and longer lives.

“The other reason is that whilst we know that even at younger age groups, HIV is still being acquired, we have also noticed that the risk of acquiring it in older ages has also increased, this is for a number of reasons.

“The reasons include the issue of the information that people have, for example there is a general belief that HIV is for younger people so therefore older people are less likely to use protective measures as compared to the other age groups.

“We also notice that for instance, older persons may lose a partner and then may opt to go into a new relationship, they may opt to marry or opt to live with a boyfriend or a girlfriend but there is not that much effort to check one’s status in that age group and as a consequence, they acquire the infections.

In 2022 UNAIDS estimated that 24 percent or 4,2 million of people living with HIV (PLHIV) globally were aged 50 years and older and in Zimbabwe, 22 percent of PLHIV (28 407) are 50 years and older.

“So these are the main things that are making us see that we have HIV rates increasing in the older age groups,” said Dr Kanyowa.

He also revealed that it has been noticed that the figures of young people acquiring HIV are dropping, whilst the population with HIV in the older age group is rising.

“If you then look at it as a proportion, it will appear very much bigger in the older age group.

“This is what we are noticing and these trends are what we need to focus our responses on,” added Dr Kanyowa.

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