Zimbabwe - access to medicines powered by foreign aid

In September 2017, I was fortunate to visit Zimbabwe as part of the Unitaid NGO delegation. Unitaid, an entity under the World Health Organisation, works on equitable access to quality health technologies worldwide, and it does this by providing grants to organisations with reputable financial track records working on the ground in-country. 

On the 13th, I visited a village in Mazowe, about an hours’ drive away from the capital of Harare, to learn from community-based distributors (or CBDAs) of HIV self-testing kits. The kits are the OraQuick tests which works with a sample collected from rubbing one's gums with the diagnostic device provided, and it returns a result within 10 minutes. These test kits, salaries of CBDAs, and tablets to record HIV results, are funded by Unitaid. 

In this picture I took in Mazowe (right), you can see a CBDA explaining to a couple how the HIV self-test works. What struck me was how extremely well trained she was, and she managed to convince the male partner to take the test, even though he was initially reluctant. It was amazing to meet and talk to the CBDAs. I asked them what their main challenges were in distributing the self-test kits, and domestic violence from partners was one of them, and access to prisons were another. 

The next day, we visited a district hospital in Murehwa, about 1.5 hours from Harare. The hospital was equipped with Alere and GeneXpert analytical machines for the accurate diagnosis of HIV and TB, including paediatric cases. These machines were too funded by Unitaid. The laboratory technician, Simba (pictured below with the Alere machine), informed us that  per day, he ran 8-12 samples with the machine as each sample takes 1 hour to analyse. It was clear that the hospital would benefit from machines with more modules so that he would be able to run more tests at the same time. I am in awe of what a great job the Zimbabwean healthcare staff is doing with these funds. 

However, I left Zimbabwe with bittersweet feelings. The great majority of health technologies for malaria, tuberculosis, and HIV is funded by foreign funders.  Medicines for other conditions must be paid for out-of-pocket. Education is not free, with primary school costing anywhere from US$40-150 per term, a fee that many cannot afford. Even middle-class families in Harare suburbs do not have reliable electricity, with some relying on solar power. Working streetlights are sparse, creating safety issues for drivers and pedestrians alike, and roads are riddled with potholes.

Talking to MDC parliamentarians Ruth Labode and James Maridadi gave me hope that things are progressing, albeit slowly. There is much that needs to be done, and I hope to be able to help.