SAfAIDS’ pDTG approach adopted by Zimbabwean government
SAfAIDS’ pDTG approach adopted by Zimbabwean government
With paediatric dolutegravir (pDTG) becoming available, community health workers in the Find, Test & Treat programme in Zimbabwe were capacitated to encourage caretakers to transition their children to pDTG. With success, as they will be absorbed in the mainstream government health system. Musa Hove of SAfAIDS Zimbabwe, tells what is needed for access to pDTG for all children living with HIV as soon as possible.
The rollout of pDTG is very successful in Zimbabwe. What is the role of SAfAIDS in this rollout?
SAfAIDS comes in as a partner supporting the Ministry of Health. Our work has really been centred around capacitating health workers and community volunteers, to enable them to disseminate key information around the importance of switching children from suboptimal HIV regimens to pDTG. This capacity building is critically important because they are the bridge between the health facility and the community.
As SAfAIDS we have also included some of our models we use for demand creation at community level. We have seen from the new materials that we've developed, that mothers are really becoming receptive for their children transitioning to pDTG. So we continue to work within communities to drive the agenda of an HIV response. That is not only community developed, but it's also community owned, community led and community driven.
How do you see the government’s acknowledgement of SAfAIDS’ expertise in community work?
It makes us feel very proud. But you know, the communities themselves do a lot of the work. They soften the ground for us to be able to carry on. So in essence, any accolade that we get we also pass that through to the communities because without them, we won't be able to do this work.
An article about the rollout of pDTG in Zimbabwe was recently published in The Lancet. Learn more about the government’s perspective on the national rollout of dolutegravir to children here.
In terms of advocacy for pDTG, what would you say is necessary at the moment?
We could capacitate all the health workers, but at the end of the day it's up to the caregivers, the mothers to be able to dispense medication and ensure that their children get their treatment. So some of the fundamental things that we've got to look at is treatment literacy at community and caregiver level. To roll out an extensive treatment literacy programme, that has mentorship and ongoing support to ensure that we also include pDTG, in the day to day work that they do.
What do you see as most successful in the Find, Test & Treat programme?
We started on this journey to achieve very huge milestones and we have achieved so much together. The partnership has grown from strength to strength. We recognise those efforts, but also hope that in the not too distant future, we can continue working in Zimbabwe to find, test and treat all missing children living with HIV.
One of the key things as the legacy of the Find, Test & Treat programme is capacitated health workers who will be absorbed into the mainstream health system by the government. We know that definitely with their skills and knowledge, we will continue to see children being born and living through the first years of their lives harm free.
The perception is that Zimbabwe is thriving. What is the state of affairs after COVID-19?
There has been a rolling back of a lot of the gains that were made prior to COVID-19. Vertical transmission has increased from about 5.4% to 8.4%. So clearly there's an increase in children testing positive. It's important that even though Zimbabwe is doing better than most countries, we should remember we also have targets to achieve. We have an elimination strategy within the vertical transmission programming. Now is not the time for us to reduce the momentum. Now is the time to actually increase the momentum so we can achieve those 95-95-95 targets and also prepare the country towards the path to elimination and eventually validation through the WHO. We need to be ready and be responsive to some of these acts that we otherwise would not have prepared for.
The Find, Test & Treat programme
Musa Hove is the Country Representative for SAfAIDS in Zimbabwe. Musa oversees all Zimbabwe Country programme operations, ensuring that they are effective in responding to the needs of communities.
As long-term partner of Aidsfonds, SAfAIDS has been involved in the prevention of mother-to-child transmission as well as paediatric HIV programming in Zimbabwe. Since 2018, SAfAIDS has collaborated with the Ministry of Health and Child Care to carry out the Aidsfonds funded Find, Test and Treat community-based programme across 3 high priority districts.