HARARE – Zimbabwe’s battle against HIV and Aids is facing a critical setback as antiretroviral (ARV) medication supplies are projected to run out within approximately 100 days, by the end of June, if the government fails to address a funding gap created by the cessation of aid from the United States Agency for International Development (USAID).
The United States Embassy in Zimbabwe’s decision to pause all U.S. foreign assistance funded by or through the State Department and USAID for review has already led to the temporary suspension of services at New Start Centres and truck stop clinics across the country. This has directly impacted patients on antiretroviral therapy (ART) and those seeking PrEP refills, causing widespread panic and uncertainty among those living with HIV.
The temporary closure of truck-stop clinics and the scaling back of services at crucial health centres across the country have triggered widespread alarm, raising the spectre of a resurgence in HIV infections, particularly among high-risk populations such as long-distance truck drivers, sex workers, and other vulnerable communities.
For years, these clinics have served as a vital lifeline, providing essential HIV prevention, testing, and treatment services in border towns, high-traffic areas, and underserved communities. They have been instrumental in reaching individuals who might otherwise lack access to critical healthcare, offering a range of services including HIV testing and counselling, antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), condom distribution, and screening and treatment for sexually transmitted infections (STIs).
The “America First” policy, which prioritises domestic developments and emphasises “reasonable use of taxpayer’s money,” has resulted in a significant reduction in US foreign aid, impacting billions of dollars in funding for local civil society organisations (CSOs) and development programs worldwide. The impact on Zimbabwe has been particularly devastating, given the country’s heavy reliance on US funding to combat the HIV/AIDS epidemic.
The immediate consequences of the funding cuts have been stark. Truck-stop clinics, strategically located along major transport routes, have been forced to shut their doors, leaving long-distance truck drivers without access to vital HIV prevention and treatment services. These drivers, often spending extended periods away from home and engaging in high-risk behaviours, are particularly vulnerable to HIV infection. The closure of these clinics not only jeopardises their health but also increases the risk of transmission to their partners and communities.
Similarly, Population Solutions for Health (PSH) New Start Centres, which have long been at the forefront of Zimbabwe’s HIV response, have been forced to scale back their services, temporarily halting ART and PrEP refills for patients. These centres, which typically offer a comprehensive range of integrated clinical services, are now primarily focused on HIV testing, with other essential programs such as family planning and cervical cancer screening assistance suspended.
Chipo, an outreach worker who has served sex worker communities since 2015, echoes Rumbidzai’s concerns. “The sex workers are crying; they are afraid of dying,” she says. She estimates that mobile clinics in Harare alone serve nearly 6,000 sex workers, all of whom are now left scrambling for basic health care.
The situation is further compounded by a shortage of condoms, which have become increasingly difficult to access since the funding cuts. “Local clinics only give us three to four strips per week,” Rumbidzai says. “In our trade, that’s not enough. People will take risks when supplies run out — something we desperately want to avoid.”
In a parliamentary session on Wednesday, Minister of Health Douglas Mombeshora attempted to allay fears, assuring the national assembly that the government would replenish its stocks by the end of June.
“We sat down and assessed the type of medicines that we need. It is not correct that all medicines were coming through USAID, I think it was 31%.”
“We have medicines to take us up to the end of June but by June, we will have replenished.”
“People should not panic, there is enough medication and medication will be available forever,” Mombeshora said.
However, Mombeshora also acknowledged that the termination of USAID funding has led to job losses for healthcare personnel in HIV treatment clinics, disrupted transport for remote healthcare access, and has forced the ministry to seek additional funding to address these challenges.
The health ministry will be approaching Parliament for support during the supplementary budget for review.
“We are therefore seized with scouting for replacements. The other challenge that we are facing pertains to vehicles and motorbikes which were used by healthcare personnel to access remote clinics.”
“Motorbikes which were used to transport blood samples were also affected by the executive order. This has culminated into a situation where our Ministry is in the process of requesting extra funding to cater for such key personnel,” Mombeshora said.
The impact of the funding freeze extends beyond the health sector, with thousands of employees in Zimbabwe’s non-governmental organisation (NGO) and civil society organisation (CSO) sectors left in limbo. The move has forced many organisations to send workers home, leaving them uncertain about their future employment and livelihoods.
Zimbabwe is home to thousands of NGOs and CSOs, many of which rely heavily on funding from the US. These organisations operate across various sectors, including humanitarian aid, service delivery, and political governance.
According to the 2019 Labour Force and Child Labour Survey by the Zimbabwe National Statistics Agency, the NGO sector employs 17,643 people, accounting for 1.2% of the country’s formal workforce. However, some estimates suggest the sector could be the second-largest employer in Zimbabwe after the government.
Employees who spoke to the news crew on condition of anonymity expressed their anxiety over the sudden freeze. “We are in a difficult position. We don’t know what will happen after the 90 days,” one worker said.
Another added, “I also do not know where I will get money for rentals since our salaries were also frozen.”
Many workers have been instructed to surrender vehicles and gadgets belonging to their organisations, further compounding their distress. The freeze has not only affected employees but also the communities they serve, particularly in the health sector.
Zimbabwe Nurses Association secretary-general Enock Dongo revealed that nurses working under the US President’s Emergency Plan for Aids Relief (PEPFAR) programme have been told not to report for duty. “We have members who have been working at local clinics who have been told not to report to duty today (yesterday). Those people are under emotional stress, and the patients who were waiting for them are affected,” he said.
The situation presents a significant challenge for Zimbabwe, requiring urgent action to secure alternative funding sources and mitigate the impact of the USAID cuts on the country’s HIV response and the livelihoods of those working in the NGO sector. Failure to do so could have devastating consequences for the health and well-being of Zimbabweans, particularly those living with HIV and Aids.
