CDC in Zimbabwe

CDC Impact in Zimbabwe

HIV

CDC has supported the Zimbabwe HIV Care and Treatment program since 2004. With support from the President’s Emergency Plan for AIDS Relief (PEPFAR), antiretroviral (ART) coverage has increased nationally. By the end of 2019, ART coverage among all HIV positive adults was 82% for adult men and 88% for adult women. Coverage for children was slightly lower at 78%.

Zimbabwe has adopted the ambitious Joint United Nations Programme on HIV and AIDS (UNAIDS) Fast Track strategy for ending the AIDS epidemic by 2030. To meet this goal CDC helped Zimbabwe implement different strategies to increase convenience and access for patients, reduce out-of-pocket expenditure, and decongest clinical facilities.

One example is the integrated HIV Testing Services (iHTS) strategy that was fully implemented in 2019 to scale up index testing for newly diagnosed PLHIV and roll out of HIV self-testing.

Targeted testing strategies will remain important towards finding the remaining undiagnosed PLHIV to achieve 95-95-95 targets (95% of people living with HIV knowing their status; 95% of people who know their status are on treatment; and 95% of people on treatment with suppressed viral load).

Cervical Cancer Screening and Treatment

HIV remains an important risk factor for cervical cancer. HIV-positive women are 4-5 times more likely to develop cervical cancer compared to HIV-negative women. Many women are surviving HIV but dying from cervical cancer, a condition that is both preventable and curable. In 2019 CDC Zimbabwe collaborated with local partners to start new screening and treatment approaches. After the meeting Zimbabwe updated national guidelines to scale up TPT to reduce burden on TB among People Living with HIV (PLHIV) and include ART and TPT same day initiation for new HIV patients.

Tuberculosis

PEPFAR and CDC have prioritized TB Preventive Treatment (TPT) scale-up as a strategy to end TB. A target of 100% TPT coverage among all eligible patients over 2019 and 2020 was set. Zimbabwe has had great success with their TPT program, where an estimated 85% of PLHIV have received TPT.

A TPT international learning session was conducted in May of 2019. Participants included representatives from the ministries of health of Zimbabwe, Uganda and Zambia that came to learn from Kenya’s experience.

Laboratory Capacity Building

CDC has provided technical support and funding to the laboratory services of the Ministry of Health and Child Care (MoHCC) since 2004. In 2019, CDC laboratory program supported Viral Load scale up in 11 laboratories from the six laboratories in 2016. This was accomplished through a robust mentorship program, integrated sample transportation system, optimizing the Laboratory Integrated Management System (LIMS). CDC has provided technical assistance to laboratories across the country to attain ISO 15189 accreditation for quality diagnostic services.

Surveillance and Health Information Systems

CDC Zimbabwe supported the MoHCC’s strategic information activities in 2019.  Activities included providing technical leadership and programmatic guidance for routine monitoring and reporting, newly diagnosed HIV & recent infection surveillance, and health management information system support. The long-term goal is to build integrated and interoperable electronic data collection systems that will feed into the District Health Information System (DHIS-2) national repository.

Global Immunization

CDC supports a secondee to the WHO African Region’s Accelerated Immunization Initiative (AII), within the Inter- Country Support Team, East and Southern Africa (IST/ESA) based in Harare, Zimbabwe. This position provides technical support and coordination for 20 member states within IST/ESA on the elimination of measles, the control of rubella/ congenital rubella syndrome and maternal and neonatal tetanus.

IST activities include promoting coordinated partner approaches, implementation of established strategies and policies, adapting guidelines to respond to country-specific needs, conducting and contributing to capacity building activities, and developing country-specific work plans.

In alignment with the Global Vaccine Action Plan (2011-2020) and the African Regional Immunization Strategic Plan (2014-2020) all member states in the ESA region have established a goal for Maternal and Neonatal Tetanus (MNT) elimination and for measles elimination by 2020.

Malaria

In 2019, malaria cases and malaria deaths increased in Zimbabwe compared to the previous year. According to DHIS2 data, approximately 310,000 malaria cases were reported in 2019, equivalent to an incidence rate of 22 cases per 1,000 population. This represented a 19% increase in the number of cases reported in 2018 (approximately 260,000). The number of malaria deaths also rose, from 236 in 2018 to 266 in 2019.

The U.S. President’s Malaria Initiative (PMI) was launched in Zimbabwe in 2011. PMI is led by the USAID and implemented together with CDC. The PMI/CDC Resident Advisor works with USAID to provide technical support to Zimbabwe’s malaria prevention and control efforts. PMI Zimbabwe provides financial and technical support for a wide range of major malaria interventions, including: entomological monitoring, vector control [insecticide-treated mosquito nets and indoor residual spraying (IRS)], malaria in pregnancy, case management, pharmaceutical and supply chain management, surveillance, monitoring and evaluation, operational research, and social and behavioral change communication.

Extramural Management

In 2019, CDC Zimbabwe continued the transition of complex and critical portfolio from international organization to local indigenous organizations. At the start of 2019, local partner funding was 6.4% and by the end of the year it was 27%. During the year Extramural Management Branch (EMB) focused on continuing to build and improve the capacity of local partners to successfully manage cooperative agreements by providing guidance and resources for the implementation, administration, and oversight of the awards. In May 2019, the EMB collaborated with the Office of the Grants Services to conduct a Grants Management Refresher training aimed for the whole office and implementing partners to ensure compliance with law, regulation, and policy in the implementation of the cooperative agreements.