The United States President’s Emergency Plan for AIDS Relief (PEPFAR) has been implementing comprehensive HIV programs in Zimbabwe since 2006 through the United States Agency for International Development (USAID) and the Centers for Disease Control and Prevention (CDC) with the goal of realizing an AIDS-Free Generation. The focus of the PEPFAR program is to achieve epidemic control, which is defined as the point at which new HIV infections and AIDS related deaths have decreased and new infections have fallen below the number of AIDS-related deaths. In alignment with this UNAIDS global goal, epidemic control can be achieved by ensuring that at least 90 percent of people living with HIV (PLHIV) know their HIV status; 90 percent of those who know their status are adherent to antiretroviral treatment (ART); and 90 percent of those on ART are virally suppressed and no longer spread the virus. The PEPFAR portfolio covers the entire spectrum of HIV prevention, care and treatment services and has contributed to a reduction in HIV incidence among 15-49 year olds (0.48% in 2017 from an estimated 0.85% in 2009). To reach the aforementioned targets, PEPFAR Zimbabwe has prioritized 40 districts, which represent at least 80% of the HIV burden nationally, to receive a comprehensive package of HIV services tailored by age, sex and risk.
The PEPFAR program continues to support the Ministry of Health and Child Care (MOHCC) to reach treatment saturation by the end of 2018. This will be achieved through a direct service delivery model focused in Harare/Chitungwiza, Determined Resilient Empowered AIDS-Free Mentored and Safe (DREAMS) and Aggressive Saturation districts to identify PLHIV through provider initiated testing and counseling (PITC), targeted outreach, defaulter tracing and adherence counseling, surge Human Resources for Health (HRH) capacity, and community index testing. In addition, PEPFAR will support a central package including procurement and distribution of antiretroviral (ARVs) drugs and viral load (VL) reagents. Ultimately, the PEPFAR program will increase the number of people receiving ARVs. The program will also continue to support voluntary medical male circumcision (VMMC), orphan and vulnerable children (OVC), and targeted high-impact prevention activities.
To align with the overall goal of achieving the UNAIDS 90-90-90 strategy, a Key Populations strategy to scale-up clinical services targeting female sex workers (FSW) and men who have sex with men (MSM) is being supported. Direct service delivery activities that increase access and quality of services received both at the facility and community level are also being supported. They include: human resources, community ART refill groups (CARGS), mobile outreach initiation units and viral load reagents to catalyze the national VL scale-up plan which is currently at 6% of ART patients nationwide.
PEPFAR Zimbabwe remains committed to attaining the 90-90-90 goals outlined by UNAIDS, and is supporting the implementation of the Treat All (Test and Start) strategy being implemented with the leadership and largely with the manpower and infrastructure of the Ministry of Health and Child Care (MOHCC).
To achieve the UNAIDS targets for epidemic control, PEPFAR has set its targets even higher. It will ensure that at least 95% of people living with HIV know their HIV status, 95% of those who know their status are adherent to antiretroviral treatment (ART), and 95% of those on ART are virally suppressed and no longer spread the virus by 2030.
PEPFAR Coordinator’s Office
2 Lorraine Drive, Bluffhill