Community Working Group on Health

CWGH launches youth-focused sexual reproductive health and rights programme in four provinces

By Gamuchirai Masiyiwa, GPJ Zimbabwe

Rumbidzai poses for a portrait in Epworth, an informal settlement in Harare. She is among thousands of sex workers affected by the suspension of US-funded mobile health clinics that provided HIV treatment, testing and contraceptives.

This story was originally published by Global Press Journal.

HARARE, ZIMBABWE — Rumbidzai, a sex worker from the bustling settlement of Epworth in Harare, has been taking antiretroviral drugs since 2017. For over two years, the mother of three has relied on mobile clinics that regularly visit her community to offer vital services such as ARVs, as well as condoms and HIV testing.

For years, the familiar sight of mobile health clinics rolling through the densely populated streets of the settlement meant survival for Rumbidzai and thousands like her. These clinics were lifelines, bringing essential HIV medication, testing and protection directly to those who needed it most.

Since Jan. 20, the clinics have all vanished — casualties of a sweeping United States foreign aid suspension that has left Zimbabwe’s most vulnerable populations in crisis.

“I don’t want to die — my children are still young. Who will take care of them?” says Rumbidzai, requesting only her middle name be used due to concerns about stigma.This story was originally published by Global Press Journal.

HARARE, ZIMBABWE — Rumbidzai, a sex worker from the bustling settlement of Epworth in Harare, has been taking antiretroviral drugs since 2017. For over two years, the mother of three has relied on mobile clinics that regularly visit her community to offer vital services such as ARVs, as well as condoms and HIV testing.

For years, the familiar sight of mobile health clinics rolling through the densely populated streets of the settlement meant survival for Rumbidzai and thousands like her. These clinics were lifelines, bringing essential HIV medication, testing and protection directly to those who needed it most.

Since Jan. 20, the clinics have all vanished — casualties of a sweeping United States foreign aid suspension that has left Zimbabwe’s most vulnerable populations in crisis.

“I don’t want to die — my children are still young. Who will take care of them?” says Rumbidzai, requesting only her middle name be used due to concerns about stigma.

A recent directive from US President Donald Trump ordering the United States Agency for International Development to cease operations has led to the shutdown of numerous crucial programs in Zimbabwe, directly impacting organizations such as Population Solutions for Health and CeSHHAR , which have long been a lifeline to sex workers.

“The sex workers are crying; they are afraid of dying,” says Chipo, an outreach worker who has served these communities since 2015. She asked only to use her middle name for fear of retribution. In Harare alone, she says, mobile clinics are serving nearly 6,000 sex workers — all now left scrambling for basic health care.

Zimbabwe has about 1.3 million people living with HIV/AIDS and close to 95% are on ARV treatment, a significant part of which is funded by the US, primarily through the President’s Emergency Plan for AIDS Relief program, known as PEPFAR.

In 2023, the allocated resources for HIV in eastern and southern African countries totalled 9.3 billion US dollars. Domestic funding covered about 40% of that amount, while the rest was provided by external sources, primarily PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Community-based mobile health clinics have proven to be an effective model for delivering health care to vulnerable populations, especially in countries with lower gross national incomes. These clinics are especially valuable for people who may not typically visit public health centers, such as people engaged in transactional sex.

Beauty Magora, who began sex work in 2015 and now serves as a community mobilizer, is worried about her upcoming HIV prevention treatment. She typically receives preexposure prophylaxis treatment every two months through mobile clinics, which provided the service free of charge. PReP is an injectable antiretroviral treatment that diminishes the chance of contracting HIV.

With the clinics suspended, she’s uncertain about switching to tablet medication. “I don’t know if there will be any effects if I switch to tablets,” she says.

Magora’s uncertainty reflects a broader crisis affecting the estimated 45,000 female sex workers in Zimbabwe, more than half of whom are HIV-positive.

The impact reaches beyond medication. Condoms, once freely distributed, have become precious commodities. “Local clinics only give us three to four strips per week,” Rumbidzai says. “In our trade, that’s not enough. People will take risks when supplies run out — something we desperately want to avoid.”

A shortage of condoms will lead to the creation of a breeding ground for infections and reinfections, affecting not just sex workers but their clients as well, says Muchanyara Cynthia Mukamuri, chairperson of the Women’s Coalition of Zimbabwe. At the same time, a huge portion of funding for antiretroviral therapy came from the US, she adds. “If that is withdrawn, will Zimbabwe be able to cope with the rise of need for HIV prevention, treatment and all these things?”

Mukamuri emphasizes that with all the natural resources Zimbabwe possesses, the country should now strive for self-sufficiency. “We need to revisit our strategies, refocus our efforts, and redirect our resources to ensure that people living with HIV are not left at the mercy of whoever decides to provide — or withhold — resources,” she says.

Meanwhile, Rumbidzai is clinging to hope for a change in policy. “If anything, Trump should lighten his heart, because our lives are hanging by a thread,” she says.

Global Press is an award-winning international news publication with more than 40 independent newsrooms in Africa, Asia and Latin America.

Photo credit: Gamuchirai Masiyiwa, GPJ Zimbabwe

By Problem Masau and Vanessa Gonye

UNCERTAINTY has gripped thousands of employees in the non-governmental organisation (NGO) and civil society organisation (CSO) sectors after they were told to go home following United States President Donald Trump’s issuance of an executive order to freeze foreign aid for 90 days.

Zimbabwe has thousands of NGOs and CSOs across a range of sectors, with the majority of them getting huge chunks of their funding from the US.

The categories that have been severely affected are humanitarian aid, service organisations and political governance.

According to the 2019 Labour Force and Child Labour Survey conducted by the Zimbabwe National StatisticsAgency, the NGO sector accounts for 1,2% of the total employed persons in the country, which translates to an aggregate figure of 17 643 formal jobs.

The figure could, however, be larger amid indications that the sector was the second largest employer in Zimbabwe after government.

Employees who spoke on condition of anonymity yesterday told NewsDay that they were uncertain about their continued employment after Trump’s 90-day review.

“We are in a difficult position. We don’t know what will happen after the 90 days,” one of them said.

“I also do not know where I will get money for rentals since our salaries were also frozen.”

Zimbabwe Nurses Association secretary-general Enock Dongo told NewsDay that nurses, who were working at local clinics under the US President’s Emergency Plan for Aids Relief (PEPFAR) programme, have been told not to come to work.

“We have members who have been working at local clinics who have been told not to report to duty today (yesterday).

“Those people are under emotional stress and also the patients who were waiting for them are affected,” he said.

“What the Trump administration has done is very disrespectful. You cannot just wake up and tell people not to come to work without notice.

“Even if the Zimbabwean government wants to chip in, it needs to prepare first. Africa should wake up and not rely on Western funds.”

Most of the workers were told to surrender vehicles and gadgets belonging to the NGOs.

Crisis in Zimbabwe Coalition (CiZC) director Blessing Vava said it was high time the country and the NGO sector came up with ways to deal with national problems.

“I think it is an opportunity for us to go back to the basics and build organic movements, where voluntarism and sacrifice are at the centre,” he said.

“Trump is doing what he is doing for his country and the American people.

“We are Zimbabweans and can never be American, so let’s focus on fixing our problems instead.”

The US embassy in Zimbabwe issued a statement confirming that the executive order was now in effect affecting aid programmes in the country.

The embassy noted Zimbabwe’s recent progress in combating HIV, noting that the country has achieved the global 95/95/95 targets — a benchmark for HIV testing, treatment and viral suppression.

However, the embassy called on government to take greater responsibility for sustaining these gains.

“They urgently need to be focused on buying antiretroviral therapy (ART) and getting nurses in clinics. They can do this,” the statement read.

Meanwhile, stakeholders in the health sector have expressed concern over massive reliance on donor funding as anything can happen leaving the masses in danger.

Community Working Group on Health executive director Itai Rusike said the consequences would be catastrophic to patients and communities in Zimbabwe that depended on US support for lifesaving interventions as they would face disruptions to critical services.

“It is risky and unsustainable for a country to depend substantially on external partners as donors can withdraw financial support anytime should their interests shift for some reason or other,” he said.

“It is very sad that when a country is highly dependent on external aid, health priority in government spending tends to fall in line with increased aid.

“Development assistance for health has crowded out government resources and created donor dependence.”

Health expert Martha Tholanah said the executive order was a wake-up call for Zimbabwe.

“Having such panic means our reliance on foreign funding is too heavy. We need more domestic resources for health from the national Treasury,” she said.

“Partners should complement the government, not the other way round. I hope we get our support for treatment sorted such that we never have to be in such distress when a foreign partner decides to withdraw their support.”

Approximately 1,2 million people in Zimbabwe are on HIV treatment and around 90% of HIV-positive pregnant women receive ART.

The developments mean children are under the risk of contracting HIV if mothers stop taking their medication and many more people will be affected given the state of the health sector in Zimbabwe.

By the end of 2023, the US had poured in over US$300 million in active programmes in Zimbabwe, according to the United States Agency for International Development foreign aid portal.

Finance minister Mthuli Ncube has indicated that the government will fund the gap left by the US through tax. -Newsday

https://www.newsday.co.zw/local-news/article/200037270/us-withdrawal-from-who-spells-doom-for-zims-health-sector

Article By Vanessa Gonye |

ZIMBABWEAN health experts have raised concern over the newly-inaugurated United States President Donald Trump’s decision to withdraw his country from the World Health Organisation (WHO) saying the world’s largest economy was one of the major funders of the United Nations agency.

Trump accused WHO of mishandling the COVID-19 pandemic and other international health crises, adding that it had also failed to act independently of the inappropriate political influence of member States.

“World Health Organisation ripped us off, everybody ripped off the United States. It’s not going to happen anymore,” Trump said during the signing of an executive order on the withdrawal, shortly after his inauguration to a second term on Monday.

Analysts told NewsDay yesterday that Trump’s decision will affect the country’s health delivery programme funded through WHO.

Medical and Dental Private Practitioners of Zimbabwe Association president Johannes Marisa said the withdrawal would be a serious blow to international health systems.

“In terms of disease outbreaks, like recently with the Mpox, with the COVID-19, with other diseases, measles and so forth, WHO has to do serious surveillance, has to do serious communication, undertake contact tracing and has to do serious case management.

“These programmes or strategies were funded by WHO, which is sponsored by the US among other countries meaning failure to access money or to have adequate funding, the World Health Organisation will be on its knees,” he said.

Itai Rusike, Community Working Group on Health executive director expressed hope for a way out of the impasse between the US government and WHO.

Rusike said WHO being the global authority on health required all the support both technically and materially to fully execute its mandate.

“The withdrawal of the US implies it will not provide the support which we hear amounts to about a fifth of the WHO budget and this is of concern when health challenges are increasing.

“This has considerable impact on the organisation’s operations at all levels and may result in reduced support for our country when the fragility of our health system demands more resources,” he said.

Rusike said Trump’s decision served as a reminder to governments to quickly move towards self-sustenance.

Tendai Westerhof, Pan-African Positive Women’s Coalition Zimbabwe’s national director, echoed the same sentiments highlighting issues of sustainability.

“80% of our funding comes from external donors and we only have 20% that we mobilise locally. So really, this calls for us as countries, especially us in the developing world, to be not too dependent on external funding.

“We appreciate that the US was funding PEPFAR and a lot of money was coming into countries through PEPFAR, through the global fund and WHO, it’s a world organisation that does not discriminate,” she said.

Westerhof added: “We must look internally and be innovative to see how best we can increase our internal domestic funding to the health budget in particular.”

In a statement yesterday, WHO director Tedros Adhanom Ghebreyesus said news of the US’s withdrawal from the organisation was regrettable.

He said WHO played a crucial role in protecting the health and security of the world’s people by addressing the root causes of diseases building stronger health systems, and detecting, preventing and responding to health emergencies.

“The United States was a founding member of WHO in 1948 and has participated in shaping and governing WHO’s work ever since, alongside 193 other member States, including through its active participation in the World Health Assembly and Executive Board,” he said.

Tedros expressed hope the US will reconsider and engage them “in constructive dialogue to maintain the partnership between the US and WHO.” –  Newsday