Zimbabwe has over the last decade written a fairy paediatric treatment tale, having accomplished a large chunk of success, raising hope of ensuring universal coverage for children to meet the 2030 targets.
Eliminating paediatric HIV cannot be accomplished in a day or even a year.
It requires concerted efforts on many fronts with government, civic society and community leaders all pulling together.
Parents-to-child transmission remains the second most common route of HIV transmission in Zimbabwe and the highest cause of HIV infection among children.
Improving the health and wellbeing of people, especially children is at the core of the Sustainable Development Goals (SDGs), reflected in targets that call for ending the epidemics of Aids, tuberculosis, and malaria; achieving enormous improvements in maternal and child health; and tackling the growing burden of non-communicable diseases.
Attaining universal health coverage is the means by which these ambitious health targets are to be achieved.
The Centre of Excellence, a model that is being facilitated by the Aids Health Foundation (AHF) is among a cocktail of HIV intervention programmes that have been incorporated in the national HIV response strategy.
The Centre of Excellence model is among services established at major general hospitals across the country with the aim of providing quality and affordable healthcare services for people living with HIV.
AHF is supporting the government to scale up early testing of HIV-exposed infants and ensure rapid return of test results by integrating new point-of-care testing technologies into national laboratory networks.
Since establishment hundreds of children living with HIV have been receiving care and treatment at opportunistic infection clinics across the country, thanks to the Centre of Excellence.
“Our Centres of Excellence model offers services to both adults and paediatric patients. Most of our Centres of Excellence are manned by medical officers who have extensive experience in HIV care and treatment. They are able to attend to the paediatric patients and offer quality service to the little ones,” said AHF country manager Ernest Chikwati.
“In some centres, we also have consultant paediatricians who offer mentorship to doctors and nurses on the management of paediatric patients. Same for adult patients, we have some specialist physicians supporting our centres.”
Chikwati said they initiate children on treatment and monitor them until they become adolescents and help with their transition to the adolescent clinic.
Chikwati said children living with HIV should have access to timely diagnosis and effective, child-friendly, antiretroviral treatment and care to ensure continuous viral suppression.
He said the Centre of Excellence facilities have started working closely with the maternity departments to ensure that exposed babies are attended to and get their confirmatory test as soon as possible.
“This is in response to the challenge of high mother to child transmission of HIV in Zimbabwe that remains above the target of 5%. There are plans to have our centres of excellence staff support the maternity staff in managing exposed babies. This will come in the form of training and capacity building,” Chikwati said.
“More needs to be done to reduce the transmission of HIV from mothers to their babies. One area that needs urgent attention is the issue of user fees for pregnant women. This needs to be scrapped because it's now acting as a huge barrier to pregnant women accessing antenatal services.”
Chikwati, who is a medical doctor, said if HIV positive women attend antenatal service early, they are put on antiretroviral medication early, and their virus will be suppressed, hence reducing the risk of HIV transmission to their babies.
Tuberculosis, pneumonia and severe bacterial infections are the main causes of hospital admission in HIV-infected children.
Of the 1, 37 million children aged 0-14 living with HIV globally; only 57% were receiving life-saving ART in 2023.
Globally, children under age 15 account for about 3% of all people living with HIV, 9% of new HIV infections and 12% of all Aids-related deaths.
Children under one year of age are among those most vulnerable to HIV.
Chikwati said early initiation of antiretroviral drugs in infants with HIV could save lives.
Meanwhile, Chikwati said women constitute the large chunk of clients at The Centre of Excellence facilities across the country.
In Harare AHF have established Centre of Excellence facilities at Parirenyatwa and Sally Mugabe central hospitals as well as Glen View Poly Clinic and Chikurubi Maximum Prison Clinic where they support with technical and resources for HIV treatment and care services.
Other Centre of Excellence facilities are at Gweru General Hospital in the Midlands province and Mpilo Central Hospital in Bulawayo.
