By Catherine Murombedzi

DANGER looms on the HIV horizon calling for a serious relook on the falling pieces of the jigsaw puzzle.
The world’s experts on HIV and AIDS gathered in Amsterdam, the Netherlands, for the 22nd Internationals AIDS Conference which ran from July 23 to 27 amid anxiety.
The conference sounded an alarm bell: ‘At the halfway point to the 2020 targets, miles to go – closing gaps, breaking barriers, entire regions are falling behind. All these need to be addressed head-on.’
In 2016, the UN raised hope with a declaration: ‘It is possible to end AIDS by 2030.’
This was tangible — the world’s 37 million people living with HIV had a new lease of life. With a cocktail of anti-HIV drugs available, the future looked bright.
The annual cost of anti-HIV medication fell from a 1996 high of US$10 000 per person to less than US$75 currently.
The anti-HIV drugs suppress the virus, forcing it to hide in reservoirs.
This meant the suppressed HIV virus was no longer transmittable.
However, interruption in taking the prescribed medicine allows the hidden viruses to mutate.
This endangers one taking the medication, making him/her contagious and risking others’ health.
The danger in the drug resistant strain is that, the one who contracted it passes it on. The strain cannot be suppressed by the US$75-a-year treatment.
Drug-resistant strains are suppressed by expensive medicines which are usually not readily available.
When one is infected with the drug resistant HIV strain, the first line drugs are no longer effective. This calls for second and third line medication which are expensive.
The United Nations joint commission on AIDS (UNAIDS) reports the drug resistant strain, if left unchecked, can result in a rise above the death toll of 22 million since 1981.
“Treatment interruption from war, glitches in transport systems, donor fatigue, patient migration, drug resistance, compounded with individuals forgetting to take medication as prescribed places a damper on the global treatment plan,” UNAIDS noted.
The other missing jigsaw piece lies in millions of people who are not aware they carry the HIV virus.
Speaking to Simbarashe Network of People Living with HIV founder, Richman Rangwani, from his Mhondoro base, all was not doom and gloom.
Rangwani urged community champions to rise and lead from the trenches.
“Most people have never taken an HIV test. They are unaware that they carry the virus. They do not see any reason to get an HIV test since they are not ill. Some people who have never taken an HIV test are unlikely to take precautions. Condom use is inconsistent (and) as a result, the global pandemic grows,” said Rangwani.
“The message seems to have drowned with HIV no longer on the agenda. Ten years ago, the radio, the newspapers and organisations drummed up the prevention message. However, I feel the message has now taken backstage as people are now comfortable (sic).
“I feel there should be no new infections. Treatment, as prevention, must be urged. All people in need of anti retrovirals must be in a position to access medication. A virally suppressed person is no longer infectious.
“My challenge lies in the numbers of people never tested. They do not know that they are at risk of passing the virus and getting drug resistant strains. As Simbarashe in Mhondoro, we still have school calls and visits to clinics urging everyone to get tested,” said Rangwani.
Donor fatigue has creeped in, with the shift now on climate change. Domestic funding needs to grow in Zimbabwe, with unemployment above 80 percent, the homegrown levy has not surpassed the US$36 million mark.
Established in 1999, the AIDS Levy is three percent of a taxable income managed by the National AIDS Council.
In 2014, the levy hit a high of
US$38,6 million and has not surpassed that. Last year, US$34 million was collected.
The Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) taken from October 2015 to August 2016 showed the country had 1,4 million people living with HIV.
The survey, a first in the country, measured the national response to uptake of services, care and treatment:
– Prevalence of HIV – 14,5 percent
– Estimated HIV incidence in 15 – 49 years – 0,4
– Estimated number of new infections
– 58 472
– Estimated annual HIV deaths –
45 621
– Number of people in need of anti-
retroviral therapy (ART) – 1.4
– ART coverage – 86,1percent
Globally, last year, one million people died of HIV-related causes, while 1,8 million were newly infected with HIV, reported the World Health Organisation (WHO).
Between 2014 and 2016, the WHO took a survey on new infections in 11 resource-constrained countries. In six of the countries, more than 10 percent of ART patients were drug resistant.
Two out of 30 HIV-positive people on ART in Zimbabwe showed signs of resistance to commonly used and most affordable drugs effavirenz and nevirapine, WHO reported.
According to WHO 2017 HIV drug resistance report, Zimbabwe is among six countries out of 11 from Africa, Asia and Latin America surveyed between 2014 and 2016 whose data showed an increasing trend of this new HIV strain.
The other five countries are Namibia, Uganda, Nicaragua, Argentina and Guatemala.
Data from the six countries, according to the report, showed they had over 10 percent of people on ART resistant to the two drugs.
With Zimbabwe having recorded
35 000 new HIV infections in 2016, the challenge of drug-resistant strain grows.