The Impact of U.S. Aid Withdrawal on HIV Programs in Zimbabwe: A Scholarly Analysis of Consequences and Challenges

Herbert Mandicheta, Suzanne Abera, Iybrig Rice

Abstract


This article critically examines the consequences of U.S. aid withdrawal on Zimbabwe’s HIV programs. Relying on secondary data and literature review, the study highlights the impact on ART access, prevention programs, and health system sustainability. The paper applies concepts from dependency theory and health systems resilience to offer a deeper understanding of Zimbabwe’s structural vulnerabilities and policy gaps. It concludes with recommendations for domestic resource mobilization, capacity building, and community-led solutions to mitigate the effects of foreign aid reduction.


Keywords


HIV; Zimbabwe; Foreign aid withdrawal; PEPFAR; Public health policy; Antiretroviral therapy; Donor dependency; Health systems resilience

Full Text:

PDF

References


Bekker, L. G., Alleyne, G., Baral, S., Cepeda, J., Daskalakis, D., Dowdy, D., … Beyrer, C. (2018). Advancing global health and strengthening the HIV response in the era of the Sustainable Development Goals: The International AIDS Society Lancet Commission. The Lancet, 392(10144), 312 358. https://doi.org/10.1016/S0140-6736(18)31070-5

Centers for Disease Control and Prevention (CDC). (2021). PEPFAR and Zimbabwe: Achievements and impact. U.S. Department of Health and Human Services.

Centers for Disease Control and Prevention (CDC). (2023). HIV/AIDS in Zimbabwe. Retrieved from https://www.cdc.gov/global-hiv-tb/php/where-we-work/zimbabwe.html

Chibanda, D., Cowan, F., Gibson, L., Weiss, H. A., & Lund, C. (2019). Prevalence and correlates of probable common mental disorders in a population with high prevalence of HIV in Zimbabwe. BMC Psychiatry, 19(1), 56. https://doi.org/10.1186/s12888-019-2039-1

Chidarikire, T., Ndlovu, P., & Mutasa, R. (2018). Community-based HIV testing and prevention programs in Zimbabwe: Impact and challenges. Journal of Public Health Research, 9(3), 115 120. https://doi.org/10.4081/jphr.2018.1421

Chimwaza, A., Gondwe, K., & Mbendera, J. (2021). Scaling up access to ART in sub-Saharan Africa: Lessons from Zimbabwe. AIDS Research and Therapy, 18(1), 45. https://doi.org/10.1186/s12981-021-00366-8

Chirenda, J., Muchabaiwa, L., & Zvidzai, M. (2021). Integrating maternal health services with HIV programs: Evidence from Zimbabwe. African Journal of Reproductive Health, 25(3), 145 157. https://doi.org/10.29063/ajrh2021/v25i3.15

Delany-Moretlwe, S., Mullick, S., Eakle, R., Rees, H., & Puren, A. (2018). HIV prevention in young women in southern Africa: Examining the impact of new biomedical interventions. The Lancet HIV, 5(2), e68 e72. https://doi.org/10.1016/S2352-3018(18)30003-6

Goga, A. E., Dinh, T. H., Jackson, D. J., Lombard, C., & Sherman, G. G. (2020). Impact of prevention of mother-to-child transmission programs on early infant HIV diagnosis in Zimbabwe. Pediatrics, 146(1), e20192943. https://doi.org/10.1542/peds.2019-2943

HealthTimes Zimbabwe. (2024, January 28). Panic grips Zimbabwe’s HIV community as Trump pauses PEPFAR funding. Retrieved from https://healthtimes.co.zw/2025/01/28/panic-grips-zimbabwes-hiv-community-as-trump-pauses-pepfar-funding

Madanhire, C., & Juru, T. (2020). Drug resistance trends in Zimbabwe’s HIV treatment program: An emerging concern. African Journal of Infectious Diseases, 14(3), 112 125. https://doi.org/10.21010/ajid.v14i3.15

Mapingure, M., Mukwenha, S., Chingombe, I., Makota, R. B., Mbunge, E., Moyo, E., … Musuka, G. (2024). Prevalence and risk factors of HIV drug resistance in Zimbabwe: Evidence from the Population-Based HIV Impact Assessment (ZIMPHIA) 2020 survey. Tropical Medicine and Infectious Disease, 9(11), 257. https://doi.org/10.3390/tropicalmed9110257

Mavedzenge, S. N., van Rooyen, H., & Barnabas, R. V. (2021). HIV prevention through the lens of economic empowerment and policy change: A review. Global Public Health, 16(7), 1023 1038. https://doi.org/10.1080/17441692.2020.1810297

Mlambo, T. (2022). Economic challenges and healthcare financing in Zimbabwe: Implications for the HIV response. Health Policy and Planning, 37(5), 678 690. https://doi.org/10.1093/heapol/czab145

Moyo, F., Sibanda, E. L., & Dube, K. (2020). The impact of ART interruptions on virological suppression and drug resistance in Zimbabwe. PLOS ONE, 15(9), e0239617. https://doi.org/10.1371/journal.pone.0239617

Moyo, M., Kufa, D., & Ncube, P. (2020). Challenges in HIV testing uptake in Zimbabwe: A retrospective study of community-based HIV testing programs. African Journal of AIDS Research, 19(1), 45 52. https://doi.org/10.2989/16085906.2020.1748215

Mudzonga, A., & Chiremba, S. (2020). The state of healthcare infrastructure in Zimbabwe: Implications for HIV management and service delivery. International Journal of Health Systems Research, 5(2), 78 85. https://doi.org/10.32474/IJHSR.2020.05.000211

Mutasa-Apollo, T., Shiraishi, R. W., Takarinda, K. C., Dzangare, J., Mugurungi, O., Murungu, J., Abdul-Quader, A., & Woodfill, C. J. I. (2014). Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe’s national antiretroviral therapy programme, 2007 2010. PLOS ONE, 9(1), e86305. https://doi.org/10.1371/journal.pone.0086305

Mutenherwa, F., & Wassenaar, D. R. (2020). Ethical and operational challenges in sustaining donor-funded HIV treatment programs in sub-Saharan Africa. Journal of Medical Ethics, 46(8), 550 556. https://doi.org/10.1136/medethics-2019-105947

National AIDS Council of Zimbabwe. (2023). Zimbabwe HIV Estimates Report.

Nyazema, N. (2016). Healthcare delivery and HIV financing in Zimbabwe: Challenges and opportunities. BMC Health Services Research, 16(1), 223. https://doi.org/10.1186/s12913-016-1535-x

PEPFAR. (2021). Zimbabwe Country Operational Plan (COP) Report 2021. U.S. Department of State. https://www.state.gov/wp-content/uploads/2021/08/Zimbabwe_COP21_2021.pdf

PEPFAR. (2022). PEPFAR 2022 Annual Report to Congress. U.S. Government. https://www.state.gov/wp-content/uploads/2023/01/PEPFAR-Annual-Report-2022.pdf

Reuters. (2024, January 22). Zimbabwe fears U.S. withdrawal will hit HIV/AIDS programmes. Retrieved from https://www.reuters.com/business/healthcare-pharmaceuticals/zimbabwe-fears-us-withdrawal-who-will-hit-hivaids-programmes-2025-01-22

Takarinda, K. C., Mutasa-Apollo, T., Madyira, L. K., Ndhlovu, C. E., Wellington, M., Mugurungi, O., & Apollo, T. (2020). Scaling up ART access in Zimbabwe: A review of progress and policy gaps. BMC Public Health, 20(1), 456. https://doi.org/10.1186/s12889-020-08562-4

The Herald. (2023). Zim makes remarkable progress in HIV fight. Retrieved from https://www.heraldonline.co.zw/zim-makes-remarkable-progress-in-hiv-fight

Togarasei, L., & Masuku, T. (2021). The withdrawal of U.S. aid and its potential impact on HIV prevention programs for marginalized populations in Zimbabwe. International Journal of HIV/AIDS Prevention, Education and Behavioural Science, 4(1), 32 39. https://doi.org/10.11648/j.ijhpebs.20210401.15

UNAIDS. (2021). Zimbabwe HIV Epidemic Report 2021. Joint United Nations Programme on HIV/AIDS.

UNAIDS. (2022). Global AIDS update 2022: In danger. Joint United Nations Programme on HIV/AIDS.

World Health Organization (WHO). (2019). Zimbabwe health financing review: External aid and health systems strengthening. WHO Press.

Zimbabwe Nurses Association (ZNA). (2021). Health workforce shortages in Zimbabwe: A national crisis. Zimbabwe Medical Journal, 27(1), 44 49.




DOI: http://dx.doi.org/10.3968/13742

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Higher Education of Social Science

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


Share us to:   


 

Please send your manuscripts to hess@cscanada.net,or  hess@cscanada.org  for consideration. We look forward to receiving your work.


 


 Articles published in Higher Education of Social Science are licensed under Creative Commons Attribution 4.0 (CC-BY).

HIGHER EDUCATION OF SOCIAL SCIENCE Editorial Office

Address: 1055 Rue Lucien-L'Allier, Unit #772, Montreal, QC H3G 3C4, Canada.
Telephone: 1-514-558 6138 
Website: Http://www.cscanada.net Http://www.cscanada.org 
E-mailcaooc@hotmail.com; office@cscanada.net

Copyright © 2010 Canadian Research & Development Center of Sciences and Cultures