Zimbabwe's economy is mainly agro-based. The formerly strong commercial farming sector was greatly affected with the expropriation of white-owned farms that began in 2000, and the replacement of large efficient farms with smaller ones worked by inexperienced farmers. The government's land reform program, characterized by chaos and violence, badly damaged the commercial farming sector, which traditionally was source of exports and foreign exchange. The agricultural sector used to offer about 400,000 jobs which have been lost due the land reform. Formerly an exporter of foodstuffs, Zimbabwe now must import grains. However the land reform has improved subsistence farming at the expense of commercial farming. Corn is the chief food source, and cotton and tobacco the principal cash crops. Other products include wheat, coffee, sugarcane, and peanuts. There are also tea plantations in the country; dairying is important in the highveld. Cattle, sheep, goats and pigs are raised.
Forests also contribute to the economy Zimbabwe with huge plantations in the eastern parts of Zimbabwe. The country is endowed with a wide variety of mineral resources, and there is extensive mining (coal, gold, platinum, copper, nickel, tin, clay, chromium ore, and iron ore). Recently diamonds have been discovered in Zimbabwe and if properly mined will go a long way in improving the economy of Zimbabwe. Industry in Zimbabwe produces a lot of products which are available for export. These include steel, wood products, chemicals, fertilizer, clothing and footwear, foodstuffs, and beverages. The power supply for Zimbabwe is generated by a hydroelectric station at Kariba Dam on the Zambezi River. The power production at the station is not enough for the economy and of late Zimbabwe has been importing electricity from neighboring countries.
The country has good road and rail networks and domestic and international air service. National Railways of Zimbabwe is responsible for operations of railway network and Air Zimbabwe for air services. The main exports are cotton, tobacco, gold, ferroalloys, textiles, and clothing. Imports include machinery, transportation equipment, manufactured goods, chemicals, and fuels. South Africa is by far the largest trading partner, followed by China, Japan, and Zambia. Due to economic sanctions minimal trading has been taking place between Europe and United States.
The economy of Zimbabwe has shrunk significantly after 2000, resulting in a desperate situation for the country and widespread poverty from among others 94% unemployment. This has been mainly due to participation in DRC war and later strained relations with the West after land reform programme. The power-sharing government formed in February 2009 between rival political parties has led to some economic improvements, including the cessation of hyperinflation by eliminating the use of the Zimbabwe dollar and removing price controls. The economy is registering its first growth in a decade, but will be reliant on further political improvement for greater growth. Though Zimbabwe has been having other problems which negatively affected the economy the presence of HIV & AIDS pandemic has worsened the impact
3.0 Impact of HIV & AIDS on the National Economy and Sustainable Social Development.
HIV & AIDS has impacted negatively on the national economy of Zimbabwe and at the same time compromising social development. The author will discuss how each sector of the Zimbabwean economy has been affected together with how social development has been compromised.
3.1 Agriculture
One of the main impacts of HIV & AIDS on agriculture is its on food security. A survey carried out in 1997 in Zimbabwe, a country with an adult prevalence rate of more than 25 per cent, estimated production loss in AIDS-affected households. The survey, conducted by the Zimbabwe Farmers' Union, found that agricultural output decreased by nearly 50 per cent in the households affected by AIDS (Kwaramba, 1997). Maize production by smallholder farmers, and commercial farms declined by 61 per cent as a result of illness and deaths from AIDS. Those production losses could result from various factors, including change in production patterns.
In Zimbabwe, commercial farming sector is the major source of food production and security. Commercial agriculture operates on a strictly profit-making basis. Thus HIV/AIDS will affect commercial farms in the same way it will affect business firms. The farmer will have increased costs will in the following areas paying employee benefits, staff turnover and recruitment, training, funerals etc. The level of these costs will be depend on skill level of affected farm workers and the type of contract, as full-time workers receiving more benefits such as funeral
assistance, pension, and widow support. If casual labourers are the most affected, and
seasonal labour peaks are less marked; farmers may not experience much disruption
to productivity.
HIV& AIDS also affect livestock production, due to frequent funerals that reduce labour input and associated responsibilities, such as herding and management. This failure to herd results in increased thefts and cattle deaths. Forced sale of livestock occurs to raise cash for medical and funeral expenses, often to middlemen, at highly compromised prices. Besides disposal of living 'assets or savings', key production implements, such as ploughs, cultivators, scotch-cart and wheelbarrow, are often sold off ( Ncube ,1998)
3.2 Health.
In Zimbabwe HIV & AIDS has affected the health sector in two various ways:- it has greatly increased number of people seeking services and the healthcare cost of HIV & AIDS patients since their care is more expensive as compared to other conditions. The cost is mainly due to laboratory tests and medications. The government has tried to subsidize some the cost so as to increase the number of patients getting HIV &AIDS care .The government has now faced with a difficult scenario: treating HIV &AIDS versus preventing HIV infection; treating HIV& AIDS versus treating other illnesses; and spending for health versus spending for other economic activities (Bollinger etal, 1999:8). The total budget allocated to health will be which makes other areas suffer at the expense of health. Maintaining a healthy population is very crucial for a country for the development of a productive workforce essential for economic growth.
3.2 Commercial Firms.
HIV &AIDS has significantly impacted commercial firms in Zimbabwe. Illnesses and deaths related to HIV & AIDS has affected commercial firms by increasing expenditures and reducing revenues. The increase in expenditures is due to recruitment, health care costs, training, burial fees and replacement of lost employees. The decrease in revenues is because of absenteeism which might be due to illness, attending funerals or time spent on training. High labor turnover leads to a less experienced and qualified labor force that is less productive (Bollinger etal, 1999:9).In poorly managed situations the HIV & AIDS -related costs to commercial firms can be very high. With proactive management these costs can be cut through effective prevention and management strategies. The commercial firms have responded differently to HIV & AIDS pandemic. In Zimbabwe only a few companies have implemented the workplace HIV & AIDS policies.
3.3 Transport.
The transport sector is highly vulnerable to HIV infection and it is very important for the sector to implement prevention strategies. Construction of transport infrastructure often involves having mobile teams of men and women working away from their families for long periods of time. This increases the chances of multiple sexual partners. This is very common with the District Development Fund workers in Zimbabwe responsible for road construction. They spent a lot of time camped in local villages and at same time having local partners.
The long distances truck drivers have be very vulnerable to prostitution which is rampant in highways of Zimbabwe. In Zimbabwe the National Employment Council in the Transport Operating Industry (NECTOI) has introduced an HIV & AIDS policy targeted to the transport industry. Some of the recommendation of the policy is to allow truck drivers to travel with their wives, promotion of condom use and establishment of testing centers along the highway (Loewenson et. al, 1999)
3.4 Mining.
The mining sector is a key source of foreign exchange in Zimbabwe. Most mine workers stay far away from their families which force the workers to be apart from their families for long periods of time. In some of these mining communities there are no entertainment facilities and workers often resort to commercial sex work. A lot of these workers contract HIV later pass it on to their spouses and communities on returning back home. The infected mining workers might also affect mining productive. Loosing mining engineers due to HIV & AIDS can be very difficult and expensive to replace. As a result, a severe AIDS epidemic can seriously threaten mining production. In 1994, Anglo-American assumed that given the age structure of their workforce 25% was HIV positive; current estimates, however, are not known (Bollinger et.al 1997:11). In order to meet their long-term human resource needs the company resolved to adopt abroad multi-skilling approach. Multi-skilling requires a detailed and comprehensive analysis of all human resources involved.
3.5 Education.
In Zimbabwe the HIV &AIDS pandemic has also affected the education sector. The supply of experienced educators has been greatly affected by AIDS-related illness and death. Most of the schools are covered by temporary teachers who are not qualified enough. A lot of children are not going to school because they are at home caring sick family members or working in the fields. Some children have even dropped out of school because their families won't be able to pay school fees due to absence or reduced household income as a result of an AIDS death. Children are also very susceptible to HIV infection through caring of sick family, abuse and early sexual debut. Due to these problems, the education system needs to educate children about AIDS and equip them to protect themselves. In Zimbabwe HIV & AIDS has been implemented to be part of the curriculum so that the issue is introduced at an early age.
3.6 Household Impacts and Implications.
In Zimbabwe almost each and every family has been affected with the HIV & AIDS pandemic it is at the level of the family and community that the fullest impacts of the HIV pandemic is unraveling. One such ramification is AIDS related poverty among households. The most vulnerable people are the most economically active and as these economical active people die, families are struggling to cope not just emotionally, but also economically. Poverty is increasing as breadwinners die and scarce savings are utilized in the period of ill health. As savings dwindle, families begin to fragment economically. One implication of this fragmentation
Of families is the rising numbers of orphan children in Zimbabwe like any other African country. The number of child headed families is gradually increasing. Most of these orphans are not going to school due lack of school fees and taking time caring the sick parents.
4.0 Proposal to AlphaBetaOmega Foundation.
The money will be used the following two critical areas:-
HIV prevention,
HIV and AIDS treatment, care and support
Each of the two areas consists of prioritized interventions and the strategies to achieve them.
4.1.0 HIV Prevention
The past decade has brought some remarkable successes in HIV prevention in Zimbabwe, with the country witnessing significant contractions in HIV prevalence and incidence. However, despite these successes, prevention remains the greatest challenge of the HIV epidemic in Zimbabwe. While attention to the epidemic, particularly for treatment access has increased significantly in recent years, the effort to reduce HIV incidence is faltering. It is evident that reducing HIV transmission requires a more nuanced and sophisticated focus on populations and communities where the most new infections are occurring. At a time of limited resources, efforts must be re-oriented towards giving much more attention and resources to populations at the highest risk of HIV infection.
One of the hardest lessons of the HIV and AIDS epidemic is that there is no single 'magic bullet' that will stem the tide of new HIV infections: combination approaches are necessary. A second lesson learnt is that for prevention efforts to succeed, prevention programming must be tailored to the specific characteristics of the epidemic that is unfolding in the area to be targeted.
The prevention interventions that we will be requesting for funding are high priority. High priority interventions are those which evidence clearly shows that their implementation will have the most potential to reduce HIV transmission. Highest priority interventions include the following:
Prevention of Mother to Child Transmission (PMTCT)
Male Circumcision (MC)
HIV Testing and Counselling (HTC)
Condom promotion and distribution
.
4.1.1 Prevention of Mother to Child Transmission (PMTCT)
During the three years will aim to reduce primary infection of HIV among women attending antenatal clinic (ANC) services, reduce unintended pregnancies among HIV positive women, reduce transmission of HIV during pregnancy, child birth and breast feeding and to ensure that all eligible HIV infected pregnant women and mothers receive ART.
Priority strategies:
Integrate HIV prevention into all ANC services;
Integrate family planning into PMTCT services;
Integrate family planning to Pre-ART and ART services;
Expand the availability of comprehensive PMTCT services for pregnant women;
Strengthen and expand Early Infant Diagnosis (EIDS);
Expand coverage of ART to facilities that offer comprehensive PMTCT services;
Strengthen retention of mother-infant pairs in PMTCT programme;
Strengthen monitoring and evaluation systems for PMTCT;
Strengthen participation of men in PMTCT services;
4.1.2 Male Circumcision (MC)
During the three years will aim to reduce the probability of transmission from HIV positive females to HIV negative males through the rapid expansion of adult MC services. Young men aged 15-29 with a particular focus on those in high HIV burden provinces
Priority strategies:
Strengthen capacity within Ministry of Health to provide leadership for MC at national, provincial and district levels;
Scale up MC services through use of mixed service delivery models;
Develop and implement communication plan to address barriers to uptake of MC services, generate timely demand for services and address potential risk compensation;
Develop and implement effective procurement and supply chain management systems for MC;
Strengthen human resource development for MC in the context of overall health workforce development;
Strengthen mechanisms for quality assurance of MC services; and
4.1.3 HIV Testing and Counseling (HTC)
During the three years we will aim to ensure that all people living with HIV (PLHIV) who are unaware of their HIV status know their HIV, with a particular focus on ensuring in particular that those PLHIV in sero-discordant relationships know their HIV status to ensure that they do not unintentionally expose their HIV negative partners to HIV
Priority strategies:
Strengthen capacity of the Ministry of Health to provide leadership for HTC at national, provincial and district levels
Expand Provider initiated testing and counselling (PITC) to all health facilities;
Expand community and home based counselling and testing;
Expand blood donor programme and screening efficiency;
Strengthen human resource development for HTC in the context of overall health workforce development;
Develop and implement communication plan to address barriers to uptake of HTC services among couples in formal and informal unions as well as among men and generate demand for services ;
Develop and implement effective procurement and supply chain management systems for HIV testing and counselling;
Strengthen mechanisms for quality assurance of HTC services; and
Strengthen monitoring and evaluation systems for HTC;
Strengthen linkages and referral between HTC and MC, FP, PMTCT,TB/HIV, CHBC and nutrition services
4.1.4 Condom Promotion and Distribution
During the three years we will aim to expand access to and correct and consistent utilization of male and female condoms among a number of key populations through social and public sector condom promotion and management. Sexually active adolescent and adults with intense focus on couples in discordant relationships, pregnant women within PMTCT services, PLHIV enrolled in the Pre-ART and ART programme, men and women testing positive in HTC sites, sex workers and their clients
Priority strategies:
Strengthen capacity of the Ministry of Health to provide leadership for condom promotion and distribution
Review and revise current education sector policies that hinder access to knowledge on correct and consistent use of condoms amongst learners;
Increase availability of both public and socially marketed male and female condoms;
Develop and implement communication plan to address barriers to condom use among priority populations and generate demand for public and socially marketed male and female condoms
Strengthen condom management systems and distribution logistics at all levels
Strengthen mechanisms for quality assurance of male and female condoms
4.2 Treatment, Care and Support
The impact of AIDS on mortality, morbidity and vulnerability of children has been severe: it is the leading cause of mortality among both adults and children. TB is highly associated with HIV and it is estimated that approximately 80% of TB cases are co-infected with HIV. As a consequence of that association, TB is a leading cause of mortality among PLHIV in the country.
Furthermore, because HIV and AIDS predominantly attack people of childbearing age, the impact this has had on children, extended families, and communities in Zimbabwe has been devastating. Deaths from AIDS in the past decade have left in the wake hundreds of thousands of orphans and vulnerable children. Expanding access to a continuum of treatment care and support for PLHIV and enhancing social protection for children and other people affected by AIDS is crucial to reducing mortality, morbidity and vulnerability due to HIV and AIDS.
The priority focus for the during the three years is therefore to reduce HIV related mortality and morbidity by expanding access to treatment, care and support for PLHIV
The following interventions will be implemented to achieve the above stated outcome impact result:
Antiretroviral Therapy (ART)
HIV and TB co-infection management
Nutritional support for adults and children living with HIV
Community home based care
4.2.1 Antiretroviral Therapy (ART)
During the three years we will aim to increase access to and utilization of ART services in order to ensure universal access to ART by all people that are eligible. Decisions on geographic priorities for expansion of ART services will be guided by provincial HIV burden data.
Priority strategies:
Advocate for supportive policy environment to facilitate scale up ART services in Zimbabwe;
Expand access to Pre-ART services for PLHIV that are eligible;
Strengthen and expand ART services ;
Strengthen human resource development for ART in the context of overall health workforce development;
Strengthen capacity of community systems to support PLHIV on ART;
Strengthen management and coordination of ART service provision;
Strengthen procurement and supply chain management systems capacity to deliver a continuous and reliable flow of high quality, effective and affordable ART drugs;
Strengthen laboratory capacity for HIV diagnosis and patient monitoring;
Strengthen monitoring and evaluation for ART including outcome measurement;
4.2.2 Tuberculosis (TB) and HIV Co-infection Management
During the three years we will aim to reduce deaths from TB among HIV-positive people. In turn, this will help to achieve Zimbabwe achieve the MDG target of halving TB mortality by 2015
Priority strategies:
Expand access to HIV testing among TB patients;
Expand access to ART for HIV-positive TB patients;
Strengthen TB screening among people living with HIV
Strengthen and expand the implementation of measures for TB infection control in health care facilities providing services to people living with HIV;
Develop interlinked patient monitoring systems for TB/HIV and recording of TB deaths among people living with HIV; and
Strengthen coordination of national level efforts to reduce the burden of HIV-related TB.
4.2.3 Nutritional Support for People Living with HIV (PLHIV)
During the three years we will aim to prevent and reducing the incidence of severe malnutrition among adults and children living with HIV
Priority strategies:
Strengthen human resource development for nutrition in the context of overall health workforce development;
Strengthen key areas of policy and guideline development;
Strengthen capacity of health facilities to provide nutritional care and support for adults and children living with HIV;
Expand the coverage of therapeutic foods for severely malnourished adults and children;
Develop and maintain quality assurance and standards for services and products; and
Strengthen monitoring and evaluation systems for nutrition programming.
4.2.4 Community Home Based Care
During the three years we will aim to ensure a continuum of care for adults and children living with HIV and AIDS from community to health facility
Priority strategies:
Strengthen capacity of services providers to provide quality and appropriate community home based care and support for adults and children living with HIV and AIDS;
Strengthen linkages and referral systems between health facilities and community home based care services;
Improve and strengthen procurement, logistics and distributions systems for community home based care services materials;
Strengthen coordination of national, provincial and district level efforts provide quality and appropriate community home based care and support;
Strengthen monitoring and evaluation systems for community home based care and support
Objective
Activity
Timeline of Activities
Budget (USD in Millions)
2012
2013
2014
2012
2013
2014
HIV Prevention
Male Circumcision
Building infrastructure.
Training of HCW.
Awareness Campaigns.
Surgical Equipment.
Male circumcision.
Awareness Campaigns.
Surgical Sundries.
Male Circumcision.
Awareness Campaigns.
Surgical Sundries.
$150M
$75M
$75
Prevention of Mother to Child Transmission of HIV
Integration of PMTCT activities into ART services.
Trainings.
Procurement of Formula feeds.
ANC HIV Testing.
ART.
Procurement of Formula feeds.
ANC HIV Testing.
ART.
Procurement of Formula feeds.
ANC HIV Testing.
ART
$100M
$50M
$50M
HIV Testing and Counseling
Establishing Testing Sites.
Training in Rapid HIV Testing.
Awareness Campaigns.
Procurement of Testing Material.
HIV Testing.
Mobile HCT.
Awareness Campaigns.
Procurement of Testing Material.
HIV Testing.
Awareness Campaigns.
Procurement of Testing Material.
HIV Testing.
$150M
$75M
$75M
Condom promotion and distribution
Training on Condom Use.
Procurement of Condoms. Awareness Campaigns.
Design of IEC Material
Awareness Campaigns.
Condom Distribution.
Distribution of IEC Material.
Awareness Campaigns.
Condom Distribution.
Distribution of IEC Material.
$80M
$60M
$60M
Treatment, Care and Support.
Antiretroviral Therapy
Training in ART.
Infrastructure Development..
Procurement of ARVS.
Offering ART Services.
Procurement of ARVS.
Offering ART Services.
Procurement of ARVS.
Offering ART Services.
$200M
$100M
$100M
HIV & TB Co infection Management
Integration of TB activities with ART. Training in TB & HIV Management.
Procurement of TB Drugs.
Procurement of TB Drugs. Offering TB Treatment Services.
Procurement of TB Drugs. Offering TB Treatment Services
$100M
$50M
$50M
Nutritional Support for Adults and Children Living with HIV
Training in Nutrition. Nutritional Gardens. Procurement of Food Supplements and Inputs for gardens.
Food Distribution.
Procurement of Food Supplements and Inputs for gardens.
Food Distribution
Procurement of Food Supplements and Inputs for gardens.
Food Distribution
$80M
$60M
$60M
Community Home Based Care
Training of Home Based Care Givers.
Procurement of Home Based Care Kits. Distribution of HBC Kits.
Procurement of Home Based Care Kits. Distribution of HBC Kits
Procurement of Home Based Care Kits. Distribution of HBC Kits
$100M
$50M
$50M
Total = S2 BILLION USD
$960M
$520M
$520M5.0 Proposed Budget and Timeline of Activities.
6.0 Conclusion.
The HIV & AIDS pandemic has affected many areas of the Zimbabwean economy which has resulted in poor economy growth and sustainable social development. Getting the funding from AlphaBetaOmega Foundation to finance HIV prevention, treatment, care and support will go a long way in ameliorating the impact of the pandemic.
