The United States will end its health assistance programmes in Zimbabwe at the end of September following the Zimbabwean Government’s decision to withdraw from...
The United States will end its health assistance programmes in Zimbabwe at the end of September following the Zimbabwean Government’s decision to withdraw from negotiations on a proposed bilateral health Memorandum of Understanding (MoU).
US Ambassador to Zimbabwe Pamela Tremont announced the development at a reception in Harare, saying Washington was now working with Zimbabwean authorities on a responsible handover of the programmes.
The announcement marks the end of more than two decades of significant US support to Zimbabwe’s health sector, particularly in the fight against HIV and AIDS.
Tremont said the decision followed Zimbabwe’s choice to decline the proposed bilateral health agreement. She said the United States respected Zimbabwe’s sovereign decision and would work with the Ministry of Health and Child Care and other partners to ensure a responsible transition.
“With Zimbabwe’s decision to decline a bilateral health MOU, U.S.-supported health programs will conclude at the end of September,” Tremont said, according to HealthTimes.
She said the two countries had worked together for more than 20 years to strengthen health systems and expand access to HIV prevention, care and treatment.
The US has provided substantial support to Zimbabwe through programmes including the President’s Emergency Plan for AIDS Relief (PEPFAR), which has supported HIV testing, treatment and prevention, medicines and other health interventions.
According to the US Embassy, about 1.2 million people in Zimbabwe were receiving HIV treatment through US-supported programmes when the proposed agreement was under discussion.
Tremont said the support had contributed to Zimbabwe achieving HIV epidemic control, with more than 95 percent of people living with HIV receiving treatment.
Zimbabwe’s HIV response has also benefited from support for antiretroviral medicines, health workers, HIV prevention services and other programmes over many years.
The proposed new agreement was intended to establish a different model for US health assistance, with greater co-investment by the Zimbabwean Government and a gradual transition towards greater national responsibility for funding and sustaining health programmes.
The proposed deal was valued at about US$367 million over five years and would have covered areas including HIV/AIDS, tuberculosis, malaria, maternal and child health and disease outbreak preparedness.
The US described the proposed arrangement as a co-financing model intended to support the sustainability of health programmes and reduce long-term dependence on external assistance.
The negotiations, however, broke down after Zimbabwe raised concerns about provisions relating to health data and biological resources.
Zimbabwean Government spokesperson Nick Mangwana said the proposed arrangement would have required the country to share biological resources and health data over an extended period without a corresponding guarantee that Zimbabwe would receive access to medical innovations that could result from such information.
He described the proposed arrangement as an unequal exchange and said Zimbabwe could not accept conditions that raised concerns about data sovereignty, national security or access to strategic resources.
The Government’s position has been disputed by the United States.
In March, a US official told 263Chat that the draft MoU did not contain provisions relating to critical minerals and said the agreement was focused entirely on public health.
The US also rejected suggestions that it was seeking private or personal health information from Zimbabweans, saying the proposed arrangement involved anonymous and aggregated health data used for purposes such as targeting assistance, measuring programme effectiveness and responding to disease outbreaks.
More recently, the US Embassy again disputed claims about the terms of the agreement.
In comments reported by NewZimbabwe.com in August, the Embassy said the proposed MoU would have provided about US$365 million in health assistance over five years and required Zimbabwe to co-invest, maintain financial accountability and transparency, and share specimens during outbreaks as part of established global health practices.
The Embassy said claims that the agreement sought private health data were “categorically false”.
The disagreement over the terms of the proposed agreement therefore remains an important part of the story behind the US decision to wind down its health assistance.
For Zimbabwe, the immediate issue is how health programmes previously supported by external funding will be sustained after the US programmes conclude.
Tremont said the immediate priority was to protect the gains made in the country’s HIV response through strong national systems, continued access to quality services and Zimbabwean leadership.
The United States has stressed that the end of its health assistance does not mean the end of diplomatic relations between the two countries.
Tremont said Washington would continue engaging with Zimbabwe, with the relationship expected to place greater emphasis on areas such as trade, investment and broader economic cooperation.
The shift represents a significant change after years in which health and humanitarian assistance formed an important part of US engagement with Zimbabwe.
The collapse of the proposed agreement also comes amid a wider change in US health assistance policy internationally, with Washington seeking new arrangements that place greater emphasis on domestic financing and sustainability.
Other African countries have been negotiating or implementing similar health agreements with the United States.
For example, Zambia announced a proposed US health partnership based on performance and co-financing, with the stated goal of strengthening its health system and moving towards greater self-reliance.
Zimbabwe ultimately chose not to proceed with its proposed agreement.
The winding down of US-supported programmes will now require coordination between American officials, Zimbabwe’s Ministry of Health and Child Care, implementing partners and other stakeholders.
The transition will be closely watched because of the number of people who rely on health services supported through US-funded programmes.
The US Embassy has said it is working with the Ministry of Health and other partners on a “thorough and responsible handover” before the programmes conclude at the end of September.
The development brings to an end a major phase of US health assistance in Zimbabwe, while leaving the Zimbabwean Government with greater responsibility for maintaining health programmes and sustaining progress made in the country’s HIV response.
