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.
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.”
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.
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.
“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.
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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