By Michael Gwarisa

One of the major funders for HIV and AIDS programs in Zimbabwe, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), has notified the Zimbabwean government that it will terminate funding for condom programming within the next 30 months, HealthTimes has learnt.

Popularly known as Madhimbare mainly because of their blue and white packaging, public sector condoms serve the biggest number of condom users in Zimbabwe especially those at high risk of HIV infection mainly Female Sex Workers (FSW), Artisanal Miners, Truck Drivers among other HIV key populations.

Condom programming remains one of the key pillars under the five UNAIDS prevention pillars. Zimbabwe has since attained the 95-95-9 HIV targets among adults ahead of schedule. However, the move to discontinue donor financing for condom programming in the absence of a solid domestic financing mechanism for HIV programs could plunge Zimbabwe’s HIV response into an abyss of uncertainty.

Speaking during an HIV prevention stakeholders meeting in Harare, Mrs Getrude Ncube, the HIV Prevention Coordinator in the Ministry of Health and Child Care, said funding for condom programing was under siege.

We still need our condoms. As we are here gathered as government, civil society and partners, let us know that our condom funding is at stake and PEPFAR has already told us that from 2026, there won’t be any condoms funded by them. The issue now is that there is donor fatigue when it comes to condom funding,” said Mrs Ncube.

She added that the HIV response would be affected badly in the absence of condom funding, and there was a need to start mobilising domestic resources to build sustainability of the condom program beyond the donors.

“Looking at our condom programming, let’s not forget that in terms of condom programming, we have been relying on our partners, PEPFAR specifically who have been supporting us through USAID both for ZNFPC and or the public sector. As a country, we are now saying should we risk all the gains we have made through our condom program in the country because there is no funding. We need as a country to look at how best we mobilise even domestic funding actually to fund condoms.”

In Zimbabwe Public sector condoms that are funded mainly by PEPFAR occupy the biggest market share, with an estimated 77 percent being under Public Sector condoms. Social Marketing condoms occupy about 22 percent and 1 percent is occupied by the private sector and this is an anomaly according to Ministry of Health Condom data.

Condom programming was one of the early HIV prevention models Zimbabwe adopted at the height of AIDS epidemic.

Dr Tsitsi Apollo, the Deputy Director HIV Program within the Ministry of Health said the donor fatigue was not only going to impact negatively on the condom program but the entire HIV response.

“We are relying so much on external funding. Even as the country progresses as far as to be an Upper Middle-Income economy, it is very important for us to rethink in terms of how we are going to fund condom programming, how we will fund ARVs for treatment, ARVs for prevention and various tests that we need for our recipients of care for prevention programs. We need to look holistically at our interventions to ensure that all the beautiful progress that we made is not just eroded overnight.” Said Dr Apollo.

She added that the Global Fund’s current grant ends in 2026. However, should Zimbabwe attain the Upper Middle Economy status in 2030, the country is less likely to receive external funding since the Global Fund uses a certain allocation formula to countries based on their economic thresholds. Despite having high HIV/ AIDS burdens, regional countries such as Botswana and Namibia do not have funding envelopes like Zimbabwe due to their economic status.

She said Zimbabwe’s HIV response should rather on the ongoing discussions around the National Health Insurance (NHI) to alleviate some of the health challenges faced by citizens in accessing healthcare services. She added that the response should also consider tapping into Private Public Partnerships for HIV funding.

Meanwhile, Zimbabwe has its flagship AIDS Levy fund. However, funding towards the levy has been deteriorating over the years owing to the high in formalisation of the economy.

Mr Raymond Yekeye, the National AIDS Council (NAC) Operations Director said they were exploring other avenues to fund the HIV response outside the AIDS Levy.

“It is the whole response that is at a critical stage in terms of how it is going to be sustained and how it is going to be funded. The AIDS Levy is probably 25%-30% of our requirements for the HIV response and that is why we are now discussing other mechanisms like the NHI because the Levy on its own will not be able to sustain or even go 50% or half of what is required in the response,” said Mr Yekekeye.

In Zimbabwe, PEPFAR’s commitment to Zimbabwe in 2024 is $210 million from October 2023 to Sept 2024 and $200 million from October 2024 to Sept 2025.

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