Zimbabwe: progress on HIV reduces death rates

With all the stress on Covid-19, we sometimes forget that HIV is and remains Zimbabwe’s deadliest viral disease despite the massive strides made in recent years to bring infections under control, to ensure that people living with HIV have a easy access to antiviral treatment and making sure it is good enough to bring their viral load down to zero.

Zimbabwe’s progress has impressed the United Nations and the World Health Organization, as resident representatives made it clear when they met with Vice President and Minister of Health and Child Welfare Constantino Chiwenga last week with another meeting later to map progress in preventing mother-to-child transmission. transmission, where again progress has been excellent although Zimbabwe seeks the perfect zero transmission solution.

Zimbabwe has now reached the 90-90-90 target, meaning that 90 percent of people living with HIV know their status, 90 percent of those living with HIV are on effective treatment and 90 percent of those living with HIV percent of those on treatment have had their viral load suppressed, so they cannot transmit the virus and are extremely unlikely to die from an AIDS-related illness.

Now Zimbabwe wants to move to 95-95-95 over the next few years. It is achievable. In fact, in one area, the middle stat where people living with HIV are on effective treatment, we are already ahead of the new target.

Last year, more than 98 percent of people living with HIV were on treatment, and we had already exceeded the target of 90 percent of people on treatment with suppressed viral loads.

Where the problem tends to be is getting people, especially the most recently infected, to be tested so that they can determine if they are living with HIV.

In one group, young pregnant women, we are doing very well since the test is part of the prenatal care that almost all women now take. This means that the mother-to-child infection is exceptionally low.

But we still envision nearly 30,000 new infections per year, well below the appalling infection rates seen at the turn of the present century, but still a worrying figure.

Women are still affected much more than men, largely due to the biology involved in transmission and the fact that adolescent girls and very young women tend to be pressured into initiating sex, despite great efforts. deployed in recent years.

The problem with the untested is that if they are living with HIV, they can be contagious and transmit the infection. So, the sooner they know they have been infected, the sooner they can start treatment and join the group whose viral load is suppressed, so it is very unlikely that they will pass the infection on.

Getting tested when the first symptoms appear means that the person has been living with HIV for some time, and depending on their personal lifestyle, they may have infected several other people.

This is why the stress shifts to bring sexually active young people into the screening program so that they know their infection status. But others with doubts should still be tested.

The predictions were that last year or this year, with the high percentage of people living with HIV knowing their status and taking the necessary drugs, the number of people dying from AIDS-related illnesses would fall below 20,000 per year.

HIV should no longer be a killer. It is now, for the overwhelming majority of people living with HIV, a highly controllable chronic disease. This means they have to take the right medicine and take it for life, but those lives can be normal and long, or at least when they die, it will be from the same causes that caused the death of the uninfected.

And there is this incredible benefit, which was not seen when proper antiviral drugs became available, that almost anyone on the right medical regimen will have their viral load suppressed below the levels where they can transmit the infection. to someone else.

It is this added benefit that gives medical experts hope that HIV can be eliminated, at least in the sense that there are no new infections, and finally after a good few decades no one is living with HIV anymore. .

The government and the Ministry of Health and Child Welfare are right to keep their running HIV programs at a high priority level and as we meet our original goals by setting new ones. Goals.

But to achieve this, the cooperation of the general population is still needed, especially at the testing stage. All upgrades to our public health systems under the Second Republic will automatically ensure that the other two goals are met as long as people cooperate.

In fact, the government and the department are keeping the pressure on and pushing forward all kinds of public health programs.

The Covid-19 vaccination campaign may be building on the infrastructure already in place for mass vaccinations against a series of childhood infections, but this campaign has never been delayed or changed and is continuing at full speed.

There is now an increasing emphasis on early detection of common cancers, a non-infectious disease that in most cases can be treated effectively if caught in time.

We are also finding that the focus is on healthy eating, which can cost no more and no less than an unhealthy diet, which in turn will limit other chronic diseases like heart disease, hypertension, and diabetes. .

Again, these can be controlled, especially if they are detected during the first tests.

Finally, we have malaria, which is still there. Again, the steps are accelerated to have early diagnosis and treatment and to get people to be more careful.

But again, as with everything from old illnesses to Covid-19, people need to exercise caution, take preventative measures, and know their status as soon as possible.

Even with Covid-19, the chances of survival are much higher for those who are infected to get tested early, rather than waiting until they are in the back of an ambulance.

We have reached the stage where our public health sector is fully operational and constantly improving.

Our doctors and nurses can do more and more every day. But for so many infections and other illnesses and ailments, the sooner the patient is identified, the sooner doctors and nurses can do something really useful. And so it comes back to us.