Zimbabwe fears HIV setbacks despite global praise

Zimbabwe has earned widespread international praise for its achievements in the fight against HIV, with the latest UNAIDS Global AIDS Update 2025 placing the country among a select group on track to meet the ambitious 2030 target of ending AIDS as a public health threat. However, local health authorities have sounded a stark warning: without urgent intervention to address recent funding setbacks, the next five years could reverse the hard-won progress made since 2020.

According to UNAIDS, Zimbabwe is one of only seven countries in Eastern and Southern Africa to have reached the 95-95-95 HIV treatment targets by 2024. These benchmarks require that 95 percent of people living with HIV know their status, 95 percent of those diagnosed are on antiretroviral therapy (ART), and 95 percent of those on treatment achieve viral suppression.

Zimbabwe's success has been driven by five years of intensified efforts between 2020 and 2024, marked by expanded HIV testing, person-centred care models, and innovations such as multi-month ART refills, which helped decongest health facilities and improve treatment adherence.

Dr Bernard Madzima, Chief Executive Officer of the National AIDS Council (NAC), welcomed the recognition from UNAIDS, describing the progress as the result of strategic and long-term investments in HIV care. However, he warned that the country's gains are vulnerable to being undone due to abrupt funding cuts in 2025, particularly from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). These reductions have already disrupted prevention programs, medical supply chains, and community-led interventions that have been central to Zimbabwe's HIV response.

"The UNAIDS are right, we are one of the countries which have achieved the 95-95-95 targets despite the cuts. But you have to understand that the cuts happened this year, while these targets were achieved over five years, from 2020 to 2024," Dr Madzima said. "Our worry is that with the funding cuts now, we might suffer a reversal of our gains over the next few years."

He stressed that while the achievements deserve celebration, Zimbabwe cannot afford to lose momentum before 2030, when the country hopes to achieve zero new infections, zero stigma, and zero HIV-related deaths.

Zimbabwe's progress remains impressive despite persistent challenges. Men living with HIV are still less likely than women to access treatment and achieve viral suppression, with 73 percent of men on ART compared to 83 percent of women, and 69 percent of men achieving viral suppression compared to 79 percent of women. This gender gap underscores the need for more targeted interventions focusing specifically on men.

Key populations such as sex workers, men who have sex with men, and people who inject drugs continue to face significant stigma and legal barriers, limiting their access to vital health services. These groups account for 25 percent of new infections in sub-Saharan Africa and often experience heightened difficulties in obtaining HIV-related care.

Zimbabwe is also grappling with the problem of late presentation, with one in four people initiating treatment only after developing advanced HIV symptoms, often due to late diagnosis or prior interruptions in care.

Nevertheless, Zimbabwe's record on reducing HIV incidence and AIDS-related mortality remains commendable. Since 2010, new infections in sub-Saharan Africa have declined by 56 percent, with Zimbabwe leading this downward trend. Globally, AIDS-related deaths have dropped by 54 percent, thanks to robust ART rollouts and improved viral load monitoring systems. Zimbabwe's efforts in preventing mother-to-child transmission have also yielded significant results, contributing to a 62 percent global decline in vertical transmission since 2010.

Dr Madzima emphasized the urgent need for Zimbabwe to build domestic funding mechanisms and strengthen community-driven responses to safeguard the gains achieved. He said differentiated services that specifically cater to men, adolescents, and marginalized groups must be expanded. Innovative solutions such as HIV self-testing and long-acting injectable PrEP could further bolster efforts to improve early diagnosis and prevention. Addressing stigma, discriminatory laws, and gender inequality also remains critical to ensuring equitable access to care.

UNAIDS has warned that the current global funding crisis could result in six million new infections by 2029 if urgent corrective measures are not taken. For Zimbabwe, a country that has emerged as a model of HIV control, such a scenario would be particularly devastating.

Still, the outlook remains cautiously hopeful. The solid foundation laid over the past five years provides Zimbabwe with a strong platform. With renewed commitment, strategic investment, and inclusive policies, the country can protect its gains and reach its 2030 goal of ending AIDS as a public health threat.