This review on DFID’s support to the health sector in Zimbabwe was published in November 2011. We awarded a green-amber score, and made five recommendations. A follow-up to this review was published in 2013.
Zimbabwe is a country twice the area of the UK with a population of 12 million. It once had a well-developed infrastructure and financial system but its economy declined rapidly from the late 1990s as its political situation deteriorated. HIV/AIDS prevalence rose to be amongst the highest in the world during the 1990s and a series of failed harvests during the 2000s increased rural poverty and malnutrition. Zimbabwe faced a health crisis in 2007-09 with a cholera epidemic, record inflation which caused many doctors and nurses to leave and a serious drugs shortage. By 2009, HIV/AIDS accounted for half of the disease burden in the country. Life expectancy had fallen to 34 years from over 60 only a decade earlier.
Total UK aid to Zimbabwe was planned to be £80 million in 2011-12, with ‘the prospect of further increases if the political situation is favourable’. The Department for International Development (DFID) expected to disburse a total of £353 million in the period 2011-15. Support to the health sector was expected to be 35% of DFID’s total bilateral spending in Zimbabwe. Much of this sought to compensate for failures in local health systems, for instance by providing emergency medicines and supporting maternal and newborn health. The largest area of assistance was the response to and prevention of HIV/AIDS, with a total of £56 million spent from 2004-11.