How Close Are We to Beating HIV in Africa?

Harare, Zimbabwe—Due to global efforts to respond to the epidemic, millions of people are receiving HIV treatment and services. But many more still lack access to the care they need. To improve the response, donors and governments require detailed information about the epidemic so they can assess progress and identify future needs. As part of a broader effort to understand the national epidemic in Zimbabwe, the groundbreaking Zimbabwe Population-based HIV Impact Assessment (ZIMPHIA) survey enrolled its first participants in October, with 12 field teams traveling to the northern region of Zimbabwe to start collecting data. It is the first of more than 15 such household-based surveys to be conducted in Africa as part of the PHIA project, which aims to provide a snapshot of the HIV epidemic in each country, representing an important step toward bringing even the most severely affected countries closer to the goal of treating all of those living with HIV and eliminating new infections.

A member of the ZIMPHIA survey team prepares to begin data collection.

Funded by the U.S. Centers for Disease Control and Prevention (CDC) through the President’s Emergency Plan for AIDS Relief (PEPFAR), the PHIA project is led by ICAP at Columbia University. Survey teams will collect information and conduct laboratory tests to estimate the magnitude of the HIV epidemic in adults and children and to measure access to prevention, care and treatment services.

“After more than ten years of global effort to expand access to treatment, there is a great deal of interest in understanding where things stand with the HIV epidemic. ZIMPHIA will allow Zimbabwe to gain a deeper understanding of what has been accomplished and what still needs to be done in the future,” said Jessica Justman, principal investigator and senior technical director at ICAP.

Owen Mugurungi, Director of the AIDS and TB Unit in the Government of Zimbabwe’s Ministry of Health and Child Care, announced the survey’s launch in the Mbire District of Mashonaland Central Province, saying, “ZIMPHIA survey data collection has started, marking a very important milestone in our HIV response efforts as a country.” Mugurungi noted that this survey will be the first of its kind to be conducted in the country. “We are expecting a smooth survey and look forward to high rates of participation by the population,” added Dr. Mugurungi.

ZIMPHIA teams will visit 15,000 randomly selected households across Zimbabwe and administer tablet-based questionnaires to consenting household members. Survey participants receive HIV and syphilis testing and counseling, with immediate return of results, all provided with privacy in each participant’s home. Participants who test positive are referred to their preferred health care facility for treatment.

Zimbabwe’s success in responding to the HIV epidemic has been the result of well-coordinated efforts at the national level. Both the Zimbabwe and U.S. governments are enthusiastic about the ZIMPHIA survey and their continued collaboration supporting the country’s HIV response. Additional resources for the survey are provided by the Government of Zimbabwe and the Global Fund.

“ZIMPHIA, and the PHIA project as a whole, will provide critical evidence that will guide HIV programs over the next decade. This is historic and timely effort will inform the next phase of the global response to the HIV epidemic,” added Wafaa El-Sadr, ICAP director.

ZIMPHIA, a Government of Zimbabwe initiative, is being implemented in partnership with the Biomedical Research and Training Institute of Zimbabwe and Lancet Laboratories. In addition to ICAP, the PHIA project partners include, the African Society for Laboratory Medicine, ICF International, Statistical Center for HIV/AIDS Research and Prevention at the Fred Hutchinson Cancer Center, University of California San Francisco’s Global Health Sciences and Westat, Inc.

Founded in 2003, ICAP at Columbia University supports programs and research that address major health issues such as HIV, malaria, tuberculosis, maternal and child health and non-communicable diseases. ICAP works in collaboration with partners around the world to support high-performing health system strengthening initiatives and implements innovative and sustainable health solutions. ICAP, situated at the Columbia Mailman School of Public Health, works in partnership with governmental and non-governmental organizations across 21 countries.