Dr Angela Mushavi National PMTCT and Pediatric HIV Care and Treatment Coordinator

1. The Zimbabwe National Plan ON Elimination of New HIV Infections AMONG Children BY 2015 AND KEEPING FAMILIES ALIVE Dr Angela Mushavi National PMTCT and Pediatric HIV Care and Treatment Coordinator XIX International AIDS Conference Washington DC 22/07/2012

2. Outline of presentation • The process of developing the eMTCT strategy • Vision and goal of the eMTCT strategy • Outcome and impact results for eMTCT for the years 2011-2015 • Summary and recommendations for eMTCT in Zimbabwe

3. Zimbabwe Population 12 million PLHIV 1.1 million CLHIV 150 000 HIV prevalence in ANC 16,1%

4. Process of Developing the eMTCT Strategy • Process led by the Ministry of Health and Child Welfare’s PMTCT Partnership Forum • Review of the 2006-2010 PMTCT and Pediatric HIV Care and Treatment Plan preceded crafting of eMTCT strategy • The Interagency Task Team on HIV Prevention and Treatment of Pregnant Women and Children; co-chaired by WHO and UNICEF (IATT) supported the review (availed a consultant) • Bottlenecks and success factors identified informed the crafting of the eMTCT strategy; which includes pediatric care and treatment (supported by EGPAF and IATT)

6. Process of Developing the eMTCT Strategy • The eMTCT strategic plan dovetails very neatly with the global plan on elimination of new HIV infections among children by 2015; and keeping mothers alive • Costing of the eMTCT strategy is being finalised (with support from the IATT) • Strategy was launched on the 28th of May 2012 with support from EGPAF

7. 2011-2015 Strategic Plan: Vision and Goal • Vision: A new generation free of HIV and families affected by HIV alive and living quality lives • The Goal: To Eliminate new HIV infections in children by 2015 and improve the survival of mothers and children in the context of HIV

8. Guiding Principles for the Strategy • Equitable access: Equity in accessing quality services for eMTCT and pediatric care and treatment • Results based management: focusing on achievement of impact and outcomes • Integrated service delivery of PMTCT and Pediatric HIV through a strengthened MNCH platform • Multisectoral and multi-disciplinary approach • Evidence based approach that builds on best practices • The “Three Ones” principle – One National Coordinating Body, One National Strategy and One M&E Plan

9. Guiding Principles of the eMTCT Strategy • Meaningful involvement of people living with HIV (MIPA) • Family centred approach: A holistic family centred approach for women, their partners and family • Partnership: Strengthening partnerships across public and private sectors as well as civil society organisations (FBOs, NGO and CBOs) • Gender sensitive • Focus on quality

10. The 7 Strategic Objectives of the eMTCT Plan • Strengthen program leadership, management, coordination and supervision of sites • Strengthen provision of quality PMTCT and Paediatric HIV treatment services integrated within the MNCH platform • Strengthen human resource capacity • Strengthen the supply chain management system for commodities

11. The 7 Strategic Objectives of the eMTCT Plan • Strengthen laboratory capacity to support eMTCT • Strengthen community involvement and participation • Improve generation, dissemination and use of strategic information

12. Zim’seMTCT Strategy is grounded in the UN Strategic Framework for Prevention of HIV Infection in Infants and Young Children Prong 1 Primary Prevention of HIV Prong 2 Prevention of unintended pregnancies Prong 3 Prevention of mother-to-child HIV transmission Prong 4 Provision of care and support for HIV-infected women, their children, and their families

13. Outcome Results • Reduced new HIV infections among child-bearing women by 50% from 13% in 2009 to 7% by 2015 • Reduced unmet need for family planning among women of child bearing age living with HIV from 13% to 0% by 2015 • Reduced MTCT of HIV from an estimated 30% in 2009 to <5% by 2015

14. Outcome Results • Increased proportion of treatment eligible HIV positive P&L women initiated on ART for their own health from 10% in 2010 to 90% by 2015 • Increased proportion of HIV-infected infants and children initiated on ART before the age of 2 years from 27% in 2010 to 90% by 2015

15. Impact level • 90% reduction in new HIV infections among children (from 15 000 new HIV infections per annum to less than 1 500) • 50% reduction in HIV related maternal mortality (from 26% to 13%)

16. Implementation strategy for attaining eMTCT stretch goals • Focused on integrated service provision across PMTCT and treatment services (adult and pediatric) • Integration with SRH and HIV; as well as within the broader MNCH platform • Community participation will be key in scaling up follow-up across the PMTCT, EID and early treatment for HIV positive children • To this end, a communication strategy has been developed to support the eMTCT strategy

18. Summary • The Zimbabwe eMTCT strategy is ambitious; it has stretch goals and focuses on impact • Importantly it focuses on delivery of a comprehensive 4-pronged approach to eMTCT and articulates a continuum of care that progresses to maternal ART and pediatric HIV care and treatment • Indeed, there is optimism that the country will attain the goal of eMTCT by 2015 and keep mothers and children alive

19. Acknowledgements PMTCT Partnership Forum-led by PMTCT Program; and with membership of other departments of MOHCW as well as academic institutions Provincial and district health teams as well as city health directors MOHCW Partners in PMTCT • EGPAF and the Family AIDS Initiative (ZAPP/KAPNEK/OPHID) • WHO/UNICEF/UNFPA/UNAIDS/UNDP • CHAI • ZVITAMBO • MSF • NAC • JSI/SCMS • ZNFPC • PEPFAR • CIFF • ESP (5 partners: DFID, NORAD, SIDA, CIDA, Irish Aid) • Global IATT agencies

20. Thank you Tatenda! Siyabonga!