Introduction: A fragile right in a shifting global context
Since the declaration of human rights over 75 years ago, the right to health has endured numerous challenges. In the developing world, particularly in Southern Africa, duty-bearers have struggled to respond to health crises, including pandemics such as AIDS and, more recently, COVID-19. In countries with fragile economies like Zimbabwe, thousands of lives have been lost to preventable diseases such as cholera. As climate change and globalization reshape disease patterns and fuel the spread of new pandemics, the future of the right to health appears increasingly uncertain.
Yet, despite these challenges, the global fight against HIV has seen remarkable progress - even in low-income nations. The world was beginning to envision an end to AIDS by 2030. Zimbabwe, in particular, exceeded the UNAIDS 95-95-95 targets, ensuring that 95% of people living with HIV knew their status, 95% of those diagnosed were receiving treatment, and 95% of those on treatment had achieved viral suppression. This achievement positioned Zimbabwe as a global success story in the HIV response.
Zimbabwe’s HIV success story: a case of strategic coordination and international solidarity
For a country with a struggling healthcare system - where people die from treatable illnesses due to poverty, lack of basic equipment, and shortages of essential medicines - how did Zimbabwe emerge as a leader in ending AIDS? The answer lies in a well-coordinated multisectoral approach, strict adherence to effective policy frameworks, and strategic resource mobilization. While Zimbabwe made commendable efforts to generate domestic resources, its HIV response remained heavily dependent on international donor funding, which supported critical aspects such as the employment of key health personnel and the procurement of antiretroviral drugs (ARVs).
Although reliable latest figures are elusive, reports indicate funding from donors such as the Global Fund and PEPFAR played a significant role in the fight against HIV. However, at the cusp of the dream, it appears the dream may have to be deferred – in January 2025, USAID announced a freeze on development aid and eventually whittled down funding on essential programmes helping many countries across the world, especially in southern Africa to respond to the HIV pandemic. Several countries, including Zimbabwe, are beginning to experience stock-outs in essential commodities, especially for the sexual and reproductive health of adolescents and young people. And the projected impact is devastating.
"Although reliable latest figures are elusive, reports indicate funding from donors such as the Global Fund and PEPFAR played a significant role in the fight against HIV. However, at the cusp of the dream, it appears the dream may have to be deferred – in January 2025, USAID announced a freeze on development aid and eventually whittled down funding on essential programmes helping many countries across the world, especially in southern Africa to respond to the HIV pandemic."
Tayson Mudarikiri
The 2025 U.S. funding cuts: a tectonic shift
In January 2025, the United States government announced a freeze on development aid through USAID, followed by an 83% cut to ongoing programs. The ramifications are already being felt across Africa. For Zimbabwe, this meant the loss of approximately US$522 million in development assistance, including nearly US$200 million previously earmarked for HIV and TB programming through PEPFAR (USAID, 2025).
Globally, the U.S. had been the single largest donor of official development assistance (ODA), contributing approximately $65 billion in 2023 alone (OECD, 2024). The sudden rollback of funding not only threatens Zimbabwe’s gains but also signals a dangerous shift in global development solidarity.
Zimbabwe’s vulnerabilities: health, economics, and accountability
Since gaining independence, the United States has invested over US$5 billion in Zimbabwe’s health and education sectors. The withdrawal of funding now leaves a vacuum the government is ill-prepared to fill. Although Zimbabwe’s Ministry of Finance has acknowledged the likely impact on HIV programming, the country’s budget allocations remain below the 15% target set in the 2001 Abuja Declaration - a target reaffirmed but routinely unmet.
In response to funding gaps, the government has introduced taxes such as a sugar tax and levies on fast food. While commendable in intent, these taxes disproportionately burden the poor, who already face out-of-pocket health costs. Furthermore, inefficiencies and corruption continue to plague the health sector. In 2020, Zimbabwe’s then-Minister of Health was arrested for inflating prices during COVID-19 procurement - a scandal that underscored the need for greater transparency and accountability (ZACC, 2020).
The regional impact: a broader recession in the Right to Health
Zimbabwe is not alone. Several countries across Southern Africa face the risk of backsliding on hard-won gains in public health. If the current trend of donor withdrawal continues - coupled with weak domestic investment and persistent corruption - the vision of health as a universal human right will remain elusive. The progress made in fighting HIV, maternal mortality, and vaccine-preventable diseases could unravel within a few years.
The role of non-state actors: bridging the gaps, sustaining the fight
Civil society and non-governmental organizations (NGOs) are stepping in to fill the gap. Our organization, terre des hommes schweiz, has established an emergency fund to support local partners working to ensure continued access to sexual and reproductive health services for adolescents and young people. While these efforts are important, they are insufficient to cover the scale of the gap.
Thus, advocacy efforts are shifting toward pressuring African governments to uphold their obligations—particularly by meeting health financing targets, improving transparency, and prioritizing the health of vulnerable populations. The responsibility to uphold the right to health must no longer be outsourced.
Conclusion: a call for sustainable solutions
The withdrawal of U.S. funding, while deeply concerning, also offers a critical moment for reflection and transformation in African health financing. For decades, many African health systems have relied heavily on external support, often at the expense of building resilient and self-sustaining domestic frameworks. This moment demands that African governments take decisive action: they must prioritize the mobilization of domestic resources for health, take meaningful steps to eliminate corruption and inefficiencies, and honor their commitments under the Abuja Declaration to allocate at least 15% of national budgets to the health sector. Additionally, it is imperative to forge new and equitable partnerships in the global health arena - partnerships that are grounded in mutual respect and shared responsibility. Without swift and sustained action on these fronts, the right to health - already fragile and unevenly realized - may become even more elusive for millions across the continent
References
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