By Lloyd Gideon Makonese – Public Health & HIV Intervention Specialist

In early 2025, Zimbabwe’s HIV response stands at a perilous crossroads. The abrupt suspension of USAID and PEPFAR funding initiated during Donald Trump’s presidency and only partially lifted, has triggered a cascade of disruptions across the country’s HIV treatment and prevention landscape. While officials offer reassurances, the lived realities for healthcare workers and patients tell a far more troubling story.

On 28 January, thousands of healthcare workers, including HIV nurse Chiedza Makura, received sudden termination notices via WhatsApp. Makura, a single mother of three, had dedicated years to providing antiretroviral therapy (ART) and related services. Her dismissal, a direct consequence of the funding freeze, left her without income and her patients without care. Clinics like Population Solutions for Health and New Start Centres, once vital for HIV testing, counselling, and ART distribution, were forced to shut their doors overnight.

Chiedza Makura was employed as an HIV nurse at Zim-TTech, a private voluntary organisation established by the University of Washington’s International Training and Education Center for Health in 2003. Zim-TTech has been instrumental in providing HIV and AIDS-related services in Zimbabwe. Makura’s responsibilities included collecting blood samples, measuring viral loads, conducting tuberculosis (TB) screenings, advocating for TB prophylactic treatment, and resupplying antiretroviral therapy (ART) .

Her sudden dismissal on 28 January 2025, communicated via WhatsApp, was a direct consequence of the abrupt suspension of USAID funding under President Donald Trump’s administration. This funding freeze severely impacted organisations like Zim-TTech, which relied heavily on external aid to support their healthcare initiatives. The withdrawal of funds led to the closure of several clinics and the termination of numerous healthcare workers, disrupting essential HIV treatment and prevention services across the country.

The ramifications extend beyond individual livelihoods. Approximately 1.2 million Zimbabweans rely on ART, many of whom now face uncertainty regarding their treatment continuity. Key populations such as sex workers, transgender individuals, and men who have sex with men, have been disproportionately affected, losing access to essential services like pre-exposure prophylaxis (PrEP), sexually transmitted infection screenings, and safe spaces for healthcare.

The government’s response has been to downplay the crisis. Health Minister Douglas Mombeshora assured Parliament that only 31% of ARV supplies were affected and that stocks would be replenished by June. However, this perspective overlooks the broader systemic issues: the loss of trained personnel, the collapse of community outreach programs, and the erosion of trust in healthcare systems.

Zimbabwe’s health sector has long been heavily reliant on donor funding. The sudden withdrawal of support exposes the fragility of this dependence. While the Global Fund continues to provide some assistance, it cannot fully compensate for the scale of the disruption. Civil society organisations, which play a crucial role in reaching marginalised communities, are struggling to maintain operations without external funding.

This crisis serves as a stark reminder of the human cost of geopolitical decisions. The suspension of aid, driven by political agendas far removed from the realities on the ground, has immediate and devastating consequences for vulnerable populations. It underscores the need for Zimbabwe to invest in sustainable, domestically funded healthcare solutions that are resilient to external shocks.

As the world watches, the international community must recognise its role in both the problem and the solution. Reinstating and safeguarding funding for HIV programs is not just a matter of policy but it is a moral imperative. The lives of millions depend on it.