Source: EDITORIAL COMMENT: Long battle still ahead to conquer HIV/Aids | Herald (Opinion)
With all the attention being paid to Covid-19, we sometimes forget that there are plenty of other diseases and illnesses that are still killing Zimbabweans and that while upgrading our health system helps, there are still long battles ahead.
Out of communicable diseases, HIV is probably easily our biggest killer now. We have sorted out with universal and mass vaccination most of the childhood illnesses that used to cut a swathe through each generation of children.
The continuing efforts to control mosquitoes and malaria are chipping away at the few hundred who still died each year.
But HIV remains despite our remarkable progress and is still killing at least four times as many people each year than Covid-19, our death rates from Aids-related illnesses only recently falling below 20 000 a year.
That is a huge improvement on the well over 100 000 dying each year in the early 2000s, just two decades ago, but as President Mnangagwa stressed on Wednesday, on the international World Aids Day, we have to maintain the pressure to defeat this illness.
This day perhaps becomes even more important than it was when set up, to remind us that HIV has not been defeated, that complacency is never justified and that we have to continue our unremitting efforts.
As a country we live with HIV, just as 1,3 million Zimbabweans live with it as individuals.
We have now achieved the 90-90-90 target. That is 90 percent of those infected with HIV know their status through a test, 90 percent of that group are on ARV medication and 90 percent of those on medication have seen their viral load so suppressed that for all practical purposes they can live the same sort of life as the non-infected, besides having to swallow a tablet each day.
Not that Zimbabwe is resting on any laurels. We have now set a new target, of 95-95-95 by 2025 and eradication of new infection and deaths from Aids by 2030.
Not that we will then be able to sit back and no longer have to worry about HIV.
Just because there will be no new infections and everyone infected is on effective treatment still means HIV will be with us until early next century.
There will be all those people who are infected, even with viral load suppression, who will have to continue their daily treatment until some time probably in the second decade of the next century when the last infected Zimbabwean dies from some other cause, perhaps a 100-year-old still on ARV getting run over by a bus.
But the point is HIV ceases to be a cause of death a lot earlier.
To even get to the 2030 target of no new infections means we have to keep up the relentless pressure that has brought us to our present 90-90-90 point.
People, although everyone now knows how HIV is transmitted, are still being infected with an extra 24 900 added to the list last year. This year will be less, but not drastically so as we chip away at the infection rate.
One major boost to falling rates is that 90 percent of people on treatment have their viral load suppressed and so are no longer infectious, but when you do the sums you find that a little over a quarter of people living with HIV are still potentially infectious, hence the need to move forward from 90-90-90.
We still have only a modest percentage of those in the younger age groups aware of their status and still to start treatment.
This is understandable since they are otherwise fit and are not showing symptoms, while the older age groups with their 97 percent on ARVs are balancing the statistical averages.
But Vice President and Minister of Health and Child Care Constantino Chiwenga did make it clear this week where the effort needs to be stepped up, with more testing more treatment immediately on infection, when it is possible to defeat HIV before it lodges in the immune system, and more outreach to the especially vulnerable groups.
President Mnangagwa stressed the need for the Government to continue finding the money, more money, needed to continue and enhance the programmes that have already brought such measurable success.
Zimbabwe is still very reliant on external funding, although the fact that we have our special extra tax with the Aids Levy and make normal budgetary funds available means that such help is more willingly given.
It’s not even just standing still and following what was done to get to the 90-90-90 target. That last 10 percent in each category will require even more effort. The President also noted that a lot of the final push is reliant on the general economic development with everyone being included.
Too many in the most vulnerable groups are in those groups because of poverty and lack of empowerment to make more health-conscious decisions.
To lose that vulnerability means they must have more practical alternatives to engaging in risky behaviour, and when you come down to it that means more schooling and empowerment so they can live their own lives better.
A lot of those who are now in the 90-90-90 group were the easier ones to get into this position, so that last 10 percent in each group does require the broad approach and the use of many roads.
The science and the facilities are there, and VP Chiwenga did stress the need to continually upgrade the public health system further, a process that Covid-19 has greatly accelerated.
But we have done so much in the past few years that victory is now achievable so long as we do not relax and so long as HIV, and all the other preventable causes of death, are continually fought.
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