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U.S. Government Assistance to Zimbabwe in 2020
March 6, 2021

The U.S. Government provided over $341 million in U.S. assistance to Zimbabweans in calendar year 2020.  The funds included over $200 million for health, with $163 million for PEPFAR’s HIV/AIDS programs alone, $80 million in emergency assistance, $26 million for resilience programs, and $12 million to promote agriculture economic growth.  We have provided over $3.5 billion in assistance to Zimbabwe since 1980. 


The U.S. Government remains the largest overall bilateral donor to Zimbabwe and provides the most support to the country’s health sector.  Assistance concentrates on the prevention and treatment of three of the most significant health threats in Zimbabwe—HIV, tuberculosis, and malaria—to help Zimbabweans live longer and healthier lives.  The U.S. Government also focuses on programs that reduce maternal, infant, and child illness and deaths.  In 2020, the U.S. Government invested over $20 million to respond to the global COVID pandemic in Zimbabwe. 


  • Under PEPFAR, the U.S. Government provides lifesaving antiretroviral medicines to more than 1.16 million HIV-positive Zimbabweans. In 2020, 76,737 HIV-positive Zimbabweans began treatment through PEPFAR.
  • Results from the 2020 Zimbabwe Population-based HIV Impact Assessment survey (ZIMPHIA) demonstrated the nation’s continued progress toward the UNAIDS’ global targets. The U.S.-funded survey found that HIV prevalence in Zimbabwe declined to 12.9 percent from a high of 29 percent in 1999.
  • ZIMPHIA also demonstrated that over 77 percent of adults living with HIV have achieved viral load suppression, meaning they cannot transmit the virus. This high level of viral suppression marks a major milestone in bringing the infection under control in Zimbabwe.
  • PEPFAR supported the development and deployment of the Impilo patient-centered electronic health record. This system now operates in 172 health facilities across Zimbabwe, bringing patients’ health histories into the hands of healthcare workers and allowing for improved patient care.
  • PEPFAR supported the implementation of a robust, open-source Laboratory Information Management System in 13 viral load testing laboratories, including a referral module and a system for real-time patient result notification.
  • Following the closure of 27 health facilities in Harare due to a health worker strike, PEPFAR supported outreach activities that provided anti-retroviral refills during nearly 30,000 visits, collected viral load samples from over 9,500 clients, and initiated over 3,700 HIV clients on tuberculosis (TB) preventive treatment.
  • In 2020, the U.S. Government provided:
    • HIV testing and counseling for 1,438,879 people.
    • Cervical cancer screening for 146,103 HIV-positive women.
    • Viral load testing for 517,015 people living with HIV.
    • ISO 15189 international accreditation status for seven viral load testing laboratories.
    • Prevention services for more than 175,000 adolescent girls and young women.
    • HIV treatment for 40,067 new HIV-positive pregnant women.
    • Support for approximately 98 percent of all antenatal care sites in Zimbabwe to provide services for the prevention of mother-to-child transmission of HIV.
    • Voluntary medical male circumcision for 127,919 men to reduce the risk of contracting and transmitting HIV.

HIV: Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) and Orphans and Vulnerable Children

  • Since 2015, PEPFAR has supported HIV prevention services to 785,000 at-risk adolescent girls and young women (AGYW) between the ages of 10 to 24 through the DREAMS program. The number of new HIV diagnoses among AGYW in Zimbabwe has reduced by about 44% in DREAMS districts, achieving the highest reduction among DREAMS countries since the program began.
  • In 2020, DREAMS reached over 175,000 AGYW aged 10-24 with services to help them prevent HIV.
  • Twenty thousand AGYW received essential health services and over 47,000 benefited from economic strengthening interventions.
  • More than 23,000 AGYW aged 10-20 in six DREAMS districts received educational subsidies for either formal or part-time continuing education and about 2,500 received pre-exposure prophylaxis to help them prevent HIV.
  • The U.S. Government provided services for 438,669 orphaned and vulnerable children and their families. This includes HIV prevention, care and treatment, education support, psychosocial services, and/or economic strengthening for 375,000 children aged 0 to 17 years across 21 districts.  Programs also provided family-centered care to over 25,000 adolescents and youth living with HIV aged 15-24. 


  • In 2020, the U.S. President’s Malaria Initiative (PMI) purchased 800,000 long-lasting insecticide treated nets (LLINs) and supported COVID-19-safe distribution of 100,685 LLINs in the 11 PMI-supported districts through door-to-door campaigns and continuous distribution channels. PMI will distribute the balance of the nets when the nets currently in use reach the end of their two-to-three-year lifespan.
  • PMI procured 475,560,192 artemisinin-based combination therapy and malaria curative drugs and 1,000,000 malaria rapid diagnostic tests to support malaria case management across the country.
  • PMI trained 209 health workers in malaria case management, including malaria during pregnancy.
  • Under indoor residual spraying efforts, PMI sprayed 131,191 structures in Mudzi and Mutoko districts, protecting 307,209 people from malaria infection.

Tuberculosis (TB)

  • U.S. Government efforts in 2020 detected 339 multi-drug resistant (MDR)-TB patients and put almost all of them on treatment.
  • U.S. Government partners traced 97 percent of 48,448 TB contacts and achieved an 84 percent treatment success rate for all forms of TB.
  • The U.S. Government provided preventative TB therapy for 120,939 HIV patients on antiretroviral treatment. 

Maternal, Newborn, and Child Health

  • The U.S. Government improved essential newborn care through the procurement and distribution of newborn care equipment to all 15 comprehensive obstetric and neonatal care health facilities in Manicaland Province.
  • U.S. Government partners provided on-the-job-training for 904 health care workers from 62 of the 71 supported facilities.

Family Planning

  • U.S. Government partners reached 48,663 clients with family planning services in all 10 provinces. 

Gender-based Violence

  • In 2020, U.S. Government partners provided gender-based violence-related services to nearly 16,000 Zimbabweans experiencing sexual violence and more than 33,000 experiencing physical and/or emotional violence.
  • In 2020, PEPFAR provided clinical post violence care to 2,759 AGYW experiencing sexual, physical and/or emotional violence. In addition, PEPFAR supported the delivery of other critical GBV response services such as trauma counseling, shelter, and legal aid to 9,937 survivors.
  • The U.S. Government trained 2,649 people to combat sexual violence against children, including religious leaders, which prevents gender-based violence and protects children against sexual violence. As a result, the implementing partner identified and rescued four minor girls, aged 13 to 15 years, from child marriages.
  • In 2020, the U. S. Government supported the development of the movie “Shaina” and its premieres on ZBC-TV and YouTube. Shaina’s dynamic and educational storyline promotes empowerment of girls and young women in Zimbabwe.  The film provides helpful tools and information about health issues and social challenges that adolescent girls and young women face, and it increases awareness of how to seek help in the event of violence or its prospect.  Over 14,000 people watched the movie on YouTube and it reached over 500,000 viewers through the Zimbabwe Broadcasting Corporation.
  • The U.S. Government supported emergency and ongoing legal services to survivors of politically motivated violence and to survivors of gender-based violence. Complementary activities provided medical and psychosocial services to victims as well as community-led trauma counseling to rehabilitate and reintegrate survivors into their communities.  Programs strengthen coordination and referral networks to organizations that deal specifically with gender-based violence. 


In response to the COVID-19 pandemic, U.S. Government programs provided:

  • Food assistance to 103,740 vulnerable Zimbabweans in eight urban areas for six months.
  • Training for more than 8,000 healthcare workers in comprehensive and advanced COVID-19 case management, and biosafety training for staff from 75 laboratories in 10 provinces
  • Implementation of a data management system for 16 COVID-19 testing laboratories.
  • Support for COVID-19 testing and contact tracing. This included technical mentorship for 58 laboratories, 40,000 sample collection kits, and 8,770 COVID-19 tests.
  • External quality assessment and waste management support for COVID-19 testing laboratories.
  • Improved surveillance systems targeting influenza-like illness and severe acute respiratory infections. This included the development of, and staff training on, a COVID-19 electronic health records solution for Zimbabwe’s 12 points of entry and for quarantine and isolation centers.
  • A seroprevalence survey to determine the number of infections not confirmed due to low testing rates and asymptomatic infections.
  • Personal protective equipment (PPE) and other supplies, including masks, sanitizing supplies, and thermometers, valued at nearly $500,000.
  • A vaccine preparedness strategy.
  • Modified distribution of antiretroviral medicines, limiting patients’ potential exposure to COVID-19.
  • $1,315,000 to support improved living conditions for returning migrant populations facing mandatory quarantine in government-run centers. 

Emergency Assistance

The U.S. Government supported the people of Zimbabwe with emergency assistance in 2020 due to prolonged periods of drought, extreme weather conditions, the COVID-19 pandemic, and a deteriorating economic context.

  • Over the 2019-2020 lean season (January to April 2020), the U.S. Government provided food assistance for over one million food insecure rural Zimbabweans.
  • The U.S. Government supported 25% of the total food needs for all of the approximately 14,000 refugees at Tongogara Refugee Camp in Chipinge District.
  • In the aftermath of Tropical Cyclone Idai, the U.S. Government provided thousands of beneficiaries in cyclone-affected communities with access to clean water and hygiene supplies, agricultural early recovery services, and immediate food assistance, while also improving disaster risk management capacity at the provincial, district, and community levels.
  • In response to ongoing drought conditions, the U.S. Government provided nearly $5.2 million to support agriculture and food security, economic recovery, water and sanitation, humanitarian coordination and information management, and shelter and settlements. 


To address the underlying causes of chronic food insecurity and poverty, U.S. Government programs improve incomes, increase agricultural and nutritional knowledge, and bolster the food and nutrition security of thousands of Zimbabweans.

  • The U.S. Government helped 12,179 people (6,319 women and 5,860 men) gain access to basic sanitation services and provided health and hygiene training to 22,111 individuals (18,999 women and 3,112 men). Between 2014 and 2019, the percentage of households that had soap and water at a handwashing station increased from two percent to 10 percent and the number of households practicing safe storage of drinking water increased from 52 percent to 98 percent.
  • U.S. Government Feed the Future programs increased targeted young farmers’ average annual net income from $254 in 2015 to $885 in 2020, an increase of nearly 250 percent.
  • Feed the Future beneficiary farmers generated sales of over $11 million in 2020, compared to just $3 million four years ago.
  • In 2020, the U.S. Government’s partner financial institutions extended 234 development credit authority (DCA) loans valued at $1,103,047 to medium, small, and micro-enterprises (MSMEs). Seventy-nine percent of the loans went to first-time borrowers and 90 percent went to women-owned enterprises.  Partner financial institutions also extended non-DCA loans valued at $283,500 to nearly 1,700 MSMEs in the agricultural sector.


Other U.S. Government Support

Other U.S. Government funding includes support for good governance, parliamentary strengthening, cultural outreach, the environment, demining, and small grants.  Cultural and educational exchange programs strengthen the U.S.-Zimbabwe relationship.  The Ambassador’s Special Self-Help program benefits communities and demonstrates the U.S. Government’s commitment to the welfare and social development of Zimbabwe.

  • In 2020, the Ambassador’s Special Self-help grants benefitted more than 48,000 Zimbabweans. These diverse grants focused on improving livelihoods, food security, human rights, civil liberties, and care for orphans and vulnerable children.  Grant recipients live and work in Manicaland, Mashonaland Central, Mashonaland East, Matabeleland North, and Harare.
  • The U.S. Government held a virtual meeting on Empowering Women’s Political Participation that brought over two hundred Zimbabwean activist women together from across the country to engage directly with human rights experts in the United States. Participants exchanged ideas on how to overcome barriers, prevent violence against women in the political sphere, and enable women’s participation in political processes.
  • The U.S. Government has invested more than $23.9 million in Zimbabwe since 1998 to protect people from landmines and promote economic opportunities through safe access to farmland. S. support for humanitarian demining in Zimbabwe has destroyed more than 42,800 landmines and returned over 2,300 acres of land to productive use, directly and indirectly benefiting 403,000 Zimbabweans.  U.S. support also provided mine risk education to over 10,500 people about the dangers of living near minefields.  In 2020 alone, the U.S. Government destroyed 6,685 mines and returned 435 acres of land to productive use in Zimbabwe.
  • To combat human trafficking, the U.S. Government supported the refurbishment of shelters, provided services to trafficking victims, and responded to emerging needs related to COVID-19. The U.S. Government also supported anti-trafficking efforts within the Southern African Development Community, including Zimbabwe, related to data collection, legislation, and the criminal justice system.
  • Transnational wildlife crime rings use Zimbabwe as a transit route for illegal wildlife products. In 2020, the U.S. Government expanded the capacity of the Victoria Falls Wildlife Trust Laboratory to process and analyze wildlife DNA samples for species detection, geographic origin, matching, and other forensics and disease tests.
  • The U.S. Government supported members of the Zimbabwean Parliament to conduct policy and legal analyses and increase their productive engagement with ordinary citizens. In 2020, Parliament took 11 out of a target of 13 executive oversight actions, including legislative committee investigations, public hearings, formal question and answer sessions, and written interrogatories regarding an executive branch program, decision, or action.
  • U.S. Government partners provided trauma counseling to nearly 500 individuals who experienced political violence. Counseling helped participants recover from acute emotional trauma and equipped them with tools to forestall such trauma in the future and to assist friends and family to reduce individual and community trauma.
  • The Ambassadors Fund for Cultural Preservation awarded a $75,000 grant in 2020 to document and preserve cultural materials, including artifacts from the ancient city of Great Zimbabwe, at the Zimbabwe Museum of Human Sciences.
  • In 2020, 280 Zimbabweans took part in professional, educational, and cultural exchanges and locally funded programs, including in the prestigious Mandela Washington Fellowship for Young African Leaders Initiative and the International Visitor Leadership Program
  • In 2020, more than 1,375 Zimbabwean students studied at U.S. colleges and universities, with the majority receiving scholarships.