The Prevalence and Politics of HIV/AIDS in Zimbabwe: Examining the Ideological, Political and Historical Factors Behind the ‘Decline’

Abstract

The reported reduction in the prevalence level of the Human Immunodeficiency Virus (HIV) in Zimbabwe has been represented as one of the most significant and rapid declines within any population since the epidemic emerged as a public health issue. This paper explains how this development has been reported, challenged and eventually owned by many of the diverse stakeholders who constitute Zimbabwe's overall AIDS response. The Zimbabwean government has claimed that the decline was brought about due to its own efforts and resources. However, while the country has received considerably less AIDS funding than its neighbours, external donations still account for the vast bulk of AIDS spending in Zimbabwe. In addition, instead of collapsing, as some predicted, the Zimbabwean state can also claim that it has presided over increased availability of antiretroviral therapy. In this paper we examine how various internal and external stakeholders deployed strategic explanations in an attempt to take credit for ‘the decline’; this is an important case study of how epidemiological data can be used to construct and contest political legitimacy.

Notes

This paper generally uses terminology as recommended by the UNAIDS Terminology Guidelines.

Attendance at ANC clinics was 93 per cent in 1999 and 94 per cent in 2005. In 2005 68 per cent had a blood sample taken (Ministry of Health, 2007, p. 122).

For a discussion on how ANC testing is carried out in Zimbabwe, see Ministry of Health, National AIDS Council and USAID 2004, p. 67) and Garbus and Khumalo-Sakutukwa (2003, p. 16), and for a summary of how estimating HIV prevalence in Zimbabwe has become more precise see ANC HIV Estimates Technical Working Group Zimbabwe, 2009a.

Disbelief also greeted the authors' enquiries about HIV prevalence decline when discussing the issue with human rights activists in Harare in July 2007.

Zimbabwe is not alone in experiencing problems with Global Fund disbursements – see ‘Global Fund freezes Zambia aid over corruption concern,’ BBC News, 16 June 2010, http://www.bbc.co.uk/news/10331717?print=true

Additional information

Notes on contributors

Stephen O'brien

Faculty of Health Sciences, University of Sydney, Australia.

Alex Broom

Faculty of Health Sciences, University of Sydney, Australia. Email: [email protected].