Harare, Zimbabwe – Rumbidzai, a sex worker of the animated colony of Epworth in Harare, has been taking antiretroviral drugs for more than two years. For more than two years, the mother of three had been on mobile clinics that regularly visit her community to offer Vital services such as such services of such vital services such as ARV, as well as HIV condoms and tests.
For years, the familiar view of mobile health clinics that run into the densely populated streets of the colony meant the survival of Rumbidzai and thousands like it. These clinics were living lines, bringing medication, tests and protection essential to those who needed them most.
Since January 20, the clinics have all disappeared – the victims of a suspension of foreign aid in the United States which left the most vulnerable populations of Zimbabwe in crisis.
“I don’t want to die – my children are still young. Who will take care of them? said Rumbidzai, asking that only his second first name be used due to concerns about stigma.
A recent directive of the American president Donald Trump ordering that the American agency for international development to stop operations has led to the closure of many crucial programs in Zimbabwe, which directly concerns organizations such as Population Solutions for Health and Cehhar, which has long been a rescue buoy for sex professional.
“Our lives are suspended by a thread.”Sex worker
“Sex workers cry; They are afraid of dying, ”explains Chipo, an awareness worker who has served these communities since 2015. She only asked to use her second first name for fear of remuneration. Harare alone, she says, mobile clinics serve nearly 6,000 sex workers – everything is now left rushing for basic health care.
Zimbabwe has approximately 1.3 million people living with HIV / AIDS and almost 95% are under ARV treatment, a large part of which is funded by the United States, mainly through the President’s emergency plan for The AIDS rescue program, known as Pepfar.
In 2023, the resources allocated for HIV in Eastern and Southern African countries totaled $ 9.3 billion. National funding covered approximately 40% of this amount, while the rest was provided by external sources, mainly PEPFAR and the Global Fund to fight AIDS, Tuberculosis and Malaria.
Community mobile health clinics have turned out to be an effective model for providing health care to vulnerable populations, especially in countries with lower gross national income. These clinics are particularly useful for people who generally do not visit public health centers, such as people who have engaged in transactional sex.
Beauty Magora, who started sex work in 2015 and is now used as community mobilization, is concerned about her next HIV prevention treatment. It generally receives a pre-exhibition prophylaxis treatment every two months through mobile clinics, which have provided the service for free. Preparation is an injectable antiretroviral treatment which decreases the chances of contracting HIV.
With the suspended clinics, she is not sure to go to the drugs for tablets. “I don’t know if there will be effects if I go to the shelves,” she said.
Magora’s uncertainty reflects a broader crisis affecting the 45,000 sex workers estimated in Zimbabwe, more than half of which are HIV positive.
The impact goes beyond drugs. The condoms, formerly distributed freely, have become precious products. “Local clinics only give us three to four bands a week,” said Rumbidzai. “In our profession, that is not enough. People will take risks when supplies will run out – something that we want to avoid. »»
A shortage of condoms will lead to the creation of a reproductive ground for infections and reinfects, affecting not only sex workers, but also their customers, says Muchanyara Cynthia Mukamuri, president of the coalition of women in Zimbabwe. At the same time, a large part of the funding of antiretroviral therapy came from the United States, she adds. “If this is withdrawn, will Zimbabwe faced the rise of HIV prevention, treatment and all these things?”
Mukamuri stresses that with all the natural resources that Zimbabwe has, the country should now strive for self -sufficiency. “We have to review our strategies, refocus our efforts and redirect our resources to ensure that people living with HIV are not at the mercy of anyone who decides to provide – or retain – resources,” she said.
Meanwhile, Rumbidzai clings to hope for a change in policy. “If anything, Trump should lighten his heart, because our lives are suspended by a thread,” she said.
