Zimbabwe’s AIDS Success Was Doubted: UNAIDS Executive Director

By Chief K.Masimba Biriwasha | iZiviso Global Editor At Large

HARARE, Zimbabwe – UNAIDS Executive Director, Michel Sidibe, said that no-one believed that Zimbabwe could succeed in responding to the AIDS epidemic at the inaugural GlobalPOWER Africa Women Network conference held recently in Harare, Zimbabwe.  Image

According to UNAIDS, Zimbabwe has achieved one of the sharpest declines in HIV prevalence in Southern Africa, from 27% in 1997 to just over 14% in 2010. With 10 times fewer resources for AIDS per capita than other countries in sub-Saharan Africa, Zimbabwe has expanded coverage of antiretroviral treatment among adults, from 15% in 2007 to 80% in 2010. At the end of 2011, nearly half a million people in the country were receiving lifesaving HIV treatment and care.

“No-one was beliving that Zimbabwe could be a success story with all the difficulties the country was facing but Zimbabwe managed to demonstarte that they can reduce by 52 percent the adult infection rate during the last ten years. Zimbabwe managed to increase the number of people in need of treatment by 50 percent during only the last two years which is important for us to underline,” Sidibe said

He added that Zimbabwe was also a success story because it introduced innovative ways to mobilize internal resources. Zimbabwe’s AIDS Levy, a tax on income to increase domestic resources for the national HIV programme has enabled the country to diversify its domestic funding for its AIDS response, raising an estimated US$ 26 million in 2011. This year the levy is expected to raise US$ 30 million.

However, the majority of people on antiretroviral drugs continue to be supported by the donor community: 76 percent of the 347 172 people on treatment are supported by donor funding.

“In general, any data, you put out is questioned. When we mentioned in our report for the first time that Zimbabwe was making progress, they were reducing the number of new infections and increasing the number of people on treatment, death was going down, people questioned us how that could happen. Many aspects about the country pointded otherwise,” he said.

He said that question surrounding the fact that the country was undergoing serious economic problems made people question the results.

“We asked the one of the best institutes in the world, Imperial College, to come and validate our data. They did all the epidieological analysis and caem up with the validation of the dats. Any place where HIV has success response record, its about leadership at all levels. Secondly, what happeend in Zimbabwe is change in behaviour.

He said that the AIDS levy had played a key part in the Zimbabwean AIDS response, and UNAIDS used it as best practice in raising locals resources for the AIDS response.

“Today, its only 13 percent of the formal sector paying for the levy. We could really look at the informal sector, it will even bring more resources. Zimbabwe’ efforts during the last two years to increase treatment in the past two years is one of the best practices,” he said.

“The Zimbabwe AIDS Levy is an excellent example that demonstrates to other African countries how to generate domestic resources to maintain and own their national AIDS responses. I encourage the Government of Zimbabwe to explore how this initiative could be expanded to tap into the informal sector to boost the resources of the trust fund.”

GlobalPOWER Women Network Africa Conference Opens in Harare

By Chief K.Masimba Biriwashs | iZiviso Global Editor At Large

HARARE, Zimbabwe – Women parliamentarians, leading African women entrepreneurs, civil society leaders, and development partners from Africa are meeting in Harare over the next two days for the inauguration and launch of the GlobalPOWER Women Network Africa.

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The conference, being attended by approximately 300 participants, is aimed at providing a strategic political platform to accelerate game changing approaches to HIV prevention and sexual and reproductive health and rights responses for women and girls. The idea to create an Africa-specific GlobalPOWER Women Network stemmed fom a September 2010 meeting in Washington DC that saw prominent female decision makers come together alongside their US peers to discuss how to accelerate the implementation of the UNAIDS Agenda for Women and Girls.

Participants at the conference are expected to address the key issues affecting girls and women in Africa including eliminating new HIV infections among children, keeping mothers alive and maternal and child health. The meeting will result in the “Harare Call to Action” to advance women’s empowerment and gender equality through HIV and Sexual and Reproductive Health and Rights responses.

President of the GlobalPOWER Women Network Africa and Zimbabwe Deputy Prime Minister, Thokozani Khupe said that women must take an active role in ensuring their empowerment.

“To achieve the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths, it is critical to recognise women and girls as key agents in making this vision a reality – society has to invest in the health of women and girls,” Khupe said.

Addressing the conference, Zimbabwe President Robert Gabrial Mugabe said the launch of the network will take the issue of women’s emancipation and empowerment a step further.

Äfter the launch, the real work will begin and call for the same passion, unity of purpose and consistency in pursuing the goals which have characterized this Women’s Network thus far. Of particular note will be the challenge of giving unstinting support to women candidates of every hue and cry; of varying professional qualifications, driven by different talents and capabilities to realise their potential in the collaborative work of Global Power Women Network, the Africa Union and UNAIDS,”said Mugabe.

In Africa, women and girls carry a disproportionate burden of the HIV epidemic – they constitute 59 percent of all people living with the disease. To make matters worse, gender inequality compounded by gender-based vioence, increase women and girl’s risk of HIV infection.

Ëmpowering women and girls to protect themselves against HIV infection and gender-based violence is a non-negotiable in the AIDS response,”said UNAIDS Executive Director, Michel Sidibe.

Pregnancy complications claim eight women daily in Zimbabwe

By Chief K.Masimba Biriwasha

Harare, Zimbabwe – Between 1 300 and 2 800 women and girls die each year due to pregnancy-related complications in Zimbabwe. This translates to eight women dying every day of the year.

According to the Zimbabwe Maternal and Perinatal Mortality Survey (ZMPMS) conducted in 2007, 725 women die per every 100 000 live births, a figure which is far higher than the Millennium Development Goals (MDG) target of 75 per 100 000 live births.

Additionally, another 26 000 to 84 000 women and girls suffer from disabilities caused by complications during pregnancy and childbirth each year.

Given such shocking statistics, it is quite laudable that the government, in partnership with international donor agencies, the private sector, civil society and individuals, is making efforts to redress the unwarranted deaths of pregnant women in the country.

As in most countries in Africa, maternal and neo-natal health services in Zimbabwe face severe resource shortages from both the public and private sector that hamper the expansion of services.

This is despite the fact that the consequences of maternal mortality are felt not only by women but also by their families and communities.

Loss of women during their most productive years also means a loss of resources for the entire society.

Yet giving birth is such an important activity in our nation that every effort must be taken to guard against the loss of life.

In fact, 50% of the deaths are due to factors which can be prevented, such as delays in seeking care and lack of effective treatment.

Pregnancy-induced hypertension, commonly known as blood pressure, bleeding after birth, and puerperal sepsis (a serious medical condition that affects a woman during or shortly after childbirth, miscarriage or abortion) also contribute to the death of pregnant women.

Conditions such as anaemia, diabetes, malaria, sexually transmitted infections, and others can also increase a woman’s risk of complications during pregnancy and childbirth, and are thus indirect causes of maternal mortality and morbidity.

In addition, Aids accounts for 25% of the deaths among pregnant women.

According to the ZMPMS, 34% of pregnant women in the country tested positive for HIV in 2007, but only 1,8% were taking ARVs with dire consequences for their own lives and their unborn babies.

The survival chances of a baby whose mother dies or is HIV-infected and not on ARV treatment are severely reduced.

Undoubtedly, the political, economic and social crisis of the past decade has had a terrible impact on the public health delivery system, significantly reducing the quality of services provided to pregnant women.

Shortages in personnel, equipment and supplies continue to plague Zimbabwe’s healthcare infrastructure, putting the lives of pregnant women at risk.

Furthermore, many women, particularly in rural areas, cannot afford the transport costs required to make frequent travels to health centres during and after pregnancy.

Most women cannot raise the fees required to consult health personnel and hence go through a pregnancy ignorant of potential life-threatening complications.

Instead, they opt to deliver at home which significantly increases chances that a pregnant woman will die, especially when the delivery requires surgical intervention, or is carried out by non-skilled persons.

Other causal factors for high maternal mortality include gender inequality and lack of women’s rights and poor sexuality education.

Like Zimbabwe, many countries in Africa will not attain the MDGs unless urgent action, political will and commitment is strengthened.

Approximately one in every sixteen women in Africa faces the risk of dying in childbirth, while thousands more face delivery-related complications and illness.

In an effort to influence African states to act on maternal and child mortality, the African Union launched the Campaign on Accelerated Reduction of Maternal Mortality in Africa in 2009.

The purpose of the campaign is to mobilise political will and action that will save the lives of pregnant women and newborn babies.

As part of the campaign, the government of Zimbabwe is partnering with international donor agencies, private companies and individual to raise funding and awareness to reduce maternal mortality in the country.

What needs to happen immediately is a thorough revamp of the public health system otherwise efforts to reach women that die from pregnancy complications will remain in vain.

Healthcare programmes to improve maternal health must be supported by strong policies, adequate training of healthcare providers, and logistical services that facilitate the provision of those programmes.

Ensuring that all women and girls have equal access to the full range of services will be key to success.
More importantly, the government needs to implement policies that promote the liberation of women from traditional, economic, legal and cultural fetters.

Female education and empowerment are critical determinants of fertility, and providing girls with access to education is likely to increase their knowledge about how to prevent pregnancy complications.

Simply put, there must be a commitment to make access to services that improve the status of women as much a part of national life as breathing air.

Cervical Cancer Kills Women in Developing Countries

By Chief K.Masimba Biriwasha

CERVICAL cancer, caused by infection with some type of human papillomavirus (HPV), is the leading cancer-related cause of death among women in developing countries.

The disease affects an estimated 500,000 women every year and kills a nearly quarter million worldwide. Eighty percent of the cases occur in developing countries where women have limited access to screening and treatment services.

“Among the most tragic public health failures of the last decade are the preventable deaths of young women in developing countries from maternal mortality and cervical cancer,” says Sue J. Goldie, a professor in the Department of Health Policy and Management at the Harvard School of Public Health.

HIV positive women are significantly more susceptible to having an HPV infection turn into cervical cancer.

This is despite the fact that there are tools available that can reverse this trend. Many governments in the affected countries have not prioritized the problem of cervical cancer in their national and health programs.

“We are now facing unprecedented opportunities to prevent these unnecessary and tragic deaths. In fact, recent concerted efforts have been made to assemble, synthesize, and interpret the available data with an eye towards actionable steps, and to comprehensively reflect on what has worked and what has not,” says Goldie. “Moreover, researchers, public health scientists, and policymakers are beginning to engage with the distinct purpose of agreeing on the most promising strategic approaches to eradicating preventable deaths in women.”

In developing countries, the vast majority of women with cervical cancer are diagnosed in late stages of the condition, and usually have little chances for long-term survival. To make matters worse, treatment for cervical cancer is rarely available even where the condition has been diagnosed.

“Unlike most cancers, cervical cancer is preventable through screening to detect and treat precancerous lesions. A conventional screening program, based on the cytological examination of cervical smears, can require up to three visits: an initial screening visit, colposcopic evaluation of abnormalities, and treatment. In countries that have been able to achieve broad cervical cancer screening coverage using cytology at frequent intervals, deaths have decreased considerably,” says Goldie.

For many developing countries, especially in sub-Saharan Africa, where poverty is endemic, and where health systems are in a state of dilapidation, cervical cancer is killing more women than necessary.

“In the vast majority of resource-poor settings such screening programs have proven difficult to implement and sustain due to a lack of human, technical, and monetary resources, and often inadequate health infrastructure,” says Goldie. “Additionally, the requirement for multiple visits, together with the need to screen at frequent intervals, has made it impossible to implement and sustain widespread organized screening in most poor countries.”

There’s need for a greater awareness of the severity of cervical cancer among women in developing countries. Also, there’s need for low-cost interventions that can be applied over a wide-scale.

Breast Ironing: Say What?

BREAST ironing, an old-age practice that is likened to the widely condemned practice of female genital mutilation, is widespread in many parts of West and Central Africa, including Cameroon, Chad, Togo, Benin, Guinea-Conakry among others.

Breast ironing is aimed to flatten the breast tissue of pubescent girls. The procedure is carried out specifically to make young women less attractive to men and boys. According to Wikipedia, the most widely used implement for breast ironing is a wooden pestle normally used for pounding tubers; other tools used include bananas, coconut shells, grinding stones, ladles, spatulas, and hammers heated over coals.

According to the UN, approximately 3.8 million or 1 in 4 girls in Cameroon alone, face the risk of having their breasts ironed often by their mothers. Unfortunately, many governments in the region do not have any policies or programmes in place to stem this heinous practices aimed at reversing pubescent growth. The onus rests on the government to empower women and make them more enlightened Continue reading

Human Trafficking for Sexual Exploitation: The Need for a Global Perspective

Across the world, approximately 200,000 women and children are trafficked each year for purposes of sexual exploitation. Currently, approximately two million women and children are held in sexual servitude. Many of them die of AIDS, other STDs, ill-health physical and psychological abuse, violence and drug abuse. A surge in public indignation supported by empirical evidence is required to put an end to this cruel form of modern human slavery. Continue reading

In Africa, Menstruation Can Be a Curse

The natural process of menstruation comes as a big problem to women and girls in many parts of Africa, contributing to both disempowerment and health risks. For young girls, menstruation is an addition to the heap of gender disparities they have to face in life.

In order to stem the flow of monthly periods, the women and girls use anything from rags, tree leaves, old clothes, toilet paper, newspapers, cotton wool, cloths or literally anything that can do the job. Most girls from poor, rural communities do not use anything at all.

Menstruation is perhaps one of the most regular individual female experiences, but in sub-Saharan Africa, the experience impacts general society negatively due to the absence of products required by women and girls to cope with menstrual flow. Continue reading

Help Me Raise A Voice For Africa’s Pregnant Women

pregnant_womanWHILE governments in sub-Saharan Africa continue to dole out money on military hardware, teargas canisters and baton sticks etc., pregnant women in the region are dying in droves due to lack of proper healthcare. Paradoxically, women and girls are the main caregivers for the sick in the absence of proper health systems. Yet when they need care the most during pregnancy it is not available, a scenario made worse by gender inequities that put the lives of women and girls at risk.

The statistics are downright shocking. In sub Saharan Africa, 1 in 16 women is likely to die as a consequence of pregnancy and childbirth, according to a recently published report titled “Measure of Commitment: Women’s Sexual and Reproductive Risk Index for Sub-Saharan Africa”.

For many women in the region, particularly in underserved remote and rural areas, getting pregnant is akin to a death sentence.

“Pregnancy is dangerous business in Sub Saharan Africa where a woman is 100 times more likely to die from pregnancy related complication than in a developed country,” states the report. Continue reading

The Great Vasectomy Fear

For most men, the idea of vasectomy, a surgical procedure to cut and close off the tubes that deliver sperm from the testicles, is a complete no-can-do associated with being sexually dysfunctional in the male psyche.

According to the latest issue of Population Reports, titled “Vasectomy: Reaching Out to New Users,” published by the Johns Hopkins Bloomberg School of Public Health, vasectomy is simpler and more cost effective than female sterilization and offers men a way to share responsibility for family planning.

“The most entrenched and powerful rumors concern manhood, masculinity, and sexual performance. Many men confuse vasectomy with castration and fear, incorrectly, that vasectomy will make them impotent,” says the report.  But in fact, “Castration involves removal of the testicles. In contrast, vasectomy leaves the testicles intact, and they continue to produce male hormones.”

The procedure which typically takes from 15-30 minutes and usually causes few complications and no change in sexual function is one of the most reliable forms of contraception. Though it does not offer protection against sexually transmitted infections or HIV, for couples it is a way for men to be directly involved in family planning. Family planning has been largely seen as the responsibility of women but vasectomies allow men to play a part.

The report states that the largest number of vasectomized men are in China, where almost 7% of women in relationships — or more than 17 million couples — rely on vasectomy for birth control. Continue reading