• Zimbabwe's national AIDS levy: A case study

      Nisha Bhat; Peter H. Kilmarx; Freeman Dube; Albert Manenji; Medelina Dube; Tapuwa Magure (Taylor & Francis Group, 2016-01-01)
      Background: We conducted a case study of the Zimbabwe National AIDS Trust Fund (‘AIDS Levy’) as an approach to domestic government financing of the response to HIV and AIDS. Methods: Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations. Findings: The literature search yielded 139 sources, and 20 key informants were interviewed. Established by legislation in 1999, the AIDS Levy entails a 3% income tax for individuals and 3% tax on profits of employers and trusts (which excluded the mining industry until 2015). It is managed by the parastatal NAC through a decentralized structure of AIDS Action Committees. Revenues increased from inception to 2006 through 2008, a period of economic instability and hyperinflation. Following dollarization in 2009, annual revenues continued to increase, reaching US$38.6 million in 2014. By policy, at least 50% of funds are used for purchase of antiretroviral medications. Other spending includes administration and capital costs, HIV prevention, and monitoring and evaluation. Several financial controls and auditing systems are in place. Key informants perceived the AIDS Levy as a ‘homegrown’ solution that provided country ownership and reduced dependence on donor funding, but called for further increased transparency, accountability, and reduced administrative costs, as well as recommended changes to increase revenue. Conclusions: The Zimbabwe AIDS Levy has generated substantial resources, recently over US$35 million per year, and signals an important commitment by Zimbabweans, which may have helped attract other donor resources. Many key informants considered the Zimbabwe AIDS Levy to be a best practice for other countries to follow.
    • Zimbabwean secondary school Guidance and Counseling teachers teaching sexuality education in the HIV and AIDS education curriculum

      Ephias Gudyanga; Naydene de Lange; Mathabo Khau (Taylor & Francis Group, 2019-01-01)
      In spite of the importance of sexuality education and HIV and AIDS education in preventing HIV infections, Zimbabwean secondary school Guidance and Counseling teachers are not engaging optimally with the current Guidance and Counseling, HIV and AIDS & Life Skills education curriculum, and hence, they are not serving the needs of the learners in the context of the HIV and AIDS pandemic. The aim of the study, therefore, was to explore how Guidance and Counseling teachers could be enabled to teach the necessary critical content in sexuality education in the HIV and AIDS education curriculum. A qualitative research design, informed by a critical paradigm, using participatory visual methodology and methods such as drawing and focus group discussion, was used with eight purposively selected Guidance and Counseling teachers from Gweru district, Zimbabwe. The study was theoretically framed by Cultural Historical Activity Theory. Guidance and Counseling teachers found themselves in a community with diverse cultural practices and beliefs of which some seemed to contradict what was supposed to be taught in the curriculum. The participatory visual methodology, however, enabled a process in which the Guidance and Counseling teachers could reflect on themselves, the context in which they taught, their sexuality education work and learn how to navigate the contradictions and tensions, and to use such contradictions as sources of learning and sources for change. The results have several implications for policy in terms of the Guidance and Counseling curriculum and engaging with cultural issues; and for practice in terms of teacher professional development, teacher training, and for stakeholder contribution.
    • Zimbabwe’s national AIDS levy: A case study

      Bhat, Nisha; Kilmarx, Peter H.; Dube, Freeman; Manenji, Albert; Dube, Medelina; Magure, Tapuwa (Taylor & Francis, 2016-01-20)
      Background: We conducted a case study of the Zimbabwe National AIDS Trust Fund (‘AIDS Levy’) as an approach to domestic government financing of the response to HIV and AIDS.Methods: Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations.Findings: The literature search yielded 139 sources, and 20 key informants were interviewed. Established by legislation in 1999, the AIDS Levy entails a 3% income tax for individuals and 3% tax on profits of employers and trusts (which excluded the mining industry until 2015). It is managed by the parastatal NAC through a decentralized structure of AIDS Action Committees. Revenues increased from inception to 2006 through 2008, a period of economic instability and hyperinflation. Following dollarization in 2009, annual revenues continued to increase, reaching US$38.6 million in 2014. By policy, at least 50% of funds are used for purchase of antiretroviral medications. Other spending includes administration and capital costs, HIV prevention, and monitoring and evaluation. Several financial controls and auditing systems are in place. Key informants perceived the AIDS Levy as a ‘homegrown’ solution that provided country ownership and reduced dependence on donor funding, but called for further increased transparency, accountability, and reduced administrative costs, as well as recommended changes to increase revenue.Conclusions: The Zimbabwe AIDS Levy has generated substantial resources, recently over US$35 million per year, and signals an important commitment by Zimbabweans, which may have helped attract other donor resources. Many key informants considered the Zimbabwe AIDS Levy to be a best practice for other countries to follow.Keywords: health care financing, HIV, AIDS, Zimbabwe