New HIV & AIDS Treatment Guidelines

HARARE – The World Health Organisation (WHO) has set new HIV and AIDS treatment and prevention guidelines to allow for early interventions once the condition is detected.

The latest information released on September 30 titled: Guidelines on when to start ART and PrEP (Pre-Exposure Prophylaxis) for HIV requires one to start anti-retroviral drug treatment upon testing HIV-positive regardless of their CD4 cell count.

It also advises countries to use HIV treatment as a prevention choice for people at high risk of infection.

Previously, ARVs were only given to HIV-positive people whose CD4 cell count had dropped to 500 and below and to vulnerable people such as children below five years, pregnant women, tuberculosis patients, and discordant couples regardless of their CD4 count.

Under the early guidelines, the first recommendation on ART initiation was based on evidence that many lives could be saved if people start treatment early, while the second guideline was based on further evidence of tenofovir — a first line ARV drug used in most countries — that it was effective in preventing HIV acquisition from an infected partner if taken as a pre-exposure prophylaxis.

“The first of these recommendations is based on evidence from clinical trials and observational studies released since 2013 showing that earlier use of ART results in better clinical outcomes for people living with HIV, compared with delayed treatment.

“The second recommendation is based on clinical trial results confirming the efficacy of the ARV drug, tenofovir for use as PrEP, to prevent people from acquiring HIV in a wide variety of settings and populations,” reads part of the guidelines.

The latest development will form part of the WHO’s revised and updated consolidated 2016 guidelines on the use of anti-retroviral drugs for treating and preventing HIV infection expected to be released during the International Conference on AIDS and STIs in Africa (ICASA) taking place here in Zimbabwe in December.

“The full update of the guidelines will consist of comprehensive clinical recommendations together with revised operational and service delivery guidance to support the implementation,” said the WHO.

Head of AIDS and TB Unit in the Ministry of Health and Child Care Dr Owen Mugurungi, said Zimbabwe welcomed these guidelines but now awaited the release of the 2016 comprehensive guidelines at ICASA.

Dr Mugurungi said the test and treat guidelines required wide consultations with stakeholders, on Monday including people living with HIV and the donor community.

If we are to adopt these guidelines, it means everyone has to be committed because this will definitely push up the figures (of people demanding ARVs),” Dr Mugurungi said.

He said there would be need for more people to get tested and to link all those tested to treatment and care.

Other stakeholders involved in HIV response also commended the WHO for the latest development, saying the guidelines would go a long way in reducing the impact of HIV and AIDS.

The executive director for Avac, a non-governmental organisation involved in HIV and AIDS advocacy, Mr Mitchell Warren, said there was need to swiftly and comprehensively fund and implement the new guidelines to begin the process towards ending AIDS.

“We can’t let these ground-breaking guidelines sit on a shelf. If taken seriously, they can help ensure that millions of people with HIV live long and healthy lives, and that millions more women and men at high risk can remain uninfected,” said Mr Warren.

He, however, said there was need for enough funding to ensure effective implementation of the guidelines.

“If fully funded and implemented, the recommendations will greatly simplify ART for people living with HIV and revolutionise prevention for people at risk. But there is much work ahead to translate them into practice, from securing resources to revamping HIV guidelines in country-after-country, to implementing comprehensive treatment and prevention programmes,” he said.

Director of Medicines Sans Frontiers’ Southern Africa medical unit, Dr Tom Ellman, said there was need for increased support from donors and governments to turn these recommendations into reality.

“HIV care has to move out of clinics and into the communities with mobilized, empowered and engaged people living with HIV that actually are part of the response. This will need effort and money, said Dr Ellman.

Dr Ellman said from his experience in Southern Africa in HIV programmes in the past 10 years, about a third of people diagnosed with HIV but not eligible to start treatment, never returned to the health facility.

“Offering such individuals treatment once they test positive could substantially reduce the number of people who may never return,” he said.

National HIV estimates show that one million people are living with HIV in Zimbabwe although infection rates are reportedly declining.

The country’s HIV prevalence rate, however, remained static at 15 percent while the number of people on anti-retroviral treatment is pegged at 63,4 percent for adults and 55 percent for children.

Source: Herald



VICTORIA FALLS,ZIMBABWE-ZIMBABWE-4 Community Adolescents Treatment Supporters will be leading a skills building workshop on “Adolescent-led treatment literacy and counselling for children and young people living with HIV” at the Pyschosocial Support Forum 2015 which will be held at Elephant Hills in Victoria Falls from the 1st of September to the 3rd of September 2014.

As part of the methodology for the skills building workshop,a team of 4 Community Adolescent Treatment Supporters (CATS) will facilitate a skills training workshop for conference delegates during which they will provide a background to the work that they are doing to promote adherence amongst their peers. They will then demonstrate the “Our Story” book, “Our story” counselling game and a short film on adherence. These have all been developed by young people living with HIV and seek to improve young people’s understanding of HIV and ART and adherence skills. Delegates will be trained how to utilize these tools within their own practice.


It is to this background that the delegates are anticipated to develop new understanding of the role of young people living with HIV in developing and implementing their own treatment literacy and counselling interventions. They will then acquire new skills in providing child and adolescent-focused information and counselling for young people initiating ART, on ART or with adherence challenges.



HARARE-Africaid Zvandiri will be hosting a track on:” Exploring challenges and opportunities in providing prevention, ART and positive living services for adolescents and young people living with HIV to improve quality and productivity of life.” at the Southern African Regional Students and Youth Conference which will be held in Harare (Harare International Conference Centre) from the 27th to the 30th of August 2015.

It is important to note that AIDS-related deaths in adolescents continue to increase as a result of poor linkage and retention in care, sub-optimal adherence and a lack of prioritization of adolescents in service delivery.


There is a critical need to hear the voices of young people living with HIV so that they themselves can shape the way services are delivered across the region.

In this track, adolescents and young people from organisations across the region will come together to share the successes and challenges from their respective countries and organisations, including the views of young key populations and young people living with HIV and disabilities.

Key issues will include positive health, dignity and prevention, access to ART and adherence, stigma and discrimination, retention challenges and sexual and reproductive health, drawing on experiences from different settings. Examples of different programme models and participatory approaches will be shared.

In this interactive session, they will discuss and make recommendations for the delivery of prevention, ART and positive living services in order to improve quality of life for their peers across the region.

The Southern African Regional Students and Youth Conference on sexual and reproductive health (SARSYC) will be held under the theme, YOUTH SRHR AND THE POST2015 AGENDA: A TIME TO INVEST IN YOUNG PEOPLE TO HARNESS THE DEMOGRAPHIC DIVIDEND IN SOUTHERN AFRICA.

The theme of the conference is founded primarily on the proposed incoming Sustainable Development Goals (SDGs) of the post 2015 development agenda and informed by the Millennium Development Goals (MDGs).

The year 2015 marks the end of the lifeline of the MDGs and marks the beginning of the SDGs; hence the conference will focus on calling the young people from Southern Africa to take the lead in the post 2015 SRHR Development Agenda through spearheading the attainment of SDGs that uphold young people’s SRHR.


HEALTH:Of Students Living with HIV

By Jephiter Tsamwi (Publisher : The SUNDAY MAIL)

ZIMBABWE-“I am a student at Hillside Teachers College and was initiated for ART in Mberengwa. When I wanted to access medication I was told to go back to Mberengwa. I spent some time raising the money and eventually managed to travel to Mberengwa. Unfortunately, when I got there, the nurses told me they were out of supply. I had to come back to Bulawayo empty-handed.”

Recently, our sister paper Chronicle quoted a student from Hillside Teachers College narrating her ordeal during the Anti-Retroviral Therapy (ART) Advocacy Meeting that was held in Zimbabwe’s second largest city.


Indeed, they say every adversity, every failure, every heartache carries with it the seed of an equal or greater benefit, but the story is different for students living with HIV. It is a different story not because they are not trying, not because they are putting less effort, but because of the existence of an interplay of flawed systems and mechanisms that are ironically supposed to at least rekindle a light of hope to the destiny of this often forgotten tribe.

Getting education provides a window of hope and opens many doors of opportunities for every hardworker. The majority of students living with HIV have defied all odds to clinch that hope and make it to college.
It, however, seems they are at the right place at the wrong time. The system has failed to protect them and cater for their sexual and reproductive health rights.

It is not enough to expose the sexual and reproductive health challenges of young people without dissecting the fundamental questions of why the situation is like that and what needs to be done.

Zimbabwe is undoubtedly a classical example of a nation that has demonstrated commitment and determination to stamp down the adverse effects of HIV and Aids and in the process, making it one of the first African countries to witness a sharp decline in HIV prevalence rate.

In recent times, we have seen different countries sending delegates to learn from Zimbabwe in terms of HIV prevention, management and even administration strategies and programmes. It is a good thing for the country.

However, the gains made thus far are at the verge of serious collapse if key emerging issues are not seriously addressed.

What the student quoted above raised is a classic example of the difficult circumstances and challenges that young people living with HIV are facing in colleges.

Many times, we have also read about these students engaging in risky sexual behaviours because of economic challenges. Of course, it is public knowledge that not all students are going astray because of lack of basic necessities at college, but truth be told, most Zimbabwean students are struggling to make ends meet. The burden is even more to the students living with HIV. But why is that so?

Below are some of the key issues:

College clinics are not accredited and/or licensed

This may sound unbelievable to the majority. But it is pretty disturbing that with all the advancement and the progress made so far by the country, only University of Zimbabwe is initiating ART. Universities like Midlands State University, itself a mega-varsity with a total population close to 25 000 is only a follow-up site for Anti-Retroviral Treatment.

Definitely as a country we have to be ashamed of this. There is certainly no excuse for this, either colleges are not serious or the policies are not dealing with this matter. Where are the students supposed to get their ARVs if institutions that house them for three to four months are not providing such?

Under-staffing and limited capacity

Whether it is Government policy or the colleges’ policy, it is unfortunate that only one nurse is often available at most colleges’ clinics. This means that if that nurse is not available for any reason, the college clinic is closed.

In other words, colleges are operating under a deceptive assumption that this one and only college nurse is forever available, every hour and every minute when students are in need of their services! To worsen the matter, the college clinics are sometimes opened only for a limited number of hours.

The reality is that most colleges are enrolling more students than their carrying capacity, yet only one individual is serving the whole college.

In the above mentioned ART advocacy meeting that this writer was part of, it emerged that very few of the college nurses are actually trained in ART initiation, especially according to the 2013 guidelines set by the Ministry of Health and Child Care

Then what after getting tested?

Research has shown us that the most used and accessed service in the college clinics is HIV testing and counselling. Perfect! Such can be used as entry points to begin dialogue with students on sexual and reproductive health matters considering their vulnerability.

However, there is no comprehensive support for students living with HIV who would have been referred to Central Hospitals or those who would have tested HIV positive.

The viral load machines at Mpilo Hospital, for example, are currently not working, yet this is one of the main hospitals where students who would have tested HIV positive are supposed to get help.

It is so unfortunate that during the meeting indicated above, the chairperson of the Parliamentary Portfolio Committee on Health and Child Care, Dr Ruth Labode, was the most shocked when she heard about the prevailing situation at Mpilo. Do policy makers really care about these things?

Flawed system in management, catering for transfers

It is outrageous to realise that in this digital world, Zimbabwe currently does not have a computerised system that tracks and monitors clients’ ARV uptake for effective and convenient record keeping.

What this means is that a student at National University of Science and Technology who was initiated on ART in Siakobvu, Gandanzara or Bocha is expected to go back to the site he/she was first initiated to get supplies of his or her medication.

If he/she wants to try with the nearest hospital, the client is expected to produce a transfer letter. You can imagine the inconvenience. The system does not even have a mechanism for at least using cellphones to confirm these transfers.

Where will a poor student who is already struggling to get at least one meal a day get the money to go back to Siakobvu mid-semester?

Inconsistent ARV supplies and defaulting

You can imagine the ultimate result of such a myriad of challenges that young people are facing in their efforts to access ART. Obviously, a lot end up defaulting taking their medication.

Some are losing their lives as a result. What is also a colossal challenge to the students is that sometimes they get only two months’ supply of medication at a time when they are supposed to spend at least 3-4 months at university or college.

Even if they manage to go back and collect the drugs, other clinics will be out of stock, thus requiring students to have multiple trips as they seek to access the ARVs. With all the hustles and processes that are needed for them to get their ARVs, this will result in them spending more time out of lectures as they go back to collect their medication.

How then are we supposed to produce quality graduates as a nation if students are day by day exposed to such harsh conditions?


That we have a lot of these challenges does not mean the future is bleak. Zimbabwe has done so well in health interventions before and solving these issues can be an easy thing to do with utmost commitment by the duty bearers.

More staff at public hospitals and college clinics

Why are we having shortages of staff in public hospitals and college clinics when the country is rich with unemployed trained nurses? It is high time Government relaxes the freezing of posts, especially within the health sector, to solve staff shortages.

The number of college nurses per college must be proportional to the number of students per enrolment if youth-friendly and quality sexual and reproductive health services are to be given to our young generation, especially those in colleges.

Procurement of drugs with longer shelf life

If young people, including the general populace, are getting two months’ supply of drugs because the available stock will be nearing its expiry dates, then Government, through NatPharm, must ensure that drugs that are being procured have a longer shelf life.

People of Zimbabwe will be able to get at least 6 months’ supply of drugs and this will make life easier for the people living with HIV.

Health service delivery package for colleges

It is pleasing to note that some colleges have set up initiatives where the college nurse can collect the medication on behalf of the students from the public hospitals. Although this is not sustainable and does not empower the student to be in full control of his/her health needs, at least they are trying.

However, what could be more sustainable would be for the Government, through relevant line ministries, to consider coming up with a minimum package for sexual reproductive health service provision that is tailor-made to cater for the college students.

This will ensure that the services are student-friendly with high chances of meeting students’ satisfactions and expectations.

Quality and rights focused service delivery

The health sector must adopt a quality and rights focused approach in service delivery, especially with regards to ART. There is need for a complete overhaul of the “one-size fits all” approach when delivering ART to the people.

Therefore, Government can consider segmenting different sub-groups and strive to cater for their specific and sensitive sexual and reproductive health needs, for example, students and many other sub-groups that may need specialised focus in service delivery.

Capacity building on youth friendly service delivery

The time for our nurses to be given names like “horrible nurses” is over. Nurses in public hospitals are notoriously known for the wrong reasons; ill-treatment of patients, shouting at clients, laziness and mean statements.

Of course, this could be a product of different factors, but the nurses need capacity building, especially on patient-friendly service provision. If the nurses, especially those in colleges are not trained in ART initiation, then colleges and Government must ensure that the nurses are equipped with these critical skills.

Digitalisation of the health system

In recognition of the critical role played by ICTs in development, Zimbabwe has done the right thing by having a stand-alone ministry focusing on that noble cause.

It is, however, surprising that the health sector is stuck in the 1920s, much to the disadvantage and inconvenience of patients. The absence of a systems approach and a digitalised way of data capturing has led the sector to rely on transfer letters as support documents for those who wish to change their collection sites.
In the process, some are being recorded as defaulters when in actual fact they are failing to access their medication due to barriers associated with the primitive systems. It is high time all Government ministries and parastatals move with time and make computers a basic tool of work in their operations.



MIDLANDS PROVINCE,ZIMBABWE-Recently, Africaid ?Zvandiri? in collaboration with Ministry of Health and Child Care, the Department of Child Welfare & Protection Services and the local community established a support group for children and adolescents living with HIV at Tongogara Clinic which is located about 40 kilometres out of Shurugwi town in Midlands Province,Zimbabwe.

A total number of 36 children and adolescents, Zimbabwe Republic Police Victim Friendly Officers, officals from the Ministry of Health and Child Care (Shurugwi District), Department of Child Welfare and Protection Services Officers, Community Case Care Workers (CCCWs),Child Protection Committee members and Care givers attended the launch of the support group.

In addition to this, the training of CCCWs also contributed meaningfully to the establishment. A follow up visit was made to the clinic in May 2015 during the training of CCCWs for Shurugwi Rural. Trained CCCWs from the area also worked with Village Health Workers in mobilizing children.

The support group members will meet once every month at the clinic and it is felt that this will go a long way in building the confidence of these children and adolescents so that they live happy,healthy and fulfilled lives.


‘Incorporate children’s rights in mainstream programmes’

Newsday-16 June 2015

LOCAL children’s rights lobby group, Africaid, has bemoaned communities’ perpetuation of stereotypes against children and their failure to integrate children’s rights into the mainstream programmes.

Africaid’s call coincided with today’s commemorations of the Day of the African Child (DAC).

This year’s edition of the DAC will be held under the theme 25 Years After the Adoption of the African Children’s Charter: Accelerating Our Collective Efforts to End Child Marriages in Africa.

Africaid spokesperson Tinashe Rufurwadzo said: “Some of the children and adolescents do not know their HIV status of which it is their right to be tested for HIV and know their status.”

He said they were also advocating for more participation of young adults in issues to do with sexual reproductive health.

Africaid implements the right to participation with attention on children and adolescents living with HIV through the Zvandiri Community Adolescents and Treatment Supporters (CATS) Programme.

CATS provides direct psychosocial and health support services to peers living with HIV, to caregivers and to young HIV-positive parents. It also seeks to implement innovative ways of communicating and creating awareness to reduce stigma and discrimination.

“This is in accordance with the African Youth Charter Article 11 which stipulates that every young person shall have the right to participation in all spheres of society,” said the Africaid spokesperson.

Each year on June 16, African countries celebrate and recognise children all over the continent despite their differences, in remembrance of the sacrifices made by South African youths in 1976 who protested the inferior quality of their education and demanded equal rights. Thousands of children were injured and more than 100 people were massacred.

Last week visiting UNAIDS executive director Michel Sidibe said challenged society to safeguard the rights of children and adolescents.