SAPES Trust Health Policy Workshop

Deputy Chief of Mission Robert ScottStatement by Deputy Chief of Mission Robert Scott

U.S. Embassy, Harare

The U.S. government remains strongly committed to supporting public health in Zimbabwe, and has stood by this commitment since 1980. Currently, the President’s Emergency Plan for Aid’s Relief (PEPFAR) is the largest part of this effort. In addition to the annual contribution of $95 million, our PEPFAR budget was increased over the past year by $34 million to fund activities targeting voluntary medical male circumcision (VMMC) and HIV prevention among adolescent girls. We also undertake activities to address malaria and tuberculosis, with funding at approximately $14 million and $6 million respectively. These health funds are programmed and administered through the United States Agency for Development (USAID) and the  Centers for Disease Control and Prevention (CDC) and form the largest part of our bilateral assistance effort in Zimbabwe.

I believe that partnership is the key term that applies to our efforts. We consistently work with the Ministry of Health and Child Care to support Zimbabwe’s National Health Strategy, bringing our own expertise and views into the discussion on the best way forward. We also work with other bilateral donors, international organizations and a range of implementing partners, coordinating our funding and responding to the constantly updated guidelines and goals that underlie all of our efforts. The complexities are obvious. Additionally, the path from requesting taxpayer resources from our Congress and moving it through the various channels for implementation takes time and dedication by our staff.

In PEPFAR we are currently undergoing what we refer to as a pivot – a change in our approach intended to support the UNAIDS 90-90-90 targets and lead more rapidly to the goal of an AIDS-free generation. We will continue to work across Zimbabwe, but a special focus will be placed on the 36 districts that represent 80 percent of the HIV disease burden. Our goals will be to emphasize access to and provision of quality antiretroviral treatment (ART).

We were pleased to have partners from the Ministry and civil society organizations join us recently in Frankfurt to discuss our annual PEPFAR budget and provide views on our pivot strategy. This constant flow of communication remains vital to effective programming and coordination.

This workshop is focused on sustainability issues regarding public health, and that is of course at the heart of all that we do.  By coordinating and identifying roles and having a very realistic view of what funds will be available we can chart a way forward that is sustainable – that doesn’t overreach as far as funding or capacity goes. In that vein, we are pleased by the recent strategic mapping undertaken by the ministry to understand gaps, evaluate sustainability of funding flows, and create a national plan that incorporates all these factors.

Ultimately PEPFAR is an “emergency response” and is funded year-to-year – political support remains, but it was never intended to be a permanent fixture and its core agenda reflects the goal of a steady transfer of responsibilities to host governments. That isn’t to signal any change, but to alert us to the fact that health cannot be “sheltered.” We need to continue to show success, show effectiveness and create the constituencies that will step forward and support sustainable funding.