By Michael Gwarisa
In a landmark move, the National AIDS Council (NAC) has stepped in to support Zimbabwe’s growing renal care burden, particularly for People Living with HIV (PLHIV), by funding essential dialysis services at Parirenyatwa Hospital.
The intervention comes amid growing concern about the hidden epidemic of kidney failure among people on lifelong antiretroviral therapy (ART). While ART has significantly extended lives, long-term use is now linked with a sharp rise in chronic kidney disease.
At the heart of the initiative is the recognition that PLHIV, often overlooked in renal healthcare planning, urgently need access to dialysis services to survive.
Parirenyatwa Hospital has set up a Renal unit which can accommodate up to 20 patients. This has got state-of-the-art equipment that has been set up on a placement basis. The challenge has been the supply of reagents and consumables,” said Dr. Benard Madzima, CEO of NAC.
“As NAC, we felt the need to step in and assist. Their requirement is around US$700,000 per year. As we know, many patients on Antiretroviral Therapy may end up with kidney failure and require dialysis, so this is an opportunity to offer services to People Living with HIV but also to those who are HIV negative. Dialysis services are critical, and it’s a timely intervention that improves the quality of life for those in need.”
Globally, studies show that PLHIV are up to four times more likely to develop chronic kidney disease (CKD) than the general population. According to the World Health Organization (WHO) and a 2020 Lancet HIV report, nephrotoxicity — especially from older antiretrovirals like Tenofovir disoproxil fumarate — and comorbidities like hypertension and diabetes, are major contributors.
In Zimbabwe, exact national prevalence figures are lacking, but nephrologists estimate that 10-15% of PLHIV in long-term care may develop some degree of kidney impairment. The Zimbabwe Renal Registry, though still under development, has already flagged increasing demand for dialysis slots across public institutions — a surge driven in part by PLHIV.
Yet the country’s renal care infrastructure remains worryingly thin. Only about 10 public dialysis centers exist nationwide, and treatment costs (ranging from US$100 to US$150 per session) are unaffordable to the average Zimbabwean — especially when up to three sessions per week are required.
The WHO recommends equitable access to renal replacement therapy for PLHIV, noting that HIV status should not be a barrier to receiving dialysis or kidney transplantation. The UNAIDS 2021 Global AIDS Update urged governments to integrate non-communicable disease management — including renal care — into HIV programs.
Several countries have already begun responding. In South Africa, public hospitals offer dialysis to PLHIV under integrated chronic care models. In Brazil and Thailand, national AIDS programs help subsidize renal therapies for HIV-positive citizens.
Zimbabwe’s move, therefore, aligns the country with progressive global health strategies — and shows a willingness to treat HIV not as a siloed condition, but as part of broader chronic care.
“This isn’t just about machines and reagents,” says Dr. Madzima. “It’s about dignity, about quality of life, and ensuring that people we’ve fought so hard to keep alive through ART don’t die because of something we can treat.”
The NAC’s intervention is expected to benefit hundreds of patients annually, with priority given to the most vulnerable. With additional support and donor alignment, officials say the model could be expanded to provincial hospitals.