. . . Non-State Actors convene urgent meeting to discuss way forward
By Brighton Chiseva
MASVINGO – The abrupt suspension of American aid to Zimbabwe has sent shockwaves through the country’s health sector, leaving thousands of health workers unemployed and key populations vulnerable to the devastating consequences of interrupted HIV/AIDS and sexual health services.
The suspension has exposed the Zimbabwean government and civic society’s over-reliance on foreign aid. According to data researched by TellZim News, the health sector has been heavily dependent on the Presidential Emergency Plan For AIDS Relief (PEPFAR) and the Global Fund, which account for 66% and 31% of HIV interventions, respectively. With the Global Fund’s contributions declining since 2020, the US aid suspension has pushed the health sector to the brink of collapse.
In response to the American Aid suspension, non-state actors have convened an emergency meeting in Kadoma recently to discuss alternative funding models. Led by the Zimbabwe Coalition on Debt and Development (ZimCODD), the group is expected to present a position paper to the Minister of Health, Dr. Douglas Mombeshora, and the Minister of Finance, Prof. Mthuli Ncube and the Parliamentary Portfolio Committee on Health, urging the government to prioritize localized health funding.
“We need to stop depending on foreign aid for this critical sector. The government must step up and allocate adequate resources to health. This suspension should be a wake-up call. We should come up with a robust sustainable funding model that we should present to the Ministries of Health and Finance respectively. The models should be anchored on localized health financing initiatives,” said one of the participants at the Non-State Actors meeting.
The non-state actors urged the government to increase domestic funding as well as allocating more resources from the national budget to health and explore innovative financing mechanisms like public-private partnerships. Also, the non-state actors call for government to improve the AIDS Levy by expanding the AIDS levy’s scope and efficiency to reduce reliance on external donors.
USAID has been a major contributor to Zimbabwe’s health sector, particularly in HIV/AIDS programming, maternal and child health, malaria, and tuberculosis. In recent years, USAID’s annual funding to Zimbabwe’s health sector has been estimated at $150 to $200 million. PEPFAR, which is the largest component of USAID’s funding, has been instrumental in providing life-saving treatment to over 1.2 million Zimbabweans.
The Global Fund has been Zimbabwe’s second-largest donor for health, focusing on HIV, TB, and malaria programs. Over the past three funding cycles (2020–2023), the Global Fund has committed approximately $600 million to Zimbabwe’s health sector. For example, in the 2021–2023 cycle, Zimbabwe received $421 million, with significant allocations to HIV (66%), TB (20%), and malaria (14%).
The suspension of USAID funding, coupled with declining contributions from the Global Fund, threatens to reverse the gains made in Zimbabwe’s health sector. With 1.2 million people on ART and thousands reliant on TB and malaria programs, the potential disruption in services could lead to: Increased HIV transmission and drug resistance; a resurgence of TB and malaria cases; and a collapse of maternal and child health services.
The government’s failure to meet the Abuja Declaration threshold (allocating at least 15% of the national budget to health) has exacerbated the crisis. With the current health budget at only 10.2%, Zimbabwe faces an uphill battle in filling the funding gap left by donors.
While ART stocks are expected to last for Six months according to Minister of Health and Child Care Dr Douglas Mombeshora, the uncertainty about what happens after that has created widespread anxiety. Health officials fear a catastrophe once supplies run out, as the distribution of ART is a complex process that requires continuous funding and logistical support.
Amid the crisis, there is a glimmer of hope. Some programs, such as the riders’ initiative, which transports samples for tuberculosis and viral load testing, have been reinstated after a temporary suspension.
“We’ve seen some programs being reviewed, so there’s a chance others might be exempted from the ban,” said an official from the Ministry of Health and Child Care.
On January 23, 2025, USAID announced the immediate suspension of its funding to Zimbabwe, affecting over 1.2 million Zimbabweans who rely on its life-saving programs. The ripple effects were felt almost instantly. Health workers employed by the Centre for Sexual Health and HIV/AIDS Research Zimbabwe (CeSHHAR) woke up to the news that their one-year contracts had been terminated, leaving them stranded and uncertain about their futures.
“We were told to stop all operations immediately, even using the procured goods and medicines,” said a CeSHHAR employee stationed at Mazorodze Council Clinic.
“It’s not just about us losing our jobs – it’s the thousands of people who depend on our services. They are the ones who will suffer the most, she added.”
The suspension has forced the closure of New Start Centre outlets across the country, with patients now redirected to government hospitals. In Masvingo, for instance, those collecting antiretroviral (ART) medication were told to go to Masvingo Provincial Hospital.
However, this transition has already begun to strain the already overburdened public health system.
“The process of registering and transferring patients is time-consuming and overwhelming for government health workers. And for key populations like sex workers and the LGBTQ+ community, this means reliving the stigma they faced before. It’s a devastating step backward, one source said.
Key populations, who are among the most vulnerable to HIV and other sexually transmitted infections, are expected to bear the brunt of the aid suspension. These groups were at the forefront of HIV prevention and treatment programs supported by USAID, and their exclusion from these services could lead to a dangerous spike in infection rates.
“The gains we’ve made over the years are at risk. We can’t afford to lose momentum in the fight against HIV, but without funding, we’re powerless,” said Farai Mahaso, Director of Batanai HIV and AIDS Services Organization (BHASO), which has since halted operations.
BHASO was implementing Community Led Monitoring (CLM), an innovative approach that empowered communities to oversee the quality of health services they received. The program’s suspension has left a void in the country’s health system, further complicating efforts to address gaps in service delivery.
The estimated number of people on antiretroviral therapy (ART) in Masvingo Province according to the 2023/2024 statistics are approximately 120,000 to 150,000. Masvingo is one of the provinces with a high HIV burden, and ART programs have been critical in managing the epidemic in the region
In Zimbabwe, around 1.2 million to 1.3 million people are said to be on ART. Zimbabwe has made significant progress in scaling up ART coverage, with over 90% of people living with HIV accessing treatment. These figures highlight the potential catastrophe that could unfold if ART programs are disrupted due to the suspension of USAID funding.
Without immediate action, the suspension of USAID funding could plunge Zimbabwe’s health sector into a full-blown crisis, undoing decades of progress in the fight against HIV, TB, and malaria.
The suspension of American aid has not only disrupted essential services but also highlighted the urgent need for sustainable, locally-driven funding solutions. As health workers and patients alike grapple with anxiety and uncertainty, the question remains: will the government rise to the occasion, or will the health sector continue to teeter on the edge of collapse? For now, the clock is ticking, and the stakes could not be higher.
