Zimbabwe, US $367 million funding tiff triggers panic?

Zimbabwe's decision to withdraw from a multimillion-dollar United States health funding agreement has triggered strong warnings from across the health sector, amid fears that the move could reverse gains made in the fight against HIV and place more than 1.2 million people at risk.

Former health minister Dr Henry Madzorera said the country should by now have achieved donor independence, arguing that existing domestic financing mechanisms were designed to cushion the health sector from external shocks. He pointed to the National AIDS Trust Fund and various health levies as instruments meant to sustain critical programmes.

"We should be completely independent right now," Madzorera said. "The funds are there. What we need is good stewardship of Zimbabwean funds."

He expressed doubt about the government's capacity to absorb the impact of a sudden withdrawal of US support, warning that without decisive reforms and accountability, patients could face treatment interruptions, rising drug resistance and preventable deaths.

Parliament's Health and Child Care Portfolio Committee acting chairperson Discent Bajila also questioned the wisdom of abandoning the agreement outright at a critical stage in the HIV response.

"It sounds quite strange that the deal is thrown away in total while there are issues around it that could have been of benefit to our people," Bajila said.

He cautioned that the effects could be immediate, particularly in relation to viral load suppression if shortages of antiretroviral medicines occur. Bajila warned that Zimbabwe risks sliding back to a period when HIV posed a far greater public health threat, undermining national development ambitions and long-term targets to end HIV as a public health concern.

Health Times editor Michael Gwarisa described the decision as politically defensible on sovereignty grounds but potentially damaging from a clinical standpoint. He urged authorities and the US Embassy to return to negotiations to safeguard essential services.

"From a political and patriotic point of view, it was a great move," Gwarisa said. "But looking from a health perspective, there's a need for the government and the US Embassy to go back to the negotiating table."

He noted that more than 1.2 million Zimbabweans rely directly on US-funded antiretroviral therapy programmes, warning that interruptions in treatment could lead to rapid health deterioration and disrupt prevention initiatives, particularly those targeting adolescent girls. He added that the withdrawal could also affect the rollout of new HIV prevention medicines.

Government spokesperson Nick Mangwana defended the decision as a matter of sovereignty. He said the proposed agreement required extensive access to sensitive health and pathogen data without firm guarantees that Zimbabwe would benefit from any resulting medical innovations. Authorities have maintained that the move was necessary to protect national interests and to uphold multilateral commitments governing data sharing through global health frameworks.

Across the health sector, clinicians, lawmakers and analysts agree that the country now faces a critical test. Whether Zimbabwe achieves long-promised self-reliance or suffers a setback in the fight against HIV will depend on its ability to close funding gaps, strengthen systems and ensure disciplined management of domestic resources.

For patients who depend on consistent access to treatment, the stakes are immediate. Continuity of care, drug availability and the stability of a response built over two decades now hinge on how swiftly and effectively Zimbabwe can replace the support it has chosen to forgo.