US to end HIV support to Zimbabwe this week: “This is not a future risk – it is a present crisis”

On 24 September 2026, a CHANGE community webinar focussed on the impending crisis to HIV and its wider health system in Zimbabwe, including TB and malaria, driven by a US decision to withdraw from further discussions over funding. [1]

This situation arises from the collapse in negotiations between Zimbabwe and the US that should have led to a bilateral memorandum of understanding (MoU) between the two countries. However, the Trump administration is using new bilateral negotiations with African countries to gain access to potentially profitable health/clinical data and other commercial reasons including mineral wealth. It appears that the Zimbabwean government was not prepared to agree, but its position comes at a huge cost. [2, 3]

The summary details below are from slides presented in the meeting as sound quality was difficult.

Reporting is also difficult because the Zimbabwean government is not engaging civil society on this issue – and it fears inflaming the government.

Current achievements in Zimbabwe include meeting the UNAIDS 95:95:95 target, with 1.2 million people living with HIV on ART and >95% having undetectable viral load. Almost 150,000 people are on PrEP and Zimbabwe was also expecting to receive 300,000 doses of injectable lenacapavir PrEP.

However, 90% of the ART and PrEP coverage, together with funding for 8,300 health care workers, is directly supported by US PEPFAR funding.

Consequences of funding collapse include an estimated annual shortfall of US$80-100 million and an immediate emergency need for $68 million.

Over five years this will result in a loss of $365 million, leading to more than 100,000 preventable deaths and 50,000 new HIV infections.

Countries that have signed MoU agreements with the US, include Nigeria, Kenya, Uganda, Rwanda, Malawi and Mozambique, but South Africa, Tanzania and now Zimbabwe are excluded.

The meeting noted that responsibility for the diplomatic failure that produced this catastrophic situation for Zimbabwe lies with the US. Furthermore, although the US Congress is aware of the problem it appears to be doing nothing about it.

Community responses will use other potential sources of emergency funding, including from the Global Fund and other international donors. They also hope that pressure on both the US and Zimbabwean governments might reopen negotiations for a fairer and more reasonable response.