Voluntary Medical Male Circumcision (VMMC) is an effective, enduring and cost effective method of HIV prevention that is recognized as a critical component of comprehensive efforts to end the AIDS epidemic. VMMC reduces the risk of male HIV acquisition by as much as 60% and curtails increasing costs of HIV care and treatment (C&T). In order to achieve population-level protection, VMMC must achieve and maintain 80% coverage, with PEPFAR and Zimbabwe setting an even more ambitous goal of 90% coverage among males 15-29 years olds (yo) (ZNASP2, 2022). Zimbabwe’s HIV prevalence is 12.9%, but health services access among men revealed large gaps: almost 25% of men had never been tested for HIV and only 43% of male respondents aged 10-29 years were circumcised, far below the 80% target for that group. VMMC saturation among men ages 15-29 remains crucial to breaking the chain of HIV transmission. PEPFAR and the Government of Zimbabwe aim to achieve 90% VMMC coverage to avert approximately 750,000 new infections by 2030. The locally-led ZAZIC consortium (an acronym comprised of partners’ names) was funded in 2013 and again in 2018 by CDC through PEPFAR to build health system capacity through integrated VMMC program delivery in partnership with the MoHCC across 14 priority districts and has a successful track record of safely meeting VMMC targets and reducing costs through a country-led approach with MoHCC staff augmented by ZAZIC roving MC teams. ZAZIC predominantly works in rural districts, demonstrating capacity to implement effectively and efficiently in highly resource constrained, lightly populated and geographically dispersed districts. ZAZIC safely improved productivity each year of operation through its blended/integrated approach that aligns with PEPFAR’s “Fulfilling America’s Promise to End the HIV/AIDS Pandemic by 2030”. Over the course of the next 5 years, the Zimbabwe Technical Assistance, Training and Education Centre for Health (Zim-T
TECH), as Prime, will lead theh ZAZIC consortium to deliver more than 60,000 VMMCs a year safely, continuing to improve quality and volume in the delivery of the minimum package of VMMC services, including increased access in hard-to-reach low coverage areas. The program will continue to increase proficiency of trained staff in VMMC service provision as well as increase acceptance of VMMC as a biomedical HIV prevention method in traditionally non-circumcising communities. In addition, ZAZIC will increase uptake of VMMC services in urban and peri-urban areas and increase uptake of VMMC services in older men, thereby helping to break the chain of HIV transmission. ZAZIC is committed to quality and reliability of routine monitoring of acceptability, uptake, and safety of VMMC services while simultaneously continue to integrate the VMMC program into the national health system, fostering and promoting sustainability. Zim-TTECH, a locally registered entity, is well poised to lead the consortium to deliver on these outcomes. Zim-TTECH aims to improve the health and well-being for all through provision of technical assistance and direct service to the health sector, as well as strengthening healthcare worker skills to support sustainability of health systems. Zim-TTECH supports the Ministry of Health and Child Care (MoHCC) and the broader health sector through direct service delivery and technical assistance while promoting collaboration, partnerships and networking with Government Ministries, beneficiaries of services, civil society organizations, funders, and other implementing partners. Continuing a process of local capacitation, ZAZIC-supported VMMC services will promote local ownership, human centered demand creation (DC) and integrated service delivery (SD) capacity that supports full transition to a sustainable model by the end of the 5-year grant cycle.
