Zimbabwe has made significant strides in combating tuberculosis (TB), successfully dropping out of the world’s top 30 most TB-burden countries with the incidence rate decreasing from 242 per 100,000 people in 2015 to 204 per 100,000 in 2022. Nevertheless, the nation continues to grapple with TB as it remains a major public health threat, disproportionately affecting those individuals living with HIV.
The improvement is believed to be largely due to the US$15-million-worth Kunda/Nqobi TB program, a groundbreaking initiative funded by the United States Agency for International Development, which allowed over 1 million Zimbabweans to be screened but which came to a close in September.
Commenting on the program’s outcome, Ronald Ncube, the head of the company that implemented the project, Union Zimbabwe Trust, noted that:
“Zimbabwe has made significant strides in reducing tuberculosis cases, with new infections dropping from 400 per 100,000 people in 2010 to 200 per 100,000 people, leading to its removal from the list of top 30 high-burden countries”.
The KN-TB project managed to significantly reduce the country’s TB incidence and also played a vital role in decreasing the HIV burden among TB patients, from 62% in 2015 to 50% in 2023, representing a remarkable 12% decrease.
Nevertheless, TB continues to be a pressing public health concern that affects thousands of lives. The country has seen a 15% increase in TB notifications, from 16,576 in 2022 to 19,483 in 2023.
Zimbabwe’s battle with TB faces challenges, including delayed diagnoses, limited access to new technologies and multi-drug resistance. Additionally, poverty, inequality and restricted access to healthcare perpetuate the disease, requiring sustained efforts to address these social determinants.
Furthermore, although TB treatment is supposed to be free of charge, 80% of patients have to fund heavy costs. Hidden expenses, such as transport to healthcare facilities, registration fees, the cost of food while accessing treatment and certain diagnostics tests such as genetic testing may not be covered under the free treatment program, forcing patients to pay out of their own pockets.
TB has a profound socioeconomic impact on those households that are affected. Compared to non-TB-affected households, those burdened by TB experience significantly higher losses of livelihood and levels of impoverishment. The financial strain of medical expenses, coupled with reduced productivity and loss of income exacerbate the economic hardship faced by these families, ultimately increasing their vulnerability to poverty.
As poverty reduction is high on the authorities’ agenda, fighting TB is just one more aspect that adds to this onerous task. Zimbabwe committed to end TB by 2030 and, against this background, the Minister of Health and Child Care, Douglas Mombeshora, stressed that “urgent investment of resources for TB prevention, diagnosis, treatment and information is vital to winning the fight against TB by saving millions more lives and accelerating the end of the TB epidemic”. He added that by prioritizing these areas, Zimbabwe could make steps towards effectively controlling TB and achieving the United Nations Sustainable Development Goals by 2030.
