It’s Our Time to Make Money: Nurses Cash In as ARV Shortage Grip Zim—Memory Sibanda, 67, has survived 28 years with HIV, but in February, the medication that has kept her alive began to slip out of reach.
“I tried three times to collect my antiretroviral drugs. Each time I was turned away,” said Sibanda, who lives in Chomutsvairo village in Zimbabwe’s Masvingo province.
“The nurses don’t tell us anything. I fear we’ll be completely cut off soon and many of us will die.”
Jobless and widowed since 2003 when her husband succumbed to AIDS, Sibanda is among thousands of Zimbabweans now gripped by uncertainty, as the country’s ARV supply runs dangerously low following abrupt US foreign aid cuts.
When she finally got medication in late February, it was only a three-month supply, half of what she normally receives.
The countdown has begun, and like many, she doesn’t know what will happen when her stock runs out.
In Harare, 65-year-old Mavis Makumbe found herself in a similar nightmare. A widow living with HIV for 24 years, she arrived at the New Start Centre to collect her medication only to find it shuttered.
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“I found a notice on the door saying it was closed and no longer operating,” she said. “I had no choice but to ration my remaining tablets. It was terrifying.”
Makumbe, who is also battling leg cancer, was only rescued by her daughter’s friends, who pooled resources to buy her six months’ worth of ARVs at $20 per month.
It’s a price tag far beyond the reach of most Zimbabweans, 80% of whom work in the informal sector and are already crushed by inflation.
The crisis has seeped into the prison system too. At Chikurubi Maximum Prison, an HIV-positive inmate told Health Policy Watch:
“We were already receiving limited doses. Now even basic painkillers are rare. Everything has worsened since America pulled the plug.”
The source of the chaos: A sweeping suspension of foreign aid by former US President Donald Trump.
On January 20, he halted all foreign aid for 90 days and later disbanded USAID, extending the freeze for another month.
Stanley Takaona, president of the Zimbabwe HIV/AIDS Activist Union Community Trust, called the decision “harsh and inhumane.”
“We’re praying that both our government and the US will show a humanitarian face,” said Takaona, 62, who has been on ARVs since 2001.
Sex workers and other high-risk groups were also hit hard as the US-funded PrEP (pre-exposure prophylaxis) programme was suspended.
As NewZimbabwe.com reported, even Zimbabwe’s impressive HIV milestones are now under threat.
The country became one of just five African nations to meet UNAIDS’ 95-95-95 targets in 2023, a remarkable feat: 95% of people living with HIV knew their status, 98% were on treatment, and 95% had suppressed viral loads.
But those gains are at risk of unravelling.
“We’re staring at a return to the early 2000s, when people were dying en masse,” said Sphiwe Chabikwa of ZNNP+, who has lived with HIV for 25 years.
“I’m on second-line ARVs, and even those are now being rationed.”
Desperation is pushing some patients to extreme measures. In Harare, bribes have become a survival tactic.
“Many people in my area are now bribing nurses just to get a six-month supply,” said one patient, requesting anonymity.
A nurse at a clinic in Harare admitted, “This is our time to make money. Our salaries can’t sustain us, so we charge a small fee for ARVs on the side.”
Yet government officials deny there’s a crisis. In Parliament, Health Minister Douglas Mombeshora insisted Zimbabwe has enough ARVs to last six months and that treatment access will continue.
Behind the scenes, however, the government is scrambling to craft an HIV sustainability plan, according to a UNAIDS report released on March 31.
Officials hope to shore up domestic funding to keep vital HIV programmes afloat.
The stakes are high. Prior to ARVs, AIDS was the leading cause of death in Zimbabwe killing 130,000 people in 2002 alone, according to UNAIDS.
But access to treatment slashed that number to 20,200 by 2021. HIV prevalence has dropped from 26.5% in 1997 to 11.9%.
That progress could vanish.
“We could lose everything,” warned Olive Mutabeni, director of Life Empowerment Support Organization (LESO). “I’ve been on ARVs since 2009. Now, I don’t even know if I’ll survive the year.”
UNAIDS modelling predicts a worst-case scenario if the US permanently withdraws HIV aid: 6.6 million new infections and 4.2 million additional deaths globally between 2025 and 2029.
For now, long queues snake outside clinics, nerves are fraying, and a sense of déjà vu looms.
“People are panicking,” said Chabikwa.
“The fear is back the fear we thought we buried with the past.”
