Development Health Legal and Parliamentary Affiars

Government working towards eliminating mother-to-child transmission of HIV, syphilis

Dr. John Mangwiro (R) officially opening the workshop in Harare

Jairos Zondai (not real name) graduated with a degree in veterinary sciences from the University of Zimbabwe at 24 years of age. His mother, a widow, sent him to school as a single parent because his father succumbed to HIV while he was nine years old. Jairos was born with HIV.

“I was born with HIV so I had occasional moments of being admitted in hospital because of ill-heath. I would miss classes most of the time. Thanks to God the Almighty, I was gifted with a high IQ hence I would catch up with others through elongated days of serious studying. Most of the time I was the best student throughout my academic career,” Jairos told Spiked Online Media at the beginning of this year.

This publication learnt with shock last week that Jairos had succumbed to HIV at the age of 30, just four years after completing his university studies and after only two years of formal employment.

However, the government is putting concerted efforts towards the elimination of mother-to-child transmission of HIV and syphilis, Vice President General Constantino Chiwenga who is also the minister of health and child care has said.

In a speech read on his behalf by his deputy in the same ministry, Dr. John Mangwiro on the occasion of the 4th Quarter National Validation Committee Meeting on the Dual Elimination of Mother-to-child Transmission of HIV and Syphilis held at the Rainbow Towers Hotel in Harare today, VP Chiwenga said more than 90 percent of infections among children occur through mother-to-child transmission.

“Of the 38 million people living with HIV in the world, one million three hundred and fifty six thousand are Zimbabweans. It is sad to note that eighty-four thousand two hundred and ninety five of people living with HIV are children between the ages of zero and fourteen years. More than 90 percent of these children were infected through mother-to-child transmission,” VP Chiwenga said.

He bemoaned the fact that HIV infections are still occurring in children yet there are interventions and antiretroviral medicines to prevent HIV transmission by mothers to their children.

According to the United Nations AIDS report released in July of 2020, the world is off-target in meeting the global 2020 targets. The situation has been made worse by the COVID-19 pandemic. This pandemic resulted in collateral damage as essential services for women and children were negatively impacted.

“Our womenfolk must visit health care facilities to receive antenatal care and delivery services, to prevent mother-to-child transmission of HIV and syphilis. Children should also receive post-delivery care.”

The World Health Organisation has come up with initiatives for countries to eliminate mother-to-child transmission of HIV and syphilis. Zimbabwe embraced the initiative since it is determined to reduce mother-to-child transmission to less than 5 percent. According to United Nations AIDS and HIV Estimates, the mother-to-child transmission is still high at 8. 17 percent in 2019.

According to the World Health Organisation Criteria, 95 percent or more of pregnant women need to book their pregnancies and 95 percent or more should be tested for HIV. Meanwhile, more than 95 percent of pregnant women who are HIV positive should be initiated on antiretroviral treatment. To eliminate congenital syphilis, less than 50 new cases of congenital syphilis should occur for every hundred thousand live births.

Paidamoyo Bryne Saurombe, the Projects Lawyer in charge of Litigation at the Zimbabwe Lawyers for Human Rights said a key consideration for validation of a country for eliminating mother to child transmission of HIV and syphilis is that for the interventions to reach the targets, they have to be implemented in a manner consistent with international, regional and national human rights standards.

These standards include human rights in relation to autonomy in decision making, informed consent, respect of privacy and confidentiality, freedom from violence, abuse, and coercive practices, and meaningful participation. 

He said Zimbabwe was the first African country to enact an HIV-specific criminal law, including it in the Sexual Offences Act of 2001. The law sought to address violence against women and made it criminal of anyone diagnosed HIV positive who “intentionally does anything or permits the doing of anything” which (s)he “knows will infect another person with HIV.”

The sexual offences law was amended in 2006 through the enactment of the Zimbabwe Criminal Law (Codification and Reform) Act, 2004. The new Act includes two HIV-specific provisions.

“The first is the section (79), erroneously titled “Deliberate transmission of HIV”. Despite its title, section 79 does not require HIV transmission or for an accused to have an intention to transmit HIV: only that they undertake an act that includes “a real risk or possibility” of transmitting HIV. Further, section 79 can be applied to anyone who knows they have HIV or who realises “there is a real risk or possibility” they might have HIV.

“The broad terms of the law means it is applicable in a wide range of circumstances including when HIV is not diagnosed, and HIV transmission is not intended or deliberate. In fact, the section does not require HIV transmission. The law does provide for a defence if the HIV-negative partner knew the accused had HIV and consented to the act while appreciating the nature of HIV and the possibility of transmission,” Saurombe said.

The second HIV-specific section is section 80 which provides for increased penalties if a person convicted of a sexual offence is found to be HIV-positive, whether or not the accused knew they had HIV at the time of the offence.

In July 2019, Zimbabwe’s government moved to repeal section 79 of the Zimbabwe Criminal Law (Codification and Reform) Act through the recently gazetted Marriages Bill. This move is informed by global thinking that suggests that criminalising HIV and AIDS stigmatised people with HIV and AIDS.

As of October 2020, there have been at least 17 HIV criminalisation cases, giving Zimbabwe the highest number of HIV prosecutions in sub-Saharan Africa.

About the author

Byron Adonis Mutingwende