Zimbabwe’s Civil Society Provides Foot Soldiers in Fighting AIDS

Evan Mawarire holding a Zimababwean flag as part of #ThisFlag Movement in 2018. (Photo Courtesy of Twitter)

PEPFAR saved my life.

The ravaging HIV/AIDS epidemic was one of the most tragic disasters I’ve ever watched helplessly unfold as a young man in Zimbabwe. The disease began taking hold in the mid-1980s, and its prevalence had reached 25% of the adult population by the time I was in high school in the 1990s.

My generation was getting infected fast, and we would soon start disappearing with no testing, treatment, or education about the disease. Many people older than me in my community, whom I still remember by name, unknowingly contracted the virus. As a result, they did not make it past 30 years of age. By the time I was a young adult, Zimbabwe was recording a shocking HIV/AIDS prevalence rate of 33.7% of the adult population.

The iron-grip dictatorship exacerbated a failing economy and underdeveloped health delivery systems. The government’s attempt to fight the virus with a 3% AIDS tax in 1999 was a far cry from the reality of what was needed.

I started #ThisFlag Movement in 2016 to challenge the government of Zimbabwe about injustice, corruption, and poverty. The goal was to help ordinary people to understand the link between bad governance and the lack of service delivery.

By 2001 the effects of a disease rampaging through our best and brightest young people were now obvious. Over the years life expectancy at birth plunged from 62 years in 1987, when the epidemic began, to only 42 years in 2001.

Apart from holding firm the value of abstinence as a key tenet of my Christian faith, the next biggest contributor to saving my life was the help that trickled into Zimbabwe in the 1990s from programs led by organizations like UNAIDS and USAID. By the beginning of 2000, it was obvious that a more robust strategy beyond distributing free condoms in educational institutions and mining and farming communities was urgently needed.

Nurse Nyaradzo Mushonga works for Seke North Clinic in Marondera, Zimbabwe in partnership with PEPFAR through USAID Zimbabwe.

President George W. Bush’s administration launched the President’s Emergency Plan for AIDS Relief (PEPFAR) in Zimbabwe in 2006. With it came a multipronged program of action that focused on achieving epidemic control through reducing new HIV infections and AIDS-related deaths.

With the 3% AIDS levy woefully inadequate, Zimbabwe’s ministry of health was itself without the kind of infrastructure needed to take full advantage of the strategy that PEPFAR was ready to provide. It became and still is the job of civil society to step in and partner with both PEPFAR and the government to deliver the full package of the PEPFAR portfolio. Without civil society’s trusted midwife-like role in national crises, Zimbabwe achieves very little effective, urgent, and accountable implementation of initiatives.

In recent years, incessant Cholera and Typhoid outbreaks have ravaged the country. That is due to derelict national water and sanitation infrastructure, along with underfunded and ignored public health policy recommendations.

Again, government has needed the donor community, civil society, and the private sector to help  deliver critical help to citizens. As thousands died during the COVID-19 outbreak, the Zimbabwe government, including the minister of health, was exposed for its role in massive multiple scandals that involved the theft of resources donated for the relief of citizens.

It became and still is the job of civil society to step in and partner with both PEPFAR and the government to deliver the full package of the PEPFAR portfolio.

Zimbabwe’s civil society’s challenges

A key role of civil society is being a watchdog so that the kind of help that programs like PEPFAR provide is actually delivered. However, this same role complicates and threatens the work of the larger civil society in a place like Zimbabwe.

In a dictatorship, anything or anyone that exposes the regime’s misdeeds or refuses to be used to cover up corrupt activities is labeled an agent of the West or considered attempting to change the regime. To this end, the Zimbabwe government has now implemented the Private Voluntary Organization (PVO) bill. The legislation gives the government full powers to regulate and influence the activities of civil society organizations.

That authority includes deregistering organizations that do not meet the standard, changing leadership deemed undesirable, and prosecuting those it deems out of compliance. This directly threatens both the existence of an effective civil society and the delivery of humanitarian assistance in times of crisis.

Activist Evan Mawarire entering a police car on January 16, 2019 after he was picked up from his home in Avondale, Harare.

I started #ThisFlag Movement in 2016 to challenge the government of Zimbabwe about injustice, corruption, and poverty. The goal was to help ordinary people understand the link between bad governance and the lack of service delivery.

The HIV/AIDS epidemic claimed millions over the years and little was ever done to demand serious and urgent responses from our government. Our desire was to hold government to account so that its leaders could do better in managing our resources and saving lives.

We organized many successful protests, some of which involved millions of people. Even though I was jailed, beaten, and tortured, we achieved our goal of a more engaged citizenry and active civil society that ensures a democratic, just, and equitable society.

As PEPFAR celebrates 20 years of consistent programs and activities that have saved generations of people across the world, we must also remember the partnering civil society groups that have been the resilient foot soldiers in delivering the help. Civil society is the tip of the spear that penetrated communities to help change behaviors.

Even though I was jailed, beaten, and tortured, our goal of a more engaged citizenry and active civil society to ensure a democratic, just, and equitable society was achieved

Independent civil society organizations are important for another reason, too: The ruling party in Zimbabwe – Zanu-PF — limits access to Zimbabwe’s rural regions, which is where the party derives most of its votes. The ruling party often approves which activities of donors or non-governmental organizations occur in those areas, even though the party says the activities are for the benefit of the people.

Imagining PEPFAR for the future

Zimbabweans’ life expectancy after birth in 2020 rebounded back to the 1986 levels of 61 years. That is a far cry from the global average of 73 years. But the phenomenal recovery, which occurred despite an economy under continual stress and the loss of our democracy, is largely the outcome of the consistent presence of programs like PEPFAR.

If PEPFAR has taught us anything, it is that solutions for challenges like the HIV/AIDS epidemic — which are threats to not just the economic futures of our countries, but to the very makeup of societies that now have decimated families — must be built to outlive us. What would happen if a future United States administration decided to end PEPFAR?

As PEPFAR celebrates 20 years of consistent programs and activities that have saved generations of people across the world, we must also remember the partnering civil society groups that have been the resilient foot soldiers in delivering the help.

To avoid exploring an obviously grim answer, the question should be asked differently. What would happen if PEPFAR continued for another 20 years? That answer literally gives us a blank canvas to imagine thriving generations beyond us.

These sort of global strategies and solutions must be designed beyond the political interests of present-day leaders. PEPFAR has spanned four United States administrations because it was not designed as a strategy to score political points. Rather, it is the genuine and well-intentioned response to a desperate situation.