In our series on PITCH Country Focal Points, Lloyd Dembure shares what he hopes to achieve with his partners before the end of the programme.

What are the top advocacy successes achieved in PITCH in your country to date?

 

In Zimbabwe, PITCH has amplified recognition and meaningful participation of KP networks in influential national health and development spaces. Implementing partners Sexual Rights Centre (SRC), POWWOW, and the Zimbabwe Sex Workers Alliance were, for the first time, exhibitors at the 2018 Zimbabwe International Trade Fair, aiming to reach out to the public about the needs of sex workers. This was after failed attempts in previous years. This breakthrough signals a new era and beam of hope for KP networks to continue challenging the status quo so that their voices are heard. LGBTI representatives GALZ and SRC were part of the Global Fund grant writing process for the first time. Also, for the first time, $2m was awarded for MSM-focused interventions, with GALZ and SRC being the implementing partners. The interventions include peer support activities as well as establishment of MSM drop-in centres in Harare, Bulawayo, Masvingo, Gweru, Mutare and Karoi.

This presents an exciting opportunity to broaden MSM-programming and help to transform the negative and stigmatising narrative that has for long defined the issues around MSM in Zimbabwe. In 2018, implementing partners SAfAIDS, GALZ, ZCLDN, SRC, Powwow, BHASO and ZIMSWA contributed to the development of the Ministry of Health Key Populations training manuals for service providers and minimum service package as technical experts. The manuals have since been reviewed by the KP technical working group and are nearing finalisation. The guidelines present a good opportunity to redefine a public health delivery system that is KP friendly.  

Another important achievement has been improved access to sexual and reproductive health and rights and justice for sex workers. PITCH partners such as SRC, POWWOW, ZIMSWA, SAfAIDS and BHASO have empowered sex workers on advocacy and rights literacy that has enabled them to engage with service providers and challenge human rights violations, such as police harassment and unlawful detention. In Masvingo, during first half of 2018, there was 35% upsurge of sex workers accessing HIV testing and PrEP with the hard to reach young sex workers also benefitting. Interestingly, the empowered sex workers were at the forefront directly engaging with service providers and demanding PrEP and other SRH services. Following rights literacy campaigns by SRC and partners in Bulawayo, there has been significant decrease of reports of unlawful detention of sex workers with no reported incidence during the first half of 2018, which marks a decline from the 12 cases reported in 2017.

Who are your two most important allies and why?

 

The National AIDS Council (NAC) is the national coordinating body with an oversight over HIV management in the country. PITCH partners have always relied on its guiding role in implementation of activities and reaching out to policy makers. NAC has played a supportive role in bridging the gap between government and civil society organisations through facilitating invitations of high profile decision makers which has positioned CSOs to influence HIV/AIDS planning, monitoring and policy processes.

The Zimbabwe AIDS Network (ZAN) is also another key partner that PITCH relies on. ZAN is an umbrella body of AIDS service organisations and has also been instrumental in improving collaboration and coordination of CSOs through the Advocacy Core Team. It has enabled civil society organisations to define inclusive advocacy asks that were tabled to strategic committees such as the Country Coordination Mechanism (CCM), where ZAN has a seat as a representative of CSOs.

Name one thing that has surprised you in PITCH since you started your role?

 

PITCH has inspired partnerships within diverse communities to influence change. Notably GALZ partnered with Zimbabwe National Network of PLHIV (ZNNP+) in 2017, which saw GALZ utilizing ZNNP+ provincial structures to distribute lubricants to its members. SAFAIDS has also partnered with champions of change from the religious sector and parliamentarians to address stigma and promote acceptance of KPs. SRC has partnered with human rights lawyers , a partnership that has strengthened the capacity of the organisation’s paralegal department to empower sex workers and saw tremendous decline of reported human rights violations of sex workers. 

What is the most important global and/or national policy event for your country in the next year?

The Zimbabwe National Adolescent and Youth Sexual and Reproductive Health (ASRH) Strategy (2016-2020) identifies the need to harmonise policy and legal framework to facilitate implementation of ASRH programmes. It recognises inconsistencies in the law in defining a child, the age of consent to sex and consent to marriage and continues to pose problems to both young people and service providers. The National Guidelines on HIV Testing and Counselling set 16 as the age of consent for HIV testing and treatment services. It stipulates that the consent of a parent or caregiver is required before performing an HIV test on a child who is below 16 years of age. Though the guidelines do provide exceptions in cases where children are considered mature minors, it does create perverse situations. Interestingly, the Ministry of Health recognises Zimbabwe as being one with the highest infection rate in sub Saharan Africa. According to ZDHS 2015 data, while 15.2% of women aged 20-24 never tested, this rises to 52.1% for adolescents aged 15-19. This indicates that seeking an HIV test may be more difficult for young people than adults. Given this background, the government in 2019 has prioritised the alignment of the laws with the 2013 Zimbabwean constitution. This provides the opportunity to lobby for removal of age restrictions in accessing SRH services, which has negatively impacted on young people accessing SRH services.

Name one thing you have learned through working in PITCH that you didn’t know before

 

One thing that I have learned in PITCH is to always be innovative and be on the look-out for key opportunities to drive advocacy results. PITCH partners have demonstrated their relevance through proactive engagement in advocacy spaces, such as Global Fund grant making, PEPFAR COP process, HIV technical working groups and fora to influence resource allocation, targeting and development of national tools and guidelines. Partners have strategically positioned themselves within various boards, such as the Country Coordination Mechanism where Zimbabwe Young Positives have gained a seat. In the meantime, new advocacy player Zimbabwe Civil Liberties and Drug Network have managed to influence national agenda on drug policy reform and harm reduction, that have seen government reportedly working on drug masterplan. 

What is the most important change you hope to see in your country before the end of PITCH?

 

In Zimbabwe, KPs have been reeling under stigma and discrimination through punitive and discriminatory policies and laws, which prevents them from accessing HIV prevention services. Since the launch of PITCH, efforts have been made by partners to change the perception of the KPs through targeted advocacy to key decision makers in the national HIV response. As a result, guidelines and tools have been developed for and with KP participation in order to promote access to HIV services for the KPs.

It is my hope that before its end, the project will inspire the creation of an enabling environment characterised by increased tolerance and reduced stigma towards KPs in public health delivery systems which will enable them to access relevant health services.