Despite the
government’s assurance of sufficient stock, recipients of care are hoarding
medication, potentially leading to artificial shortages in some urban health
facilities.
The funding freeze
and cuts on funding by the Trump administration, if effected in full could cost
the country approximately US$522 million. The 90-day-review period ends on 19
April, and the nation awaits the outcome. The freeze has already affected
hundreds of civil society organisations, health workers, and clinics.
While ART is
free in public hospitals, council-run clinics, and mission hospitals, however,
the uncertainty surrounding funding has sparked panic among recipients of care.
Zimbabwe is one of the few countries globally to have domestic funding for HIV.
The AIDS Levy
in Zimbabwe is a notable example of a domestic funding mechanism for health.
Established in 1999, it imposes a 3% tax on individuals’ taxable income and
companies’ profits (excluding the mining industry until 2015). Managed by the
National AIDS Council (NAC), the levy has generated significant revenue,
including US$38.6 million in 2014.
Sadly, with the
United States dollar component of the AIDS Levy having been carried by the NGO
sector and those supported by those employed by the United States Agency for
International Development (USAID), the Centre for Diseases Control (CDC), the
United States President’s Emergency Plan for AIDS Relief (PEPFAR) and many
other foreign funded organisations, the proceeds to the US dollar component
have gone down. The country needs to come up with sustainable ways besides the
numerous taxes.
At law, 55% of
the AIDS funds is dedicated to purchasing antiretroviral medications.
The AIDS Levy
has contributed significantly to Zimbabwe’s HIV response, particularly in
ensuring a stable supply of antiretroviral therapy for second and third line
treatment.
The
consequences of stockpiling of ART could lead to wasted medication, expired
drugs, and unintended consequences. With 1.2 million people on ART in Zimbabwe,
the situation requires careful management to ensure a steady supply of
medication.
The National
AIDS Council (NAC) Chief Executive Officer, Dr Bernard Madzima, in a speech
read on his behalf by Dr Raymond Yekeye, the Operations Director, addressing
editors in Chinhoyi reassured the nation that there was enough ART.
Dr Madzima said
there was no need to panic. The country had enough antiretroviral therapy for
six months in the inventory.
“The country
has enough stock for everyone on ART. We had already procured medicines for
HIV, TB, and malaria, but deliveries were being made in phases. The next
shipment is on the way,” said Dr Madzima.
He highlighted
that 31% of ARVs in Zimbabwe were procured through US funding. The Global Fund
(GF), other partners and the government procure the rest.
Availability
assured
Speaking at the
same workshop, Dr Owen Mugurungi, Director in the AIDS/TB Unit said there
currently has been no disturbance in the supply chain and distribution.
“Stocks of ARV
supplies, HIV, viral load and other lab test kits, as well as condoms are
available at facilities/service points, district, regional, and national
warehouses with minimum or no disruption of distribution,” said Dr Mugurungi.
The UNAIDS
country report as of 10 April, 2025 states: “Some USAID and CDC-supported
organisations have resumed work, while others are still on pause pending the
90-day review.
Public health
facilities continue to provide key services despite disruptions, with support
from the Global Fund in 21 out of 64 districts.
“Human
resources disruptions are affecting HIV treatment services, including medicine
distribution, patient management, and monitoring.
“HIV prevention
services for key populations (sex workers, men who have sex with men, gay men,
people who use drugs, transgender persons, prisoners) are disrupted, including
access to PrEP exposure prophylaxis (PrEP), HIV testing, counseling, ART
services, opioid agonist therapy, and harm reduction services.
“DHIS2
(District Health Information Software 2) is impacted due to the pause in human
resources funding.
“Stigma and
discrimination programmes funded by PEPFAR have stopped, affecting key
populations.
“Despite
disruptions, public health facilities and the Global Fund continue to provide
essential services,” said the report on their website. Masvingo Mirror
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