HIV services uninterrupted despite US aid withdrawal

Ray Bande
Senior Reporter
MORE than 6 000 people living with HIV in seven districts, including Mutare and Chipinge, have been successfully integrated into public health institutions, while over 90 percent of healthcare workers left jobless following the withdrawal of United States funding have either been absorbed or are in the process of being re-engaged by Government.
The developments have helped avert major disruptions to HIV and AIDS programming following the end of US-funded health support on September 30, when Zimbabwe and the United States failed to agree on a new Health Memorandum of Understanding.
Investigations by The Manica Post established that patients who had been receiving care through USA-funded New Start Centres have largely been transitioned, either to Government and municipal health facilities or into alternative HIV care programmes established to outlive donor support.
According to information provided by Population Solutions for Health (PSH), more than 6 000 clients from Mutare, Chipinge, Harare, Chitungwiza, Bulawayo, Gweru and Masvingo have been transferred to public health institutions.
In addition, more than 7 000 other clients have been absorbed into private HIV and AIDS care programmes that continued operating after donor funding ended.
The transitions follow the closure of the PREVENT Project, an HIV prevention and treatment initiative implemented by PSH in partnership with FACT, CeSHHAR and the Ministry of Health and Child Care, with funding from the US Government through the US Department of State.
For nearly two decades, the US Government was one of Zimbabwe’s largest health sector partners, injecting more than US$1,9 billion into the country’s healthcare system since 2006, and playing a significant role in strengthening the national HIV response.
The funding contributed to Zimbabwe’s progress towards achieving the UNAIDS 95-95-95 targets, which aim to ensure that 95 percent of people living with HIV know their status, 95 percent of those diagnosed receive sustained antiretroviral therapy and 95 percent of those on treatment achieve viral suppression.
Despite concerns raised when donor funding ended, health officials say service delivery has remained stable.
Speaking on the province’s preparedness to manage HIV and Aids programmes in the post-donor funding era, Manicaland Provincial Maternal, Newborn and Child Health Officer, Dr Cephas Fonte, said Government had moved swiftly to ensure that both human resources and service delivery systems remained intact.
He said Zimbabwe’s health sector already had strong institutional capacity built over many years, including a mentorship programme that enabled nurses at primary healthcare level to initiate and manage antiretroviral therapy.
“The mentorship programme was initiated by the Ministry of Health and Child Care, working with the World Health Organisation, long before many partner interventions. It was introduced to decentralise HIV treatment services and bring care closer to communities.
“We therefore have a large pool of trained healthcare workers within the ministry structure who are capable of continuing this work. The health system was already in place before development partners came in to provide support,” said Dr Fonte.
He revealed that Government had received Treasury support to recruit health personnel and address staffing shortages across the country.
“We had nurses, primary healthcare counsellors and community health referral workers whose contracts ended after the withdrawal of US funding.
“However, Government has since received Treasury approval to recruit additional personnel. The Health Services Commission introduced the Health Transition Framework, allowing healthcare workers previously employed by partners to indicate their willingness to join the Ministry of Health and Child Care.
“We are pleased that more than 90 percent of them have expressed willingness to return. Recruitment is currently underway. As a result, there has been very little disruption in terms of human resources,” he said.
Dr Fonte said the health sector currently has more than 8 000 vacancies available for recruitment.
He stressed that many of the affected personnel were originally trained using Government systems and can therefore be readily integrated into the public sector.
“The partners did not train these nurses and counsellors. They were trained through Government institutions and programmes. What we are seeing is largely a transition of personnel from partner-supported programmes back into the Ministry of Health and Child Care,” he said.
Dr Fonte also expressed confidence that Zimbabwe has sufficient domestic financing mechanisms to sustain critical HIV services.
Among the funding streams available are the National Aids Levy, sin taxes and other health-related levies introduced by Government.
“We have the AIDS Levy, which continues to provide resources for HIV and TB programmes. We also have other funding streams, including taxes on certain products and services, as well as support from private sector partners.
“The President and the Minister of Health and Child Care have made it clear that no one requiring antiretroviral therapy will be denied treatment. Laboratories remain functional and continue to provide all essential tests. The health system will continue operating,” he said.
PSH said it had anticipated the eventual withdrawal of donor funding, and had already begun implementing a sustainability strategy through a Social Enterprise model established in 2023.
According to the organisation, the initiative was specifically designed to preserve access to essential HIV and primary healthcare services beyond donor support.
“PSH created its Social Enterprise to help keep key HIV and basic healthcare services running over the long term.
“Although the early end of donor support accelerated this work, it has been part of PSH’s plan since 2023. When determining where clients would continue receiving care, PSH considered their preferences and their willingness and ability to pay for services,” said the organisation.
Nationally, 55 percent of clients receiving antiretroviral therapy through PSH programmes opted to continue receiving care through the organisation’s cost-recovery model, where patients contribute modest fees or use health insurance to support service delivery.
The remaining 45 percent were transitioned to Government health facilities to ensure uninterrupted access to life-saving treatment.
In Manicaland, the majority of clients elected to remain within the PSH care network.
PSH said 66 percent of clients who had been receiving services through the PREVENT Project in Mutare chose to continue their HIV treatment through the cost-recovery model at Mutare New Start Centre.
In Chipinge, 37 percent opted for the same arrangement at Chipinge New Start Centre, while the remainder were successfully integrated into Ministry of Health and Child Care and local authority health facilities.

Source: HIV services uninterrupted despite US aid withdrawal – herald

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