HARARE – As Zimbabwe continues to scale up efforts in the fight against HIV/Aids which has been around for the past three decades, Daily News Features Editor Thelma Chikwanha had a conversation with UNAIDS Country Coordinator Tatiana Shoumilina to find out on progress made so far.
DN: What investments have been undertaken by your organisation in collaboration with government to end HIV/Aids in Zimbabwe so far?
TS: We have been talking about two things which we call the background, let me start with financing.
We have been talking about it as a burden but recently we have come to understand that investment in health and HIV/Aids is not a liability.
Our return on investment is the lives changed, the deaths aborted and many infections which are prevented.
This is what we are working for, to see people alive and that is the impact.
As long as we are talking about disbursement we are not as strategic as we are when we talk about investment.
We look for the best results and we bring them back to the people.
There are several points which are characteristic about Zimbabwe- people first, commitment to act for people; commitment to translate into action, valuing participation of people, partnerships, there is leadership through and through, the ability to identify the most urgent need.
DN: Women constitute the largest number of people living with HIV/Aids and especially in Africa, when you talk about coming up with programmes to reduce the spread of Aids what exactly is being done for women?
TS: One of the issues we have had to deal with was about young girls in the villages. We went to Bindura with Padare (a non-governmental organisation working with communities) we support their programmes there.
The point was there are many issues that young girls are facing today which they cannot even discuss with anybody.
Leaders do not understand there is no dialogue; there is no place where they can come and say we have an issue of say sexual transmitted infections. When it comes to transactional sex it comes to not knowing what to do, not seeing much of a future, plus the traditional norms in the area.
We realise that we are living in the 21st century.
Padare then started looking at how it can create a platform for dialogue for girls and the community leaders.
Girls are more vulnerable than boys and they have fewer opportunities. We then went into discussions with community leaders and service providers and we said lets listen to each other and a lot of interesting things came out.
The girls requested to be educated on sexuality; this is about investing in something that is very real and essentially existing in the community. It’s just a matter of scratching a little bit and getting something out. Traditional systems are good for other things but sometimes they hinder progress.
DN: What do you think are some of the real challenges women face in the fight against HIV/Aids?
TS: We did notice that girls suffer. We did notice that families suffer because of peer pressure and tradition. If something happens to the girl; she is expected not to disclose it because the family is ashamed but because of what society says about pregnant girls.
Why is a girl going to the clinic and what kind of condoms is she asking for?
These are some of the issues but times have changed.
This brings me into my point about investing into the future.
When you invest in the future, you talk of investing in women.
If you bring up a healthy, confident and trustworthy girl, her children too will be much happier, but if she is sitting there thinking who is going to say what about me then she starts to bring her children down.
Not everything about empowerment is about creating wealth opportunities, educational opportunities. When you bring up girls’ self-esteem, you have empowered her.
Empowerment is about creating self-worth. When you are aware of that fact then you have a value, you then begin to value yourself.
It’s not only about opportunity, it’s about raising people to value themselves. There is need to create an environment where they can speak out where there is nothing prohibitive and dangerous.
DN: What do you attribute to the decrease in the HIV prevalence and incidence rate bearing in mind that Zimbabwe receives far less funding than its neighbours in the region.
TS: Every cloud has a silver lining and if we have a lot, we spend left right and centre we don’t even remember what we want or why we are even spending and we are jumping on every opportunity.
We watch so many things being done, so many interventions that we lose track of what we are doing. Then when we do not have much, we plan and prioritise where we put our resources to good use.
You prioritise in a manner that makes much more sense until two years ago, many countries were talking about Aids response and Aids resources in terms of funding we are missing $300 million here…we are missing it there…a gap here another one there. But what we are doing here in Zimbabwe and what has got us the greatest ground — the targets are on people, all the gaps are on people.
It’s not about how many people we need. When it’s about people you negotiate people, you don’t negotiate money. It’s about putting people first, with commitment and taking action and with leadership involvement.
DN: There were several reports in the past that there was a shortage of antiretroviral drugs in the country. How many people are now accessing treatment?
TS: There are over 600 000 people receiving treatment basically everyone who presents themselves at a hospital and has a CD4 count of 350 and below can access treatment.
Zimbabwe has achieved universal coverage of adult treatment.
The problem we have is that some people present themselves to a doctor when it is already too late.
We seek to empower women and girls in communities, there are other issues which girls cannot discuss with anyone else like sexually transmitted diseases and other sexual reproductive health issues.
We then come in and facilitate dialogue. We link the girls up with community leaders thereby creating a platform for women to be heard by their leaders.
We also realise that women are naturally more vulnerable than men and have fewer opportunities than boys even though they are more intelligent.
When we were in Bindura, girls actually asked to be educated about sexuality issues.