1. HIV PREVENTION TARGETS FOR ZIMBABWE
Presented by: Tapuwa Magure
National AIDS Council

2. Presentation Outline Background: Discussion Paper 2
National Prevention Target Setting Process in Zimbabwe
National Impact and Programme Targets for 2020
Zimbabwe Score Card

3. Discussion Paper 2
National Prevention Targets and Improved Accountability

4. Issue Statement
Establishing targets and then monitoring progress remains a powerful motivating tool in the global AIDS response
‘What gets measured gets done’
Monitoring progress against targets & accountability: used successfully for HIV treatment and to achieve major reductions in new HIV infections in children

5. Moving from Global to National Targets
Achieving national targets will require a supportive environment that encourages and allows for the adoption of safer behaviours and the use of prevention services and commodities.

6. KEY GAPS
Gaps in baseline data
Gaps in routine monitoring of prevention programmes
Gaps in national and international accountability

7. Key Considerations for a Strengthened Response
Defining priority locations and populations
Establishing effective systems for monitoring HIV prevention
Prevention cascades

8. Recommendations from Discussion Paper 2
Set national HIV prevention targets that reflect the global targets and the local epidemic
Designate or re-confirm the entity responsible for coordinating and implementing prevention programmes, and hold the entity accountable for achieving the targets
Establish routine monitoring systems to track programme performance
Review progress against key national and global targets, using information provided to UNAIDS by Global Prevention Coalition Member Governments
Key prevention programme performance indicators should be harmonized between partners

9. National Prevention Target Setting Process
Review of ZNASP III results 2015 (programme & survey data)
Development of extended ZNASP III to 2020
Development of GF Concept Note
Prevention target setting Regional Meeting
Participation – GoZ multi-sectoral, civil society, funders, development partners
Review of Global Targets – against ext. ZNASP III & GF concept note
Consultation – national, all stakeholders

10. Targeted reductions by 2020
Impact indicators (1)
Baseline, 2010 & 2015
Source: HIV Estimates & ZIMPHIA, 2015
Global Target
Against 2010 Baseline
National Target (ZNASP III against 2015 baseline)
Targeted reductions by 2020
75%
50%
Number of new infections
2010: 63,000
(15-49)
2015: 32,000
(15-64)

11. Impact indicators (2) 2. HIV incidence among women 15-24 2010: 1%
2010: 1%
Baseline, 2010 & 2015
Source: HIV Estimates, 2016
Global Target
Against 2010 Baseline
National Target (ZNASP III) against 2015 baseline
Targeted Reductions By 2020
75%
50%
2. HIV incidence among women 15-24
New infections reduced by 50% by 2020 against 2015 baseline
Target 2020
3. Number of new infections in children (0-14)
2015: 0.56%
New infections in KP: Methodology for tracking under development (UNAIDS)

12. Coverage Key Populations: Sex Workers
Baseline, 2015
Global Target
Against 2010 Baseline
National Target (ZNASP III)
Targeted Coverage 2020
90%
of FSW
reached with combination prevention interventions (outreach & condoms)
5. Reached in last 3 months + given condoms
4. Pop Size Sex Workers
48,000 (population size estimate - draft)
Baseline 2015
Same as 2015 (expected to be more accurately measured)
Target
2020
33 %
of FSW

13. Service availability (1)
7. No of dedicated sites providing services to sex workers
40 dedicated sites for FSW (36 NAC/UNFPA/CeSHHAR and 4 FACT)
Baseline 2015
40 sites (maintain coverage, intensify services & mobilisation
Target
2020
10 static clinic sites (Harare, Karoi, Bulawayo, Masvingo, Gweru, Mutare,Nyamapanda, Chirundu, Victoria Falls and Beitbridge)
and 20 outreach clinic sites
GF Performance Framework/ Concept note
MSM – Very low coverage in 2016 with less than 200 reached through prevention interventions. GF support aims at increasing reach to 7,000 in 2018 and 10,000 in 2020.
Funding Gap for 10 current outreach sites from 2018

14. GF Performance Framework/
Service availability (2)
11. Number of PrEP sites
7 outreach sites for PrEP (Sex workers – CeSHHAR, PSI)
Baseline 2015
No. of districts offering PREP 62/62 (100%) by 2020
Target
2020
10 fixed sites for sex workers as well as up to 20 outreach sites.
6 fixed sites for MSM (Harare, Bulawayo, Masvingo, Gweru, Mutare and Victoria Falls)
GF Performance Framework/
Concept note
PreP initiation among FSW and MSM by Dec 2016:

15. 14. No. of condoms distributed/sold (millions)
Consistent with needs estimate for Zimbabwe from Global Condom Fast-Track tool (38 condoms per man aged 15-64)
34 pcs per sexually active male
40 pcs per sexually active male

16. Voluntary medical male circumcision
16. No. of VMMC conducted (all age groups)
Cumulative 636,911 ( VMMC Programme Data)
Baseline 2015
Target of 1,420,065
( )
Target
2020

17. Coverage : Adolescent girls and young women
Indicator
Baseline 2015
Target 2020
GF Performance Framework/CN
17. No. of high-incidence districts
 26 ( source: Hotspot mapping report,2015)
Reduce by 50% the number of high incidence districts.
18. % high-incidence districts covered with comprehensive programmes
 0%
50% (need to define comprehensive programs)
30 hot spot districts covered with DREAMS (4 districts), Sista2sista (30 districts), SASA Model (4 Districts) and One Stop Centres (6 Districts).
19. % girls completing lower secondary education
63.1 % MICS, 2014,
 80%
20. % condom use at last sex with non-regular partner
 50% female 15-24,
81% male (Source: ZDHS 2015)
 90%
Mention prevention financing – national and global target 25%, Reality in GF is around 10%

18. Engaging with the draft global score card
Scorecard was shared with the country in preparation of prevention coalition
Inputs were found to be based on country data & reporting (minor updates required)
Reviewed trends emerging from the scorecard

19. Identified
strengths
areas for improvement
data gaps

20. Insights from score card
Provided a snapshot of HIV prevention situation
Incidence reduction largely on track for 2020
Good progress in condom promotion, SW programs
Despite scale up of VMMC, progress relatively slower at population-level than in some other countries
Data gaps on some key populations
Potential for country-to-country support within the region
Sharing of country practices on condom programming, sex work programs
Learning from progress in VMMC in highest-performing neighbouring countries

21. Summary
National target setting is possible - even in resource constrained environment (participatory & evidence-based)
Challenges: Data gaps for some baselines and key populations (Size estimates & IBBSS only done for FSW)
Translation of global targets into national targets requires balance between ambition and resources / capacities
What get’s measured gets done!
Response not possible without sustained partner support

22. Thank You!!!