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6 Combat HIV/AIDS, malaria and other diseases
Where we are?
- HIV/AIDS prevalence rate has declined to 15.6 percent from 25 percent in 2003, 20 percent in 2005, 18 percent in 2005/06 and 16 percent in 2007.
- 1.3 million People living with HIV/AIDS and which females constitute 54 percent.
- Comprehensive knowledge about HIV/AIDS is still low with only 55 percent of women aged 15-49 years had comprehensive knowledge of HIV transmission. The knowledge tends to increase with education and wealth (MIMS 2009).
- Slightly over half (53 percent) of the women aged 15-24 years had comprehensive knowledge of HIV transmission.
- According to the Ministry of Health and Child Welfare, the number of children orphaned by HIV and AIDS steadily increased since the early 90s, reaching estimated peak of 1,008 542 in 2006 before decreasing to 975,000 and 956,000 orphans in 2007 .
- Zimbabwe had an OVC prevalence of 37 percent and orphan- hood prevalence of 25 percent, with no major sexual differentials for both. External assistance to support the office has been channelled through the Child supplementary feeding Programme (CSFP) and the Expanded Programme of Immunization (EPI), 1982.
Status and Trends
Zimbabwe has met the Abuja target of a malaria incidence rate of 68 per 1,000 people. 27% of all at-risk households have at least one insectide-treated net. TB incidence rates have significantly increased, rising from 97 per 100,000 people in 2000 to 782 per 100,000 in 2007. 78% of all TB cases were treated successfully in 2007, but detection rates remain below 40%.
HIV and AIDS Prevalence in Pregnant Women
Similar declines are evident in the HIV prevalence rate for pregnant women. This rate fell from 25.78% in 2002 to 16.1% in 2009.
Malaria was the third leading cause of hospital admissions in Zimbabwe in 2009. Controlling malaria is one of the government’s main priorities. In 2000, the Government of Zimbabwe signed the Abuja Declaration, agreeing to try to meet the target of reducing malaria cases by 50% between 2000 and 2010, and by 75% by 2015.
Indications are that the rate declines as the government’s prevention programme scales up interventions. It is not yet possible to quantify the contribution of each factor to the reduction of the disease. The case fatality rate, particularly for the group aged five years and above, has been also been gradually declining since 2004. Zimbabwe has made efforts to control malaria through vector control, ensuring that at-risk households receive sprays and free or subsidized mosquito nets. In 2009, Zimbabwe achieved coverage of 74%, which is not far from the WHO target of 85%.
Zimbabwe currently ranks 17th out of the world’s 22 high-burden TB countries. The TB incidence rates significantly increased during the last decade, rising from 97 per 100,000 people in 2000 to 782 per 100,000 in 2007. This increase is attributed to the high incidence of HIV and AIDS and it is estimated that 72% of all TB patients are co-infected with HIV.
In relation to the global indicator for the rate of successful TB treatment, Zimbabwe attained a record high of 78% in 2007. However, this is still low in comparison to the global benchmark target of 85% recommended by WHO. Likewise, TB case detection rates have not improved; which continues to hover below 40%, far below the target of 70%.
The MoHCW has made recent moves to improve the diagnosis of TB by revamping the functionality of its 115 diagnostic centres and ensuring that nonfunctioning sites become operative. Joint collaboration between the TB and ART programmes has seen 69% of TB patients accessing HIV testing services and cotrimoxazole preventive therapy.
Other diseases: Cholera
The most recent Cholera outbreak (August 2008 to June 2009) saw a total of 98,592 reported cases and 4,288 deaths and was the severest on record. Poor water and sanitation provisions, particularly in urban areas gave the outbreak a distinct urban preponderance at its outset. From January 2009 it assumed a more rural outlook, with 2,631 deaths (61.4%) occurring at community level.
Major challenges in Achieving Goal 6
The major challenge is the unstable human resource base, arising from high staff attrition. There is also a shortage of essential medicines and equipment for high-quality care. Further, user fees levied by public facilities that do have the drugs and equipment, deter many clients from accessing them.
Cholera and other diarrheal disease outbreaks will continue to occur until the water and sanitation situation improves. Both urban and rural areas are at risk. The breakdown and poor maintenance of water and sanitation infrastructure needs large capital investment to rectify, which a major challenge towards halting and reversing the incidence of diarrheal diseases by 2015.
Requirements for Achieving Goal 6
- Increase access to Anti-retroviral drugs to people with advanced HIV infection
- Continue to increase HIV/AIDS awareness
- Increase access to insecticide treated nets to all high-risk households
- Continue to reduce malaria morbidity and mortality by scaling up vector control
- Improve the efficiency of the health delivery systems through training of microscopists and renovation of diagnostic centres.
- Scale up collaboration between TB and ART programmes.
The 8 Millennium Development Goals
- 1 Eradicate extreme hunger and poverty
- 2 Achieve universal primary education
- 3 Promote gender equality and empower women
- 4 Reduce child mortality
- 5 Improve maternal health
- 6 Combat HIV/AIDS, malaria and other diseases
- 7 Ensure environmental sustainability
- 8 Develop a global partnership for development
Targets for MDG6
- Halt and begin to reverse the spread of HIV/AIDS
- HIV prevalence among population aged 15-24 years
- Condom use at last high-risk sex
- Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
- Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
- Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
- Proportion of population with advanced HIV infection with access to antiretroviral drugs