The loss of USAID aid has severely limited access to essential health services in southern Africa, particularly in the areas of HIV prevention, sexual and reproductive health, and community-based programs. Zimbabwe’s rejection of new U.S. funding has far-reaching consequences.
Since the U.S. government withdrew from multilateral frameworks such as the World Health Organization (WHO), the U.S. Agency for International Development (USAID) has focused on “life-saving measures.” As a result, programs aimed at prevention, education, and community empowerment have been eliminated. This is creating major gaps and challenges in the healthcare system, particularly in southern Africa. Nevertheless, Zimbabwe is declining to enter into a new bilateral partnership with the U.S.
In December 2025, the government rejected a funding package—out of concern for control over its population’s sensitive health data and reservations about the requirements for data sharing. The decision shows that the government considers the protection of national health systems and health information to be important, if not more important than financial support.
Growing Pressure on the Ground
After a year without USAID, the consequences in southern Africa are already significant. HIV, tuberculosis, and malaria programs have been cut, while prevention services—such as access to HIV prevention and testing, as well as youth-friendly safe spaces—have been severely reduced. In Zimbabwe, as in the rest of Southern Africa, limited access to contraceptives, pregnancy tests, or treatment following a possible HIV exposure is exacerbating gaps in care, particularly for vulnerable groups. The pressure on health care workers and community-based organizations is mounting—they must cope with rising demand using ever-dwindling resources.
“The pressure is forcing the country to strengthen health financing and locally managed, resilient health systems. terre des hommes schweiz is supporting its partner organizations in their efforts to continue providing essential services for young people.”
Nodumo Ndhlovu, National Coordinator for Zimbabwe and South Africa
Local organizations, including terre des hommes schweiz and its partners, must adapt to the new conditions and the challenging environment. At the same time, the need for their projects and services is growing. At the regional level, there is a risk of major setbacks in public health, while inequality in access to health care is increasing. This includes a rise in teenage pregnancies and child marriages, as well as deteriorating conditions regarding sexual and reproductive health and rights (SRHR), the treatment of sexually transmitted infections, and mental health support. As a result, fewer young people are likely to receive essential SRHR health services.
Toward Greater Independence
The short- and medium-term impacts are severe. However, the crisis also highlights just how vulnerable reliance on foreign aid is. The increased pressure is forcing the country to strengthen its own health financing and locally managed, resilient health systems. terre des hommes schweiz is supporting its partner organizations in ensuring that essential services for young people continue to be provided.
Nodumo Ndhlovu, National Coordinator for Zimbabwe and South Africa
