Zimbabwe’s HIV crisis: U.S. aid cuts leave millions at risk

The 2020 Zimbabwe Population-based HIV Impact Assessment estimated that 12.9% of the population is living with HIV - about 1.23 million people. Approximately 1.2 million people in Zimbabwe are on antiretroviral therapy (ART).

Zimbabwe is one of only five other African countries to have met the UNAIDS 96-95-95 targets. This means 95% of people with HIV know their status, 95% of those diagnosed are on ART, and 95% of those on ART have achieved viral load suppression.

The recent move by the US to freeze foreign aid threatens two decades of Zimbabwe’s progress in ending HIV. The freeze has affected USAID and PEPFAR, disrupting HIV services for vulnerable populations.

UNAIDS Director of Data for Impact, Mary Mahy, warned that the impact on the HIV response could be severe. Between 2025 and 2029, the funding freeze could lead to 6.3 million AIDS-related deaths. It could also result in 8.7 million new infections globally.

PrEP disruptions affecting key populations in Zimbabwe

For Rumbidzai Mhlanga (38) from Harare's Hopely suburb, the suspension of aid has been devastating. She can no longer access Pre-Exposure Prophylaxis (PrEP) for HIV prevention. Rumbidzai was one of the first people to receive long-acting injectable cabotegravir (CAB-LA) as PrEP after its rollout in 2024.

"I got my first injection last year after switching from oral PrEP to the new injectable PrEP. I was due for my second shot in February this year, but now I can't get it because only pregnant and breastfeeding women are getting PrEP," Rumbidzai said.

She obtained her PrEP refills from the New Start Centre clinic in Harare.

"We are now at greater risk of contracting HIV. Now, I don’t know where to get my second dose. I used to get my medication at New Start Centre, but that has stopped."

Rumbidzai is afraid of contracting HIV or STIs. She also worries about managing possible side effects from her previous injection without clinical support.

"The injectable was still new in Zimbabwe and it was only available at  six study sites. Now, I have no idea where to go if I develop side effects or need more information. I also don’t know how long I am protected after my last injection. I feel lost, and I am now at high risk of infection," she lamented.

Although the New Start Centre has resumed full operations, it only offers PrEP to pregnant and breastfeeding women. Population Solutions for Health (PSH), formerly PSI, manages the facility.

Dr. Noah Taruberekera, the PSH Managing Director, confirmed that PrEP was not available for most populations.

"Our services have resumed, including HIV testing, PrEP for pregnant women, tuberculosis (TB) screening and treatment, cervical cancer screening and treatment, and comprehensive care for survivors," he said.

Human resources disruptions after U.S. aid cuts

According to the Ministry of Health, approximately 19,000 healthcare workers were enrolled for payment under U.S.-funded programs, and about 15,000 were receiving payment. Over 1,000 nurses, some of whom were manning opportunistic infection clinics under U.S. funding, were affected during the first few days.

“Most of the workers were involved in HIV, AIDS, TB, and malaria programs. So these are the programs that have been mainly affected by the executive order. We had to redeploy workers to make sure there was no facility which was only manned by employees paid by our partners or our NGOs, to make sure that no service was disrupted,” said Dr. Douglass Mombeshora, Zimbabwe’s Minister of Health and Child Care.

Availability of Antiretroviral Treatment (ART)

As of February 2025, the country only had a six-month supply of antiretroviral drugs. Dr. Mombeshora highlighted that 31% of ARVs in Zimbabwe are procured through U.S. funding. The government buys the rest. He noted that the government would seek more funding to buy the life-saving drugs.

"We had already procured medicines for HIV, TB, and malaria, but deliveries were being made in phases. We have enough stock until the end of June. However, shipments meant for June to December were halted," he said.

Dr. Mombeshora emphasized that the government would not wait for the 90-day period set by Trump to act on the ARV stock issue.

"As a Ministry and as a government, we have mobilized resources. If you check the newspapers today, you will see we have floated a tender to procure medicines covering June to September."

Despite these measures, some clinics in Harare are already experiencing low ART supplies. The City Health Department confirmed that some facilities have less than six months' stock, particularly for Tenolam D, a critical HIV management drug.

Harare City Health Department Deputy Director, Dr. Michael Vere, attributed the low ART stocks to supply chain issues.

"We have an average of five months’ stock of critical ARVs. That is the average period of stockholding for these essential drugs," he said.

ART situation in rural communities

Many health facilities in Zimbabwe are giving out fewer ARVs per refill.

"Most clinics and rural health centers in Murehwa are only giving a three-month supply of ARVs. The situation remains stable, but patients have to visit health centers more often for refills," said Tukuisai Todewa (53), an HIV activist with Zimbabwe HIV and AIDS Activist Union Community Trust in Murehwa, Mashonaland East. 

Murehwa District Hospital still offers six months’ worth.

Public health experts have urged Zimbabwe to explore sustainable solutions to mitigate the impact of U.S. aid cuts on its HIV response. Strengthening domestic funding for HIV programs, expanding public-private partnerships, and leveraging support from other global donors are critical to maintain progress.

HIV in focus

This news story has been published as part of our HIV in focus news network. This is a network of writers and journalists from focus countries, dedicated to delivering news on HIV and sexual health. The network aims to amplify the voices of communities most affected by HIV and share the stories that matter to them.

About the writer

Michael Gwarisa is a multi-award-winning Zimbabwean health journalist whose work has been credited in various academic studies and referenced in numerous news articles. He is passionate about reporting on HIV, sexual and reproductive health (SRH), gender, AMR and climate change. He is also a 2023 Africa CDC Public Health Journalism Fellow and a certified public health communicator.