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By Joyce Mukucha
Following that more countries are now revising their HIV service delivery models and recognize that it is time to deliver differently, Government of Zimbabwe has been urged to prioritize health sector and put more focus on ensuring that a differentiated service delivery is extended to People Living with HIV(PLHIV).
Speaking on HIV advocacy issues during a Health Communicators Forum science media cafe in Harare yesterday, the Zimbabwe HIV/AIDS Activist Union Community Trust(ZAUCT) Deputy Secretary General, Angeline Chiwetani said the health system in the country was continuing to deteriorate and PLHIV group were hardest hit by the situation.
She highlighted that when it comes to PLHIV who are on treatment, a one-size-fits-all model of HIV services does not work for all PLHIV thus the need to ensure that community voices are amplified and making sure that a client-centred approach that simplifies and adapts HIV services across the cascade to better serve individual needs and reduce unnecessary burdens on the health system is adopted.
Concerning HIV support systems, Chiwetani bemoaned the way services are being extended to people on treatment especially when it comes to Viral Load (VL) detection as she emphasised the need to make noise to ensure that there are no delays in as much as releasing of results is concerned.
She pointed out that people tend not to go for VL because their results were not coming out in time which as a result affect health of many.
“As a country, we still have a long way to go and there is need to make noise when it comes to Viral Load(VL).People who are on treatment end up choosing not to go for Viral Load because the process is not helping in any way. For instance a person go for VL this year, they are forced to do another one next year before the first one’s results come out. So how is their health being monitored? People end up being given the medication which is not even helping them.
“Zimbabwe is still lagging behind because people have no confidence of going to clinics and hospitals because nothing special they are being given there besides their antiretroviral drugs. What if someone is reacting to the medication and he/she is just continuing to take it and to make matters worse without knowing their VL. Efforts should be made to make sure that when people on treatment visit the health facilities, they get checked up for other problems and continue being monitored,” said Chiwetani.
She reiterated the need to have an approach to monitor everything for people who are on treatment as well as dealing with co morbidities.
Chiwetani also stressed the need for strengthened HIV advocacy explaining that it cannot be done in silos, but it requires everyone’s effort especially the media to ensure that community voices are amplified and heard.
“We must join hands and make sure that we continue making noise about existing gaps in as much as HIV care and treatment is concerned. The media should also play role of reporting issues that bring the voices of the community using the right language and words. Issues of access and treatment are critical areas which require advocacy especially for key populations (KPs).”
She said the media must make sure that the health messages they disseminate come out clear and correct to avoid misinformation and aim to save lives.
“Its your duty to figure out the red flags and report about it, where the health facilities do not have medications and not providing needed services, its your duty to hold the government accountable.We have lost a lot of people because of poor health systems and those are the stories that need to be reported now and again.”
Highlighting that 85 percent of the funds in Zimbabwe were coming from external partners and giving an example of what happened in Macedonia, Chiwetani emphasised the need for government of Zimbabwe to urgently have a transitional plan which will help to make sure that in times of disasters and when there is no more funding from external donors, people on treatment still survive.
“It is important for the government to have a transitional plan. As you can see, HIV funding is gradually being shifted, the focus is now more on Covid-19 and let’s say another outbreak comes again, the focus continue to be more and more shifted and the people on treatment are the ones who suffer.
“If the HIV funding from external donors stops today or any other time, what is going to happen to the majority who are on treatment? What will happen to our relatives who are in rural areas who cannot afford to buy the expensive drugs? We are going to lose thousands of lives like what happened in Macedonia, the situation was really bad and heartbreaking. It is of paramount importance for government to be accountable and responsible to put measures in place.”
Local, treatment of ART drugs, she said, was a solution to ensure that everyone access full package of affordable medication highlighting that it also helps reduce scarcity of medicines in health facilities.
ZAUCT HIV/TB Advocate Tariro Kutadza also reiterated that government must prioritize health sector giving more attention on comorbidities for Zimbabwe to become a healthy nation.
“They are people who are on treatment but also have other conditions like diabetes, cancer especially cervical cancer on women and we have lost some of our women of this. Therefore, there is need to focus on core morbidity issues and find ways that that are practical and effective to give quality health services to those in need of them,” she underscored.
Regarding the COVID-19 fourth wave, Kutadza said there was need for the country to become fully prepared to ensure that those in urban-distant communities and those in urban areas access their medication and health services without encountering any challenges.
“Measures should be out in place to make sure that PLIHIV do not struggle when it comes to accessing their medication. They must not be interrogated at roadblocks, people need to understand their situation and also shun from discriminating and stigmatizing people on treatment,” said Kutadza.