"My Story has a good end thanks to the DREAMs Club- Delphine, age 16.

Allison DiVincenzo

The top three health threats facing the people of Zimbabwe are HIV, tuberculosis (TB), and malaria.  These diseases contribute significantly to maternal and childhood illness and deaths.  Declining economic conditions and rising costs of living have eroded a health system once known regionally for its well-educated, robust workforce and ability to provide advanced medical care.  USAID supports programs to reduce preventable deaths and lessen the disease burden, especially among women and children under five. 

HIV and AIDS

USAID’s HIV prevention, care and treatment activities under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) have contributed to the great successes achieved under the national AIDS program.  Since PEPFAR’s inception in Zimbabwe in 2006, the annual number of HIV-related deaths has declined by 80 percent. AIDS-related deaths have fallen from 121,000 in 2005 to 24,000 in 2017.  Although the number of AIDS-related deaths continues to decrease, HIV prevalence in Zimbabwe remains high.

In 2019, PEPFAR contributed more than $160 million for HIV prevention, treatment, care and support activities in Zimbabwe.  This investment has resulted in more than 960,000 Zimbabweans being put on lifesaving antiretroviral medicines (ARVs) to date.

More than 90 percent of all antenatal care sites in Zimbabwe have PEPFAR-supported services for the prevention of mother-to-child transmission of HIV, allowing pregnant women who test positive for HIV to initiate lifelong antiretroviral therapy, saving the lives of newborns.

In 2016, the U.S. Government launched a $60 million initiative in six districts in Zimbabwe to  reduce new HIV infections among adolescent girls and young women.  The initiative, called DREAMS, helps more than 476,000 girls live Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe lives.

Annually, the United States provides substantial HIV prevention, treatment, care, and support through PEPFAR to:

• Provide voluntary medical male circumcision for over 200,000 men;
• Support HIV testing and counseling for over 2 million people;
• Support community level interventions that care for orphans and vulnerable children infected or affected by HIV, improving the well-being of over 307,000 children; and
• Support HIV prevention, treatment, care, and support among adolescent girls and young women and key populations, including sex workers.

Tuberculosis

USAID supports the national tuberculosis (TB) control programme to prevent, find and detect, and treat TB cases across Zimbabwe.  TB is the second leading cause of death in Zimbabwe, and many cases are drug resistant.  USAID support has helped the TB program detect 78 percent of the cases, initiate 91 percent of the cases on treatment, and successfully treat 85 percent of all TB patients.  

USAID supports universal testing of patients for TB and HIV, rollout of newer and shorter TB treatment regimens for patients with drug resistant TB, and refurbishment of national TB reference laboratories.  USAID also supports a robust sample transport system, which serves more than 900 of the 1,500 health facilities nationwide, drastically reducing turn-around time and increasing the number of specimens collected and tested.  Patients with HIV and TB have seen a 75 percent reduction in HIV-associated TB mortality between 2016 and 2018, and Zimbabweans affected by TB now live longer and healthier lives.

Malaria

Malaria remains among the top three causes of illness and death in Zimbabwe.  Pregnant women and children under five are among the most vulnerable and over half of the population lives in areas at risk.  

In 2011, Zimbabwe was designated as one of the U.S. Government’s President’s Malaria Initiative (PMI) recipient countries and USAID works to prevent malaria transmission and improve treatment to reduce malaria related deaths through indoor residual spraying, wide coverage of long-lasting mosquito nets for both indoor and outdoor sleeping spaces, and improved management of malaria cases in 45 districts.  USAID provides vital commodities such as mosquito nets, rapid diagnostic tests, and life-saving medications, while also training health care workers and promoting social and behavior change. 

In just 10 years, the coordinated efforts of USAID, the Global Fund, and the National Malaria Control Program have contributed to a substantial drop in malaria cases in Zimbabwe from 1.2 million in 2008 to 264,278 in 2018 – a 78 percent reduction.  

In the immediate aftermath of Cyclone Idai in 2019, PMI provided 175,000 insecticide-treated bed nets to isolated communities in Chimanimani to prevent malaria.

Maternal, Newborn and Child Health

USAID’s support in maternal, newborn and child health has increased the number of safe childbirths and improved maternal and child health services in all districts of Manicaland Province.  USAID activities have also strengthened reproductive health services for rural women across the country, improving access to a wide range of methods, including long-acting and permanent methods. 

In 2018, USAID supported on-the-job training for more than 60 percent of the targeted healthcare workers in all districts in Manicaland to improve quality of care for mothers and babies.  This support contributed to a 10 percent increase in the number of women who received services to mitigate bleeding during childbirth, saving the lives of both mothers and children.   

Health Supply Chain Management Services

To support quality service delivery and ensure an uninterrupted supply of lifesaving medicines nationwide, USAID works to improve the country’s medical supply chain management system.  This support includes forecasting future needs, procuring and distributing essential medicines and supplies, and data reporting and use.  Additionally, USAID programs provide both public sector and socially-marketed condoms.