AHEAD of World Aids commemorations, United States ambassador to Zimbabwe Bruce Wharton (BW) sat down with our correspondent Nokuthaba Dlamini (SE) for a wide ranging interview.
They discussed the US support in Zimbabwe’s fight against HIV and accusations that America was meddling in Zimbabwe’s political processes among other things. Below are the excerpts:
SE: A lot has been said about the level of support the United States is providing to Zimbabwe. How much is the US currently providing per year to support Zimbabwe in various sectors?
BW: Our commitment to the people of Zimbabwe remains strong as it has been since independence in 1980.
We were, of course, the first nation to recognise an independent Zimbabwe in April of 1980.
Since that time I think our commitment has been amply illustrated in terms of our support to the people of Zimbabwe in issues such as education, healthcare, housing, agricultural development, economic development, somewhat over $2 billion worth of assistance in the last 33 years.
At the moment we have three major areas of support to Zimbabwe.
First is healthcare: We provide about $95 million a year in assistance to the healthcare structures in Zimbabwe.
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A lot of that focuses on HIV and Aids prevention and treatment, malaria, tuberculosis, maternal and infant healthcare and on prevention of other communicable diseases.
The next big block of support has to do with economic development.
We have got a very active agricultural development programme in various provinces and most of it has been geared toward improving food security and income generation for small farmers.
Thirdly, we have provided and continue to provide humanitarian assistance. We have at different times in the course of Zimbabwe’s history fed as many as seven million people.
SE: You are in Victoria Falls to attend the World Aids Day commemorations, how would you characterise the level of US support to the HIV and Aids prevention, treatment and awareness in Zimbabwe?
BW: Our support to HIV and Aids in Zimbabwe has been mainly through the President’s Emergency Fund for Aids Relief (Pepfar).
Globally, since 2003, Pepfar has committed to supporting smart investments where resources are effectively and efficiently utilised.
To date, Pepfar has committed over $44 billion to the Global Fund to fight Aids, tuberculosis and malaria and remains the world’s largest and most successful foreign assistance programme.
In Zimbabwe, we work closely and in collaboration with the Health and Child Care ministry in implementing various programmes.
A good example is the Families and Communities for the Elimination of Paediatric HIV (FACE-Paediatric HIV) programme with $60 million in Pepfar support over five years (2012 to 2017).
This initiative is designed to strengthen national programmes addressing prevention of mother to child transmission of HIV.
The programme seeks to reduce the rate of mother-to-child HIV transmission from 14% to less than 5% by 2015, and to provide 90% of HIV positive pregnant women in Zimbabwe with life-long anti-retroviral therapy (ART).
Pepfar has supported the expansion of ART initiating sites from five in 2012 to 1 500 nationwide to date. I am pleased to note that Pepfar has committed $95 million towards the response to HIV and Aids in Zimbabwe for 2015.
ND: Talking about ART supplies, there have been reports indicating the prevalence of ART drugs on the black market.
Are you aware of any leakages in the system to the extent that these supplies find their place in the black market? What mechanisms are available to ensure that there are no leakages?
BW: That is a development that we have also read in the press, but cannot confirm. However, Anti-retroviral (ARV) drugs provide a lifeline to thousands of Zimbabweans living with HIV and Aids.
When stocks dwindle and products are scarce, lives are at stake. Through Pepfar, we are supporting the USAid- DELIVER project, in collaboration with the Health ministry, NatPharm and other partners.
These partners work to strengthen public health supply chain management for drug supplies. This support covers other areas which include preventing mother-to-child transmission of HIV, TB drugs and laboratory supplies, malaria drugs and rapid diagnostic tests, male circumcision commodities and primary health care packages.
SE: The number of people receiving ART remains constant, yet the number of people in need keeps increasing, are there any plans to increase the number of people currently covered by USG support?
BW: The number of individuals requiring ART has increased due to the increase in the threshold of the CD4 count in Zimbabwe.
Currently, World Health Organisation guidelines recommend that people with HIV start ART when their CD4 counts fall below 350 CD4 cells/mm³. However, in Zimbabwe ART guidelines recommend treatment thresholds of 500 CD4 cells/mm³.
This has increased the number of people requiring ART. In 2012, the US was providing support for 80 000 Zimbabweans and we increased that number to 140 000 in 2013.
We will continue supporting this number in the 2015 funding year.
SE: You have been in the press hailing Zimbabwe’s response to HIV and Aids pandemic, what measures has the US put in place to ensure that this response does not slow down or decrease?
BW: One of the things that we focused on has been to ensure that our funding promotes integration of HIV services with other essential health care services, especially TB, maternal health and family planning services under the US government’s Global Health Initiative.
In addition, we are working with local and international institutions to build the capacity of Zimbabwe’s health workers.
Our Pepfar team works closely with the Global Fund to Fight Aids, Tuberculosis and Malaria implementers to improve co-ordination and effectiveness of investments in these disease areas.
In addition, we have been doing a lot to continue to strengthen health systems to ensure effective response to HIV and Aids and other pandemics.
As I mentioned earlier, our Pepfar budget for Zimbabwe was approximately $95 million.
This budget is inclusive of $5 million to support the government of Zimbabwe’s plan to eliminate new HIV infections in children and save mothers’ lives, $20 million to scale-up adult treatment and $19,6 million for voluntary medical male circumcision in effort to avert new HIV infections.
An additional $9 million was made available for the Pepfar Zimbabwe programme to target specific programmes to addressing gender-based violence, integration of prevention of mother-to-child transmission and orphans and vulnerable children programmes, building the capacity of local organisations, and characterisation and service delivery for key populations.
Pepfar supports the Medical Education Partnership Initiative to strengthen medical education and research at the University of Zimbabwe with a total of $15 million in awards over five years.
SE: What programmes does the United States government support in the southern region — Matabeleland, Masvingo and the Midlands.
BW: We have several programmes that are implemented in different parts of Zimbabwe.
In Victoria Falls, for example, we have provided support to Populations Services Zimbabwe (PSZ) to implement a full range of sexual and reproductive health services as well as take family planning services into remote and underserved parts of the country.
PSZ has 10 teams servicing over 700 clinics and sites in 57 districts and operates a BlueStar social franchise clinic here in Victoria Falls.
We have worked with several partners closer to Victoria Falls to enable villagers to earn an income such as the harvesting of the Devil’s Claw about 20km from here.
Devil’s Claw is used for medicinal purposes and is a natural crop.
In Binga, farmers have been receiving training to start market gardens and build weirs as well as grow Rosella.
These are a few examples of some of the programmes we are doing in the region. All of them are intended to ensure economic self-sufficiency.
SE: It appears the support to HIV and Aids has been generally acknowledged by the government and non-governmental organisations; yet tensions in the political and economic sectors continue. How would you describe US-Zimbabwe relations at present? Are they improving or worsening?
BW: In the wake of the elections of 2013, we remain concerned the democratic process was still subject to political pressure.
Holding an election without a publicly useful voters’ roll does not lend to either transparency or credibility.
Problems with voter registration prior to the elections, problems with access to State media prior to the elections — there are a whole list of things — we looked at the Sadc Guidelines on Elections as one of the basis with which to evaluate the Zimbabwean elections, and the elections in our view fell short.
But at the same time, I don’t want us to wait five years for another election to sort of go through this process again, so I think the sort of things that will make a big impression on the US government include aligning the new Constitution with the laws of Zimbabwe, a process which is going to take some time.
There are about 400 laws that have to be aligned, but that would be a very positive signal.
I think being mindful of what politicians say in public, showing that Zimbabwe is a society in which, as President (Robert) Mugabe said at independence, “there is a place in Zimbabwe for everyone.
Zimbabwe needs all of its citizens to work for the success of the country”, reinforcing those points in public speeches rather than looking for divisions and differences, I think that will make a big impression.
We were delighted recently to be able to report that the president has signed into law this new legislation to fight trafficking in persons that is a very important issue in Washington and something that I think will lead to enhanced recognition that this is not the same Zimbabwe that existed in 2008.
This is going to be an iterative process; I can’t give you a menu that if you do A, B, and C; the United States will respond with an E, F and G.
But it is going to be a sort of give and take; that’s why I keep talking about partnership. Zimbabwe can do things and the United States can do things and over time I think we can rebuild and improve the relationship.
SE: When you announced some HIV and Aids support to community-based organisations early this year, your embassy featured prominently in current conversations about problems in the ruling party, with some party officials claiming that senior officials were receiving support from the US to topple Mugabe.
I am aware that you have denied these allegations, but I wanted to find out if anyone has presented you with evidence that this support is being used to this effect?
BW: The big issue that has driven these reports is the issue of Zimbabwe’s political future. While everyone is concerned on this issue, we are not focusing on the critical economic policies. I think the economy is the most important issue at the moment.
We certainly are trying to focus on the economy. I have given speeches on ICT and we are working to attract American investors to Zimbabwe.
Within the last month I met with Microsoft about opening an office here in Zimbabwe. The US office, Overseas Private Investment Corporation is coming back into Zimbabwe.
I have talked about the importance of clear economic policy. Clarifying what the indigenisation means, all countries have the responsibility to protect their citizens’ economic rights.
So indigenisation is not a bad thing, but it has to be consistent and transparent.
I think returning agricultural land to productivity is vital and I have talked about the role that clear marketable title certificates have in returning land productivity.
We support the International Monetary Fund staff-monitored programme as the way to move the economy forward.
My concern again is even though the economy seems to issue number one, it has to be built on a base of confidence in the democratic process, confidence in the political future of the country. So there is a whole range of issues going on and all of these issues should be addressed by the people of Zimbabwe.
SE: In your ongoing monitoring work, have you identified some lapses that could result in this funding being abused for political ends?
BW: Rather than supporting individuals, we support communities.
Rather than supporting political personalities, we support political processes and institutions.
So our work with Parliament is through Southern African Parliamentary Support Trust not directly through members of Parliament.
Our interest here is for a strong effective Parliament and MPs who are able to fulfil their roles and not in trying to have special relationships with them.
It is communities who apply, but when MPs go around their constituencies and meet some groups who need the funds, they can inform the communities that the US government is funding projects and explain the application process.
SE: Finally, the EU has been reportedly relaxing some elements of its sanctions programme on Zimbabwe and has resumed bilateral assistance to Zimbabwe.
There are questions whether the EU consults with you in implementing these measures and whether the US might take a similar stance?
BW: First of all the targeted sanctions are not the same as they were a year ago. We do review them and revise them. We have taken some people off the list and added a few on the list. There are a small number of people on the list than they were two years ago.
Sanctions were put in place because of our concern about people who were undermining democracy, human rights and the rule of law in Zimbabwe and our concern of the long-term effect those actions had on the economy of the country and the country’s ability to meet its own needs.
However, we cannot say if Zimbabwe will do A, America will do B. There are a lot of shades of grey for us to say ABCD.
But there are a number of things that would reflect well.
One of those is the implementation of the new Constitution. The Constitution is a very progressive document, but it has to be implemented well.
Zimbabwean leaders should focus on those things that make Zimbabwe attractive to investors, a court system that is transparent, systems that make it easy for people to invest if it would make itself attractive to investors it would simultaneously address that whole issue of targeted sanctions.
