HIV/AIDS in Zimbabwe and Zimbabwean cholera outbreak

At independence, policies of racial inequality were reflected in disease patterns of the black majority. The first five years after independence saw rapid gains in areas such as immunisation coverage, access to health care, and contraceptive prevalence rate. Zimbabwe was thus considered internationally to have an achieved a good record of health development.

Zimbabwe suffered occasional outbreaks of acute diseases (such as plague in 1994). The gains on the national health were eroded by structural adjustment in the 1990s, the impact of the HIV/AIDS pandemic and the economic crisis since the year 2000. In 2006, Zimbabwe had one of the lowest life expectancies in the world according to UN figure – 44 for men and 43 for women, down from 60 in 1990, but recovered to 60 in 2015. The rapid drop was ascribed mainly to the HIV/AIDS pandemic. Infant mortality rose from 6% in the late 1990s to 12.3% by 2004. By 2016 HIV/AIDS prevalence had been reduced to 13.5% compared to 40% in 1998.

The health system has more or less collapsed. At the end of November 2008, some operations at three of Zimbabwe’s four major referral hospitals had shut down, along with the Zimbabwe Medical School, and the fourth major hospital had two wards and no operating theatres working. Due to hyperinflation, those hospitals still open were not able to obtain basic drugs and medicines. The situation changed drastically after the Unity Government and the introduction of the multi-currency system in February 2009 although the political and economic crisis also contributed to the emigration of the doctors and people with medical knowledge.

In August 2008 large areas of Zimbabwe were struck by the ongoing cholera epidemic. By December 2008 more than 10,000 people had been infected in all but one of Zimbabwe’s provinces and the outbreak had spread to Botswana, Mozambique, South Africa and Zambia. On 4 December 2008 the Zimbabwe government declared the outbreak to be a national emergency and asked for international aid.

By 9 March 2009 The World Health Organization (WHO) estimated that 4,011 people had succumbed to the waterborne disease since the outbreak began in August 2008, and the total number of cases recorded had reached 89,018. In Harare, the city council offered free graves to cholera victims. There had been signs that the disease is abating, with cholera infections down by about 50% to around 4,000 cases a week.

The 2014 maternal mortality rate per 100,000 births for Zimbabwe was 614 compared to 960 in 2010–11 and 232 in 1990. The under 5 mortality rate, per 1,000 births was 75 in 2014 (94 in 2009). The number of midwives per 1,000 live births was unavailable in 2016 and the lifetime risk of death for pregnant women 1 in 42.