By Paul Sixpence
LOCAL and international sexually transmitted infections (STIs) experts and partners have launched unique and innovative national advocacy agendas focusing on Kenya, South Africa and Zimbabwe.
For Zimbabwe, the national STI advocacy agenda seeks to build a “coordinated national STI response where STIs are prioritised, quality care is delivered, and affected communities contribute to shaping policy and practice.”
According to Zimbabwe’s STI national advocacy agenda, titled, “Advancing STI prevention and care in Zimbabwe,” it is estimated that ONE in every FOUR women who visit clinics with vaginal discharge have gonorrhea. Further, 20 percent of young people aged between 18 and 24 years are suspected of having either chlamydia, gonorrhea or trichomoniasis infection. The only respite from these sad statistics is that, apart from HIV, syphillis is the only other STI in Zimbabwe that has widespread testing services.
“Zimbabwe has made huge strides on HIV, but curable STIs have been left behind,” says Dr. Chido Dziva Chikwari one of the lead health experts leading the STI advocacy agenda process in Zimbabwe. “This agenda is about drawing attention to STIs, because if we want to achieve universal health coverage, we cannot afford to neglect STIs.”
AVAC, an international non-governmental organisation that works to advance the ethical development and delivery of STI prevention and treatment options, working collaboratively with national experts and partners has developed the Kenya, South Africa and Zimbabwe national STI advocacy agendas.
“The STI advocacy agendas were developed in response to rising STI rates alongside declining resources for prevention, diagnostics, and research,” says Dr. Alison Footman, Senior Programme Manager of STIs at AVAC. “There is a clear need to strengthen coordinated, country-led advocacy to ensure STIs remain a public health priority. Kenya, South Africa, and Zimbabwe were selected based on strong local relationships, existing advocacy momentum, and opportunities to influence national policy, funding, and program implementation.”
Zimbabwe’s national STI advocacy agenda
Health experts highlight that STIs across different settings remain as a persistent and under-prioritised public health challenge. To address this challenge, Zimbabwe’s advocacy agenda seeks to strengthen national coordination and elevate STIs as a policy priority.
“The STI advocacy agenda is a plan to begin active engagement on how we can improve STI management in Zimbabwe,” says Dr. Constancia Mavodza, a health expert co-leading the STI advocacy agenda process in Zimbabwe. “It brings government, civil society, and communities together to call for prioritization of STIs in the national health agenda. We hope to develop STI priorities with all stakeholders to allow for synergies and concerted action from government, health workers and communities.”
The overarching priorities of the national advocacy agendas across the three countries seek to “document and align national STI priorities, strengthen health workforce on STI management and to institutionalise community representation in advocacy,” a summary document of country advocacy agendas opines.
In Zimbabwe, apart from HIV and Syphillis, the majority of STIs are syndromicallymanaged. This means that clinical decisions are based on a patient’s symptoms and signs, rather than laboratory tests. Zimbabwe’s advocacy agenda also focuses onpreparing for emerging STI diagnostic technologies and innovations.
Challenges and gaps in the national STI response
An analysis of the country’s STI ecosystem conducted by experts identified a number of structural and implementation gaps that limit success in addressing the management of STIs.
Gaps and challenges as detailed in the country’s national advocacy agenda vary from underfinancing, limited access to diagnostic tools and national preparedness to adopt new diagnostic innovations, training gaps for healthcare workers, insufficient integration of community voices in policymaking and programming.
“These gaps disproportionately affect young people, women, and key populations who
already face structural barriers, stigma, and limited access to quality services. Without
coordinated advocacy and structured engagement, Zimbabwe risks continued
fragmentation, inequitable service delivery, and missed opportunities for prevention,
surveillance, and uptake of new innovations,” the national advocacy agenda document further notes.
The national STI advocacy agenda as a pathway to improved sexual health outcomes.
The advocacy agenda proposes several remedial actions that radiate from principle of equity and community management. The agenda advocates for the centering of communities as active contributors to policymaking, programming and accountability through dialogues and engagement to reduce stigma, enhance community awareness and acceptability.
“Too often, communities experiencing the greatest burden of infection have limited influence over policy discussions, guideline development, and service design. This agenda seeks to ensure that community perspectives and lived experiences inform national STI priorities,” the national advocacy agenda further adds.
Through structured policy engagement with various stakeholders including government the advocacy agenda will seek to integrate STI priorities within existing “sexual and reproductive health (SRH), HIV, antimicrobial resistance, and universal healthcare frameworks.”
To ensure success, the advocacy agendas were collaboratively created with in-country experts to reflect local priorities rather than external driven goals.
“Success means that STIs are more visible, prioritised, and resourced within national health agendas,” says Dr. Footman. “This includes stronger policies and guidelines, increased investment in diagnostics and prevention tools, and more integrated, people-centered STI services. It also means sustained advocacy leadership within each country where local partners are effectively engaging policymakers, shaping programmes, and driving long-term progress in STI prevention and care.”