HIV patients pay hidden fees as ARV shortage deepens in Zimbabwe

A growing crisis is unfolding in Zimbabwe as some nurses at public clinics in Harare are reportedly charging people living with HIV illicit fees for access to lifesaving antiretroviral (ARV) medication, amid a worsening shortage of the drugs.

The crisis has been triggered by a global aid freeze initiated by former U.S. President Donald Trump. On January 20, Trump suspended all international assistance for 90 days, a move that halted critical health aid to countries like Zimbabwe. The shutdown included the disbanding of the U.S. Agency for International Development (USAID), and the suspension was later extended by 30 more days, further tightening the aid chokehold.

Stanley Takaona, president of the Zimbabwe HIV/AIDS Activist Union Community Trust, said the aid cuts have left Zimbabwe “in a very difficult situation,” threatening years of progress in the national HIV response.

"We're facing a situation where patients must choose between life and poverty. The global aid freeze has disrupted the ARV supply chain, and the most vulnerable are paying the price," Takaona told Health Policy Watch.

Zimbabwe had made significant strides in HIV treatment, becoming one of only five African nations to meet the UNAIDS 95-95-95 targets by 2023. But that progress now hangs in the balance. As of 2022, 1.3 million Zimbabweans were living with HIV, with approximately 1.2 million of them on ARVs.

Long queues at clinics have become commonplace, and desperation is driving many to pay bribes to receive what used to be freely distributed medication.

"Many HIV positive people in my area, including myself, are now bribing nurses at local clinics in order to get the usual six months' allocation of treatment drugs," said one Harare resident, who asked to remain anonymous for fear of reprisal.

A nurse at a Harare clinic, speaking anonymously, confirmed the illegal activity:
"It's our time to make money from desperate HIV patients because our salaries alone can't sustain us. With the ARVs now scarce, we just put a small fee on them for our own benefit in backdoor deals."

The government, however, denies any shortages. During a parliamentary session in February, Health Minister Douglas Mombeshora assured lawmakers that Zimbabwe had secured a six-month stockpile of ARVs and that treatment access would remain uninterrupted.

Despite the official position, the situation on the ground tells a different story. The government's pre-exposure prophylaxis (PrEP) programme for high-risk groups such as sex workers has already been suspended, while community health advocates continue to raise alarms over dwindling medicine stocks and growing desperation.

Calls are mounting for immediate intervention from the government and international partners to restore ARV supplies and stop the exploitation of patients. Advocacy groups warn that without urgent action, the nation could see a reversal in decades of hard-won progress against HIV/AIDS.