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“We are losing ground”: Counsellors’ demotivation threatens Zimbabwe’s HIV gains

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BY NOKUTHABA DLAMINI 

The men and women who have been at the heart of Zimbabwe’s fight against HIV — the primary health counsellors — say their morale has hit rock bottom as they continue to work without job security, inconsistent pay, and uncertain futures.

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These counsellors, stationed across hospitals and clinics countrywide, form the backbone of the country’s HIV prevention and treatment programme. They handle testing, counselling, and patient follow-ups — ensuring those on antiretroviral therapy stay in care and that new infections are detected early.

But as Hwange West legislator Vusumuzi Moyo warned in Parliament, the system supporting these essential workers is “crumbling quietly.”

“Their salaries have been very erratic, sometimes going for months without pay,” Moyo told VicFallsLive after his parliamentary question to the Minister of Health and Child Care. “These people are the heartbeat of HIV management. They’re paid from the Global Fund, but payments have not been consistent, and the government has taken too long to incorporate them into the civil service.”

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Currently, the counsellors are funded under the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) — a donor mechanism that has kept thousands of Zimbabwean health posts afloat for years.

However, global aid shifts, including the ripple effects of the U.S. administration’s restrictions on foreign aid, have made their positions increasingly vulnerable.

Health Minister Dr. Douglas Mombeshora confirmed during a recent parliamentary session that staff bids had been submitted to Treasury for approval to absorb counsellors into the government payroll.

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He said that while donor funding has decreased, both the U.S. Government and Global Fund have continued to prioritise support for human resources at primary healthcare level.

Still, for many of the counsellors — and for communities relying on them — the wait has been too long.

Moyo painted a grim picture of what’s happening in hospitals.

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“If you go to referral hospitals like Forrester, you’ll find that about 90% of male ward patients are people who have defaulted on treatment,” he said. “It’s because counsellors are no longer motivated. They used to follow up with patients, call them if they missed visits, and make sure they stayed in care. But now, with no pay or recognition, there’s no incentive to keep doing that work.”

He warned that the country’s AIDS-related deaths are rising again, undoing the progress Zimbabwe had made in reducing HIV prevalence.

“Our statistics had been improving — even other countries were benchmarking our model. But now, it’s as if we’re back to the old days. You see people sick again, wards filling up, and that speaks to a system that’s failing quietly,” Moyo added.

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Zimbabwe has long been recognised as one of Africa’s HIV success stories, cutting its national prevalence from over 26% in the early 2000s to around 11% today, according to research studies. Much of that progress was driven by a strong network of community-based counsellors who ensured people were tested, treated, and supported.

 

 

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National

Zimbabwe fast-tracks approval of long-acting HIV prevention drug Lenacapavir

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BY WANDILE TSHUMA

Zimbabwe has taken a major step in the fight against HIV following the rapid approval of Lenacapavir, a groundbreaking long-acting injectable for HIV pre-exposure prophylaxis (PrEP). The Medicines Control Authority of Zimbabwe (MCAZ) authorised the drug in just 23 days, marking one of the fastest regulatory approvals in the country’s history.

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The application, submitted by pharmaceutical company Gilead Sciences in October, underwent an expedited review because of its public health importance. MCAZ says the fast-tracked process did not compromise scientific scrutiny, with the product subjected to a rigorous assessment of its safety, efficacy and quality.

Lenacapavir is designed for adults and adolescents weighing at least 35kg who are HIV-negative but at substantial risk of infection. Unlike traditional daily oral PrEP, the medicine is administered as a six-monthly injection, following an initiation phase that includes one injection and oral tablets on Days 1 and 2. Health authorities say this long-acting formulation could dramatically improve adherence and expand prevention options, particularly for communities where daily pill-taking is difficult.

MCAZ Director-General  Richard T. Rukwata described the approval as a landmark moment in Zimbabwe’s HIV response.

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“The rapid approval of Lenacapavir reflects MCAZ’s dedication to accelerating access to trusted, high-quality health products. This milestone brings new hope for HIV prevention and reinforces our commitment to safeguarding public health,” he said.

To fast-track the process, the Authority applied a regulatory reliance approach, drawing on scientific assessments from the World Health Organization’s Prequalification Programme (WHO PQ). This allowed evaluators to build on internationally recognised review processes while ensuring Zimbabwe’s own standards were met.

The introduction of Lenacapavir comes as Zimbabwe continues efforts to reduce new HIV infections, particularly among young people and key populations who face barriers to consistent PrEP use. Public health experts say the drug’s twice-yearly dosing could be a game changer in improving uptake and protection.

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MCAZ says it remains committed to ensuring Zimbabweans have access to safe, effective and good-quality medical products, in line with its mandate under the Medicines and Allied Substances Control Act.

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Zimbabwe makes gains against TB

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BY WANDILE TSHUMA

The World Health Organization (WHO) data show that Zimbabwe continues to make measurable gains in its fight against tuberculosis (TB).

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According to the Global Tuberculosis Report 2025, Zimbabwe’s estimated TB incidence has declined to 203 per 100,000 population, representing a 3.8 % reduction from 2023. The report states that “TB incidence in Zimbabwe has fallen to 203 per 100 000, a 3.8 % reduction from 2023.” 

On treatment outcomes, the country’s overall success rate for all forms of TB has improved to 91 %, up from 89 % in 2023. The report quotes: “Treatment success for all forms of TB has improved to 91 %, up from 89 % in 2023.” 

For drug-resistant TB (DR-TB), progress has also been recorded: treatment success rose from 64 % for the 2021 cohort to 68 % for the 2022 cohort. As the report notes: “treatment success for drug-resistant TB increased from 64 % for the 2021 cohort to 68 % for the 2022 cohort.” 

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In the critical sphere of TB‐HIV co-infection, Zimbabwe saw a drop in the co‐infection rate to 49 %, down from 51 %. The report states: “TB/HIV co-infection rates have fallen to 49 %, down from 51 %.” 

Zooming out, the 2025 global report shows that across the world TB is falling again, although not yet at the pace required to meet targets. Globally, incidence declined by almost 2 % between 2023 and 2024, and deaths fell around 3 %. 

However, the report warns that progress is fragile. Funding shortfalls, health-system disruptions (especially during the COVID-19 era), and the ongoing challenge of drug-resistant TB threaten to erode gains. The WHO page reminds that the 2025 edition “provides a comprehensive … assessment of the TB epidemic … at global, regional and country levels.” 

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For example, although more people are being diagnosed and treated than in previous years, not enough are being reached with preventive interventions, and many countries are still far from the targets set under the End TB Strategy.

 

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National

Government extends Victoria Falls Border Post operating hours to 24 hours

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BY WANDILE TSHUMA

The government has officially extended the operating hours of the Victoria Falls Border Post to a full 24-hour schedule, according to an Extraordinary Government Gazette published on Thursday.

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The change was announced under General Notice 2265A of 2025, issued in terms of section 41 of the Immigration Act [Chapter 4:02]. The notice states that the Minister of Home Affairs and Cultural Heritage has approved the extension with immediate effect from the date of publication.

The Gazette declares:

“It is hereby declared that in terms of section 41 of the Immigration Act [Chapter 4:02], the Minister has extended the operating hours for the Victoria Falls Border Post to twenty-four (24) hours on a daily basis, with effect from the date of publication of this notice.”

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The move is expected to boost tourism, trade, and regional mobility along one of Zimbabwe’s busiest tourist corridors, which connects the country to Zambia and the broader SADC region.

Stakeholders in tourism and logistics have long advocated for extended operating hours, citing increased traffic through Victoria Falls and the need to align with neighbouring countries that already run round-the-clock border operations.

 

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