WITH the United States recently announcing a suspension and review of foreign aid, Zimbabwe has pledged to ramp up domestic resource mobilisation to ensure continued funding for its health sector.
The developments come as a shift in US foreign aid policy saw President Donald Trump sign multiple executive orders that limited funding to international health programs, including HIV/AIDS.
The US has been a major global funder of food security, humanitarian assistance and various health programmes, including the President’s Emergency Plan for AIDS Relief (PEPFAR).
More than 20 million people – two-thirds of all people living with HIV accessing HIV treatment globally – are directly supported by the PEPFAR.
In Zimbabwe, PEPFAR is the leading funder of HIV programming with the organisation having committed US$210 million to Zimbabwe in 2024 and US$200 million from October 2024 to September 2025.
Finance Minister Mthuli Ncube said Zimbabwe will have to rely on taxes to plug a large gap left by the US foreign aid cuts.
“We are talking about US$200 million or so (on PEPFAR) that is at stake. Our response really should be domestic resource mobilisation, which is what we have been doing,” Ncube told the media recently.
He said the tax on sugar content in drinks, plus a one percent tax recently introduced on fast food would play a crucial role in the domestic resource mobilisation drive.
Ncube added that already, Zimbabweans pay an AIDS levy, and sin taxes on beer, also targeted at healthcare.
“All these taxes form the base that we can use to build resource mobilisation to support our health needs. It has to be through this kind of thinking where we raise resources to support the health sector domestically as foreign funding is under threat,” Ncube said.
On its part, FBC Securities said enhancing domestic resource mobilisation can mitigate the challenges, although the efficiency of such strategies might be limited given that the economy is already overtaxed and highly informal.
“To mitigate these challenges, the Zimbabwean government must take decisive action by strengthening domestic revenue mobilization, restoring investor confidence, restructuring state-owned enterprises, and improving governance and fiscal discipline,” FBC Securities said.
National Director of the Pan-African Positive Women’s Coalition, Tendai Westerhoff, emphasised the need to prioritise sustainability, explaining that the problem with donor funding is its unpredictability.
“We should form resilient systems in terms of ensuring that we have domestic resourcing so that if donors pull out, we can continue with programs because pulling out of donors does not hold HIV infections. We are still getting new HIV infections,” she said.
Westerhoff, who has been living with HIV for close to 23 years, called on countries to commit to the 15 percent of Abuja Declaration, which is not happening in most cases.
“A lot of countries, including us, we are still falling far short of that 15 percent commitment to the health budget, so that we can strengthen the capacity at every level to fight HIV and AIDS,” she said.
On her part, Martha Tholanah, who gets her antiretroviral drugs from Parirenyatwa Hospital expressed concern regarding Zimbabwe’s capacity to fill the gap left by PEPFAR.
“The funding has been assisting in terms of treatment, prevention care and livelihoods. As you know, there is no health without livelihoods. Now, how do we start building from the rug that has suddenly been pulled from under our feet?” she questioned.
“This means our reliance on foreign funding is too heavy. We need more domestic resources for health from the national treasury. Partners should complement the government, not the other way round,” she added.
The 60-year-old Tholanah has been living with HIV for over 21 years and has been relying and living on antiretroviral drugs procured through funding from PEPFAR, the AIDS Levy and other development partners.
Foreign aid has been a crucial component of Zimbabwe’s economic framework, supporting critical sectors such as healthcare, food security, infrastructure, and social programs, in the absence of reduced access to external funding, lost revenue from high informalisation, and lost dividends from state-owned enterprises.