By a Correspondent
Severe administrative bottlenecks, limited diagnostic capacity and funding shortfalls in Zimbabwe are leaving HIV-positive returnees fleeing anti-immigrant violence in South Africa struggling to access critical antiretroviral (ARV) medication.
The crisis has already proved fatal, according to the family of Renious Gumbi, 49, a Zimbabwean bricklayer who had lived in South Africa for two decades before returning home.
Gumbi reportedly struggled to access his local South African clinic after anti-immigrant groups blocked access to the facility, resulting in a prolonged interruption of his treatment. His family said he later developed serious health complications and died shortly after returning to Zimbabwe.
Gumbi’s case highlights the wider health risks facing thousands of Zimbabweans returning from South Africa amid escalating anti-immigrant tensions.
More than 100,000 Zimbabweans had returned home by July 18, according to government figures, with the influx driven in part by rising hostility towards undocumented migrants and pressure from groups such as Operation Dudula and March and March.
The United Nations has described the return of tens of thousands of Zimbabweans as a major humanitarian challenge, with the Beitbridge border becoming a key entry point for families whose lives have been disrupted in South Africa.
“More than 100,000 people fleeing or being displaced are the kind of numbers MSF sees in hot conflict areas, not relatively stable democracies,” said Caroline Masunda, a representative for Médecins Sans Frontières (MSF).
The organisation is providing emergency ARV refills alongside South African authorities at the Musina border crossing.
Upon entering Zimbabwe, however, returnees can face significant barriers to securing long-term HIV treatment.
While the Ministry of Health and Child Care has screened tens of thousands of returnees at ports of entry, health authorities say patients cannot simply be enrolled into long-term HIV treatment programmes at border facilities.
Addressing Parliament, Health Minister Douglas Mombeshora said long-term ARV regimens could not be initiated at border checkpoints because of limited access to the baseline diagnostic services required to guide treatment, including viral-load testing.
Returnees are therefore referred to local health facilities, where administrative procedures, patient registration and waiting times can prolong interruptions in treatment.
Some returnees, including Gilbert Muzokomba, 58, and Nelisiwe Mugodhi, 23, reported experiencing severe symptoms, including high fevers, chronic coughing and rapid physical deterioration, while waiting to be placed on local ARV registers.
The influx of displaced patients is placing additional pressure on Zimbabwe’s health system, which provides HIV services to an estimated 1.3 million people living with HIV.
The pressure has been compounded by uncertainty surrounding international HIV funding, following changes in United States foreign assistance and concerns over the future of PEPFAR-supported programmes.
Health and legal advocates warn that prolonged interruptions in HIV treatment could have consequences beyond individual patients, including increased illness, treatment failure and the potential emergence of drug-resistant HIV.
“Most of these returnees are secretive about their health status due to stigma and don’t know where to access help after years away,” said Kensington Marufu, an HIV advocate and lawyer.
“This lack of continuity and adherence will negatively impact overall national HIV control.”
