Zimbabwe’s HIV epidemic has shifted dramatically over the past two decades, but deep-seated disparities persist, particularly among vulnerable populations.
An estimated 1,3 million people are living with HIV in Zimbabwe, with prevalence higher among women than men.
The burden is disproportionately heavy among adolescent girls and young women aged 15-24, whose risk of infection remains significantly elevated compared to their male peers.
Globally, this age group accounts for a large share of new HIV infections, and Zimbabwe mirrors this trend, underscoring the urgency for targeted, evidence-based interventions.
Key populations — including sex workers, men who have sex with men and others at heightened risk — also face elevated vulnerability due to stigma, discrimination and structural exclusion.
Government and partner programmes — including those coordinated by the National Aids Council (NAC) — have expanded testing, prevention and care services to key populations and vulnerable groups such as adolescent girls and young women, sex workers and men who have sex with men.
These interventions are part of community-based outreach and peer support models, which aim to reduce new infections and improve retention in care.
In 2024 alone, programmes supported pre-exposure prophylaxis (PrEP) services to thousands of high-risk individuals, demonstrating how prevention services are reaching beyond just treatment.
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Taken together, these figures show millions of Zimbabweans have directly benefited from HIV intervention programmes — not just through ART coverage, but also through prevention, testing and support services that are extended into rural and urban communities alike.
The high coverage levels reflect strong programme reach, robust service delivery and community engagement, key outcomes linked to NAC’s financial discipline and transparency.
Against this backdrop, NAC has emerged as a pillar of accountability in Zimbabwe’s public health sector, with its ability to sustain the national HIV response increasingly linked to strong financial transparency and disciplined corporate governance.
This was underscored during NAC’s recent annual general meeting (AGM), where Health and Child Care minister Douglas Mombeshora commended the institution for safeguarding public resources through strict adherence to public finance management principles.
Mombeshora noted that adherence to public finance management and corporate governance frameworks had helped entrench transparency, accountability and ethical stewardship of public resources.
“These principles are not abstract ideals; they are the foundation of public trust and the assurance that resources reach the citizens who need them most,” he said.
Mombeshora acknowledged that NAC operated for part of the year without a formally appointed board, with oversight responsibilities temporarily falling to his ministry.
Despite this governance gap, he said NAC remained operationally focused and recorded notable achievements, including reductions in new HIV infections and sustained treatment outcomes, as evidenced by the attainment of the 95-95-95 targets.
However, Mombeshora challenged the NAC board and management to exercise decisive, timely and accountable leadership to safeguard Zimbabwe’s HIV response amid declining donor support and growing reliance on domestic financing.
He stressed that delays in decision-making and financial authorisations were no longer tolerable as they directly impact patient care and cost lives.
“It is my distinct honour to address this AGM of the National Aids Council and to formally receive the annual report and audited financial statements for the year 2024 on behalf of the government of Zimbabwe as shareholder,” Mombeshora said.
The minister warned that the evolving financing landscape demanded a more agile and responsive NAC Board.
“The financing environment for HIV and health is changing rapidly.
“Donor funding is declining, and the sustainability of our response increasingly depends on domestic resources,” Mombeshora said.
He emphasised that the NAC board was not ceremonial, but the strategic nerve centre of the institution, carrying fiduciary responsibility to ensure efficient use of resources, timely decision-making, risk anticipation and uninterrupted service delivery.
The minister also challenged the NAC board and management to uphold the highest standards of corporate governance, strengthen internal controls and ensure timely audits to protect the integrity of the Aids Levy and maintain public confidence.
NAC board chairperson Nester Mukwehwa described the year under review as a defining year for Zimbabwe’s HIV and Aids response, citing major gains in governance, sustainability and service delivery, including the early achievement of the global 95-95-95 HIV targets.
“The year 2024 has been a landmark for Zimbabwe’s HIV response, defined by the National Aids Council’s unwavering commitment to institutional integrity and strategic foresight,” Mukwehwa said.
She noted that despite global uncertainty around health financing and increasing pressure on donor-supported programmes, NAC remained firm in safeguarding Zimbabwe’s gains towards ending Aids by 2030.
Guided by the NAC Strategic Plan, the Zimbabwe National HIV and Aids Strategic Plan (ZNASP IV 2021–2026), the National Health Strategy and National Development Strategy 1, Mukwehwa said the national response remained focused, inclusive and resilient.
“Among several achievements, the response successfully achieved the 95-95-95 targets ahead of the 2025 target year, a testament to the collective effort of government, partners and communities,” she said.
She paid tribute to NAC management and staff, singling out chief executive officer Bernard Madzima and his team for anchoring the national response during a challenging period.
“On behalf of the NAC board, I wish to express my sincere gratitude to the chief executive officer, Dr Bernard Madzima, and his team for their diligent work and unwavering commitment,” Mukwehwa said.
The board chair also acknowledged the Ministry of Health and Child Care, other government ministries, development partners and communities for their continued support and resilience.
Mukwehwa said NAC would remain professional, vigilant and compassionate as it enters the new year, reaffirming its commitment to ending Aids as a public health threat by 2030.
This transparent stewardship has laid the foundation for expanded grassroots intervention, enabling NAC to scale up community-led outreach that ensures prevention, testing and support services reach villages, towns and marginalised communities where HIV risk remains highest.
NAC has over years strengthened strategic programmes that directly address vulnerable groups while linking expenditure to measurable outcomes at community level.
Among these are adolescent girls and young women-focused initiatives, including the DREAMS and Sista2Sista programmes, which combine HIV prevention, sexual and reproductive health education, social protection and economic empowerment in high-burden districts.
For key populations, NAC works through decentralised structures and partners to deliver layered prevention services such as HIV testing and counselling, condom distribution, PrEP and gender-based violence (GBV) support, tailored to the specific needs of sex workers, MSM and transgender individuals.
“Sound financial management and transparency are not optional for us — they are central to ensuring that every resource entrusted to NAC delivers measurable impact in communities,” Madzima said.
He emphasised that accountable systems have made it possible to extend services even into underserved rural areas, while strengthening long-term sustainability.
“Our focus has been to build strong governance systems that support sustainability, accountability and effective coordination of the multi-sectoral HIV response,” he said, adding that integrity and compliance remain non-negotiable pillars of the institution.\Madzima said 2024 was marked by notable advancements in prevention, treatment, care, and support services, bringing NAC closer to its vision.
“The Prevention of Mother-To-Child Transmission (PMTCT) initiative achieved a national coverage rate of 88,19%, with Harare and Bulawayo provinces attaining 100% coverage.
“This success reflects the effectiveness of our integrated approach, which ensures that pregnant and breastfeeding women receive timely antiretroviral therapy (ART), significantly reducing vertical HIV transmission.”
NAC-supported campaigns such as “Not in My Village” have engaged traditional and community leaders to reduce HIV infections and teenage pregnancies in high-prevalence provinces.
