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Tuberculosis treatment in jeopardy as Zimbabwe loses US Aid

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Natasha Gwashure holds her son, Anashe, who is receiving free tuberculosis treatment at Beatrice Road Infectious Diseases Hospital in Harare. The hospital, which has relied on USAID funding for TB treatment, faces uncertainty following a US aid freeze.

BY LINDA MUJURU

Natasha Gwashure watches as tuberculosis ravages her 1-year-old son Anashe’s frail body. He has been ill for more than a month. Gwashure struggles to accept the diagnosis. Her only solace is that they have access to free medication.

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“Without this support, the chances of defaulting on treatment because of monetary constraints would have been significantly higher,” she says.

 

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For years, the United States Agency for International Development has stood at the front lines of Zimbabwe’s TB battle, providing critical support for detection, treatment and prevention. But this lifeline now hangs in the balance as a US executive order threatens to undermine years of progress, potentially forcing patients, like Gwashure’s son, to abandon lifesaving treatments.

 

TB is a particularly vicious illness. Left untreated, the mortality rate is about 50%. It spreads easily, when an infected person coughs or sneezes, or even sings or speaks.

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US President Donald Trump issued an executive order on Jan. 20, his first day in office, to suspend nearly all international aid. That includes USAID programs, which administer lifesaving health and other services around the world.

 

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The recent funding freeze leaves a huge gap in Zimbabwe, where nearly all funding for TB treatment comes from international donors. Just 4% of that funding is domestic.

 

In 2024, USAID allocated 7 million United States dollars for TB treatment, screening and other necessary interventions in Zimbabwe. Despite decades of medical advances, tuberculosis still rampages across the globe. TB affected 10.8 million people in 2023; 1.3 million of those were children.

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In Zimbabwe, the battle against TB reveals a health care system struggling to keep up. In 2021, just a little over half of an estimated 30,000 new infections received treatment.

 

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The human cost of scrapping USAID programs is already evident here. Hospitals that once benefited from US-backed health programs now face mounting pressure as health workers supported by these initiatives have been forced to stop working.

 

A local nurse, who requested anonymity for fear of retribution, says it’s strained an already overextended health care system. She says that nurses previously funded by USAID-backed organizations, who primarily cared for patients with HIV, TB and other diseases, have stopped reporting to work. And what used to be handled by a full team of nurses is now falling on just a handful.

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The freeze has begun dismantling Zimbabwe’s TB care network. New Start Centre — once a cornerstone facility, providing essential CD4 count testing, TB screening, diagnosis and counseling — has already gone dark, its doors closed as funding runs dry.

 

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Noah Taruberekera, executive director of Population Solutions for Health, which has relied on USAID support for these centers, acknowledges the dire challenges now confronting patients and health care providers. He says he is not authorized to share additional details.

 

The funding crisis ripples beyond TB control, casting a shadow over HIV programs — a critical concern since TB preys particularly on those with HIV. While effective antiretroviral therapy can reduce the risk of developing TB, ongoing screening and preventive measures are vital for those with HIV.

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HIV co-infection affects 68% of TB cases in Zimbabwe, but the national government covers only 7% of the required TB budget. International donors contribute 60%, leaving a significant funding gap.

 

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Despite the mounting challenges, Dr. Fungai Kavenga, deputy director of TB and prevention control in the government’s Ministry of Health and Child Care, remains hopeful.

 

“If donor support diminishes, I am confident that the government of Zimbabwe can still ensure a steady supply of treatment for TB patients,” he says.

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But Barbara Samu, a TB patient receiving care at Beatrice Road Infectious Diseases Hospital, underscores the critical role of donor support. She received free medication because USAID supported the hospital.

 

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“I can’t even begin to imagine where I would find the money for treatment,” she says. “I would be facing a death sentence.”

 

Global Press is an award-winning international news publication with more than 40 independent newsrooms in Africa, Asia and Latin America.

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Tens of Thousands in Zimbabwe Go Hungry as the Rains — and US Aid — Hold Back

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Tanayeishe Musau eats baobab porridge after school at his home in Mudzi, Zimbabwe, where the dish has become a daily staple amid worsening drought and hunger. Once a simple supplement, baobab porridge is now a primary meal for families like his, following widespread food shortages and the suspension of international aid.

BY LINDA MUJURU

This story was originally published by Global Press Journal.

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Agnes Tauzeni stands on her parched field. She is a mother to two children, and is expecting another. But now, in a time that might otherwise have been joyful, her hopes wither like the struggling crops before her.

 

Three times she’s gambled on the rains; three times the sky has betrayed her. Her first two plantings failed. The soil was too dry to sustain life. Though her third attempt yielded a few weak shoots, they offered little promise of a meaningful harvest. El Niño-driven droughts have disrupted once-reliable rains, leaving Tauzeni’s family and many like hers struggling to feed themselves.

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“I am always hungry,” Tauzeni says.

 

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She worries about the health of her unborn child, based on how little nutrition she consumes herself.

 

Adding to this, food aid, previously funded by the US Agency for International Development, halted suddenly in January. That transformed what was already a struggle into a desperate battle for survival.

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The food aid ended when US President Donald Trump, on his first day in office, issued an executive order that paused nearly all US foreign aid, most of which was administered by USAID. That agency is now all but defunct.

 

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Food aid in Zimbabwe was an ongoing area of funding for USAID. In November 2024, the agency announced $130 million for two seven-year programs, implemented by CARE and Cultivating New Frontiers in Agriculture, that would provide food aid and other related support to areas of Zimbabwe most in need. The programs, which stopped, were just part of an ongoing slate of activities designed to help Zimbabwe’s neediest people.

 

About 7.6 million people in Zimbabwe — nearly half the country’s population — need humanitarian assistance, according to a 2025 UNICEF report. Of those, nearly 6 million, like Tauzeni, rely on subsistence farming.

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Through the support of organizations with funding from USAID, people previously received cereals, edible seeds, oil and food vouchers.

 

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“A sudden withdrawal can put the entire community in a dire situation,” says Hilton Mbozi, a seed systems and climate change expert.

 

Tauzeni recalls that her community used to receive food supplies such as beans, cooking oil and peanut butter to help combat malnutrition.

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When Tauzeni got married in 2017, her fields promised abundance. Her harvests were plentiful, and her family never lacked food. Now, those memories feel like whispers from another world. The past two agricultural seasons, those harvests have been devastatingly poor.

 

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With an empty granary and dwindling options, Tauzeni’s family survives on the same food every day: baobab porridge in the morning and sadza with wild okra in the evening. But Tauzeniworries whether even this will be on the table in the coming months.

 

“The little maize I have, I got after weeding someone else’s crops, but that won’t take us far,” she says.

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Tauzeni says a 20-kilogram (44-pound) bag of maize costs US$13 in her village, an amount out of reach for her. Her only source of income is farming. When that fails, she has no money at all.

 

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Hunger like Tauzeni experiences is widespread. Some families now eat just once a day.

 

Headman David Musau, leader of Musau village where Tauzenilives, says some people in his village did not plant any seeds this season, fearing losses due to the low rainfall. The government provides food aid inconsistently, usually 7 kilograms (15 pounds) of wheat per person for three months.

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“It’s not enough, but it helps,” he says.

 

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But without any other food aid, survival is at stake, he says. “People will die in the near future.”

 

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Zimbabwe’s new mothers face extortion for ‘free’ child health cards

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Photo credit: Gamuchirai Masiyiwa, GPJ Zimbabwe

BY GAMUCHIRAI MASIYIWA

Summary: The quiet return of maternity fees and the black-market sale of essential documents put extra burdens on mothers as they struggle to navigate a broken system.

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First-time mother Connie Jowastands with her 3-month-old baby nestled against her back, chatting with other mothers in line. Like many women at this crowded clinic in Harare’s Mabvuku suburb, Jowa is trying to get a Child Health Card, which was unavailable when she gave birth at a public hospital, and was still out of reach at her local clinic. Health cards are mysteriously out of stock.

 

But they can be bought under the table, if you know who to ask and are willing to pay.

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Zimbabwe’s Child Health Cards, meant to be free to new mothers, are crucial documents that track babies’ growth, vaccinations and medical histories. Without them, each clinic visit becomes a reset button. Inquiry into the child’s medical history starts from scratch. Since July 2024, the cards have disappeared from health facilities across Harare’s central hospitals and 42 council clinics — even though the card’s producers say they’re making enough to meet demand. This artificial shortage has birthed a shadow market where clinic staff quietly sell this essential document to desperate mothers. This sort of nickel-and-dime bribery exposes deep cracks in a health care system that’s already failing the most vulnerable people.

 

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What started as a clandestine operation has become an open secret.

 

“When cards arrive at a clinic, they’re kept by the sister in charge. But it’s usually nurse aides or junior staff who sell them, working in cahoots with other staff members,” says Simbarashe James Tafirenyika, who leads the Zimbabwe Municipality’s Nurses and Allied Workers Union.

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Someone who sells 100 cards can pocket around US$500, she says, and none of that money goes to the government of the council.

 

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The going rate for the Child Health Card is US$5, say several mothers who spoke to Global Press Journal.

 

Medical Histories on Scraps of Paper

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When the system works as designed, every mother receives a Child Health Card when her baby is born. Now, most mothers must track their infants’ medical histories on scraps of paper.

 

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Harare’s council clinics alone deliver more than 3,000 babies every month, with each mother left scrambling for documentation.

 

“I feel hurt,” Jowa says. “I want to know what vaccines my child has received and their purposes, but I just can’t get that information.”

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A nurse aide assistant at one of the council clinics has witnessed this shadow market.

 

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“If a nurse is selling, they ask the mother to be ‘skillful’ if they need the card,” says the assistant, who requested anonymity for fear of retribution. In Zimbabwe, “skillful” is a common euphemism for paying small bribes.

 

While the Ministry of Health and Child Care is supposed to supply the cards for free, Prosper Chonzi, the City of Harare’s director of health, admits supplies have been erratic for six months and that people have complained about being forced to purchase these cards. Clinic workers may be exploiting the known shortage and coordinating among themselves to sell the cards rather than providing them for free, he says.

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“We can’t rule that out,” he says.

 

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The card shortage coincides with the quiet return of maternity fees in public hospitals. Though not officially announced, hospitals have begun billing mothers after delivery — a policy change the government would neither confirm nor deny.

 

High Inflation, More Corruption

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Between 2011 and 2024, more than 1 million pregnant women in the country delivered babies for free at health care clinics, under a scheme called results-based financing. Maternal mortality rates dropped during that time.

 

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But these gains, partly achieved through better access to safe delivery services, face new hurdles as budget constraints and economic pressures reshape the health care landscape.

 

Even in 2021, a study from Transparency International Zimbabwe surveyed over 1,000 people in Zimbabwe and found that 74% had been asked to pay a bribe while trying to access health care services. A feeling of being underpaid amidst a deteriorating economy and high inflation was a key driver among health workers who solicitated bribes, which has been a rising trend, according to the study.

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“The motivation for earning an extra income is strong especially in countries with a high rate of inflation,” the study states.

 

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Zimbabwe’s health care system faces chronic challenges, including an exodus of health workers to other countries, inadequate funding, drug shortages, obsolete infrastructure and more. In 1991, the government introduced user fees across public institutions as part of an economic structural adjustment program. The government abolished the fees in 2011, only to partially reinstate them around 2013.

 

Prudence Hanyani, a community activist in Harare, says the reintroduction of user fees in public hospitals will burden women who already shoulder extra costs, like paying for midwives, so they can get better treatment when giving birth.

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“Maternal health services should be free,” she says, “because giving birth is a service for the nation that contributes to the country’s population.”

 

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Mothers Pay the Price

 

Valerie Shangwa, who gave birth four and a half months ago at a private maternity hospital, still has no card for her daughter.

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“You know how difficult it is to keep a paper,” she says. “When nurses ask about last month’s weight, you end up guessing, and that distorts the whole record.”

 

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Charlton Prickise, technical director at Print Flow, says his company sells Child Health Cards only to government-authorized health facilities and faces no shortages.

 

“The shortages mean health facilities simply aren’t coming to get them,” he says.

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Though Print Flow hasn’t detected leaks, Prickise recalls finding other versions of this card on the market two years ago, possibly from a nongovernmental organization. Print Flow isn’t the sole supplier of the cards, and they haven’t received any government orders recently.

 

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In a written response to Global Press Journal, Donald Mujiri, spokesperson for the Ministry of Health and Child Care, said the shortage of Child Health Cards is due to supply chain inefficiencies and insufficient donor funding. The cards, he says, are procured with government funding and aid from supporting partners such as the United Nations Children’s Fund. Nevertheless, Mujiri says, the ministry needs to strengthen the supply chain management system at all levels and proactively mobilize resources for procuring the cards.

 

Meanwhile, mothers wait — or pay the price. Faith Musinami, 26, delivered her daughter in July 2024. An orderly told her the clinic only had cards for boys, but if she wanted, they could organize one for US$5. Musinami had not budgeted for the cost. She sacrificed the last penny she had.

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This story was originally published by Global Press Journal.

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Ranger killed by elephant in Kariba

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BY NOKUTHABA DLAMINI 

A 62-year-old ranger, Josphat Mandishara, was tragically killed by an elephant in Kariba yesterday.

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Mandishara, who worked for the Zimbabwe Parks and Wildlife Management Authority (ZimParks), was on patrol in the Gatche-gatche area with fellow rangers and police officers.

At around 10 pm, Mandishara returned to the harbor where their boat was docked, and that’s when he encountered the elephant. The elephant charged at him, causing fatal injuries. His colleagues were nearby, resupplying at the Gatche-gatche Irrigation Scheme.

Mandishara’s body was taken to Kariba District Hospital for a post-mortem, and the incident was reported to the police.

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ZimParks has sent a team to manage the problem elephant and prevent similar incidents in the future.

The Director General of ZimParks, Prof. Edson Gandiwa, and his team have sent condolences to Mandishara’s family, friends, and colleagues. Mandishara will be remembered for his dedication to wildlife conservation in Zimbabwe.

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