The early years of HIV and Aids

Forward Nyanyiwa
Barely five-years-old and emerging from a protracted liberation struggle, Zimbabwe found itself fighting a different kind of war.

It was in the autumn of 1985 that Zimbabwe recorded its first HIV and Aids case.

Government moved set up a surveillance system, and a hospital in Hurungwe was chosen to monitor the spread of the virus.

In this district, cases increased expontentially from 19 in 1986 to 290 in 1987, 433 in 1988 and this was ravaging mostly people in the 17-30 years age group.

Across all spheres, HIV made itself felt: in sports, music, politics, rural communities, affluent suburbs – none were spared.

It was a challenge that Dr Timothy Stamps – who took over the Health Ministry from Dr Felix Muchemwa in 1990 – would have to contend with for a major part of his public service.

“The biggest problem was denial and somehow, it was understandable because this was a new phenomenon. Health workers were putting on protective clothing when attending to infected patients and that is how stigma was sown.

“I played a pivotal role, educating the health workers that this was just a disease which we could contain, but understand me, it was not that easy,” said the affable Dr Stamps in a recent interview.

Now Health Advisor in the Office of the President and Cabinet, Dr Stamps went on: “There was a lot of confusion among those who were supposed to preach about the disease and fight stigma, especially one renowned journalist and publisher (name withheld) who was the son of a nursing sister in a TB hospital.

“He promoted the idea that HIV and Aids was an American invention to prevent sex and he popularised the saying ‘American Invention to Dissuade Sex’ (Aids). Unfortunately, his death was a result of a defaulted TB treatment and suggestive HIV symptoms.”

Pivotal in fighting stigma was HIV and Aids activist Auxillia Chimusoro, now late.

In a televised interview in 1989, Chimusoro revealed to the world that she was HIV positive. She received a lot of brickbats – but also drew a lot of praise and set the tone for the battle against stigma.

Soon, a support group was started and she became an internationally acclaimed HIV and Aids activist until her death in 1998.

David Mankaba, the bass guitarist with the famous Biggie Tembo-led Bhundu Boys, was one of the first local celebrities to reveal he was HIV positive.

These early years of HIV and Aids were marked by much denial.

“Yes, ministers have tended to shy away from the issue because it seemed contaminated. There were a lot of emotions about the condition which led to unnecessary loss of lives, but we continued to educate our people. Traditional healers also weighed in, inventing ways of fighting the disease but our major thrust was on prevention,” recalled Dr Stamps.

But with time most people began to accept reality and see the bigger picture; and Government in 1999 created the National Aids Council through an Act of Parliament. In January 2000, the Aids Levy was introduced, and companies and workers started being taxed three percent of income to help fund HIV and Aids interventions.

The year 1999 also witnessed the major landmark of the State’s prevention of mother-to-child transmission (PMTCT) initiative following a visit to Uganda by a high-powered Zimbabwean delegation on a fact-finding mission on how to combat the pandemic.

“I preferred to call it prevention of verticle transmission of the condition but it seems PMTCT had caught on. The reason I did not like PMTCT was because it brought about stigma to the mothers and we debated with my colleagues but it, however, carried the day.

“There were many factors then, the issues to do with exclusive breastfeeding and confusing Zidolam (AZT) short course,” Dr Stamps added.

With PMTCT, expectant mothers started getting Nevirapine during delivery and a short course of AZT for a month after birth. Those who would have visited the health centres early and found to be positive would get AZT at 36 weeks of pregnancy as a short course.

Dr Owen Mugurungi, director of the Aids and TB Unit in the Health and Child Care Ministry, said although the PMTCT was effective, the short course was confusing.

“The PMTCT was a noble programme which was effective as it helped reduce transmission by almost 50 percent. Even a university graduate would not comprehend the doses and their times. That the mother was taking a different drug from the child made the situation worse hence we had to switch to Option B+,” said Dr Mugurungi.

However, a generation of people had missed PMTCT; those born from 1986 to 1998.

“That is very unfortunate and disturbing because from the time the first case was reported up to 1999 when we introduced PMTCT, there were no medications and we preached condom use and abstinence.

“Some people remained sceptical and they continued with unprotected sex and now the children born that period are now adults and they can’t understand how they got infected,” Dr Mugurungi said.

With Government chasing the 90-90-90 targets by 2020, Dr Stamps feels major successes can be achieved with the right financing and for as long as people live by the gospel of “mutually faithful life-long partnerships, abstinence and correct condom use”.

“We can achieve the said targets if the ministry continues with the gospel of behavioural change. During my time, we pushed for abstinence and mutually faithful lifelong partnerships and this should be hammered home,” Dr Stamps said.

He hailed NAC’s mighty effort in dealing with HIV and Aids, adding “… we have made major strides in combating the once deadly virus. We can safely reach our goal of eradicating the condition by 2030”.

But for this to happen, the former Health Minister said, it was important for Government to monitor drug resistance and continue educating the public on prevention and treatment.

“The new HIV drug-resistant strain can derail all the progress that has been made so far but I don’t think it can be a problem if managed well.

“Again it is preventive all the way, we should monitor those with resistance and plan accordingly. We have the capacity to handle it,” he advised.

Zimbabwe’s progress towards the 90-90-90 targets (ages 15-64 years) currently stands at: 74 percent of people are now aware of their HIV status; 87 percent are on treatment; and 86 percent are virally suppressed.

UNAids 2017 estimates are 1,3 million Zimbabweans are living with HIV, with an adult prevalence rate of 13,5 percent.

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