For Zimbabweans With HIV/AIDS, a Hard Road

When police arrested Monica Nzou for selling fruit on a slum corner, they taunted her about her AIDS.

Nzou, 34, a shy, painfully thin street peddler who is one of 700,000 Zimbabweans uprooted by a government crackdown on informal settlements, begged to be released. She had two young daughters to take care of, she told the officers. She was HIV-positive, a widow -- her husband had already died of AIDS.

“They laughed and said they were going to charge me with murder for infecting my husband,” she recalled softly. “Then they took away my shoes. They told me to walk barefoot back to the countryside. They said, ‘Go away and die.’ ”

That is the fate that confronts not just Nzou, but millions of other HIV-positive Zimbabweans, a once-prosperous African state sinking ever deeper into mass hunger, economic ruin and authoritarian rule.

Haunted by one of the world’s highest rates of HIV/AIDS, Zimbabwe would be facing a daunting public health challenge even in the best of times. More than a quarter of its 12.7 million citizens are infected with the deadly virus, U.N. statistics show. As many as 3,000 new cases surface in the country every week.

Yet today, surging inflation, a lack of foreign currency to buy imported medicines, and President Robert Mugabe’s ruthless slum-clearing campaign all mean that fewer Zimbabweans than ever have access to crucial antiretroviral drugs that are prolonging life elsewhere.

In the last three months, the U.N. reports, hyperinflation has jacked up the cost of a monthly cocktail of generic HIV drugs from $7.70 to $17 or more -- a fatal increase in a country where the average laborer earns the equivalent of $20 a month.

Just getting enough food to eat has become a struggle for untold thousands of Zimbabweans weakened by HIV or AIDS. The nation’s farming output has been slashed by drought and a disastrous land-reform policy. And in the cities, the poorest HIV/AIDS victims have stopped taking their medicines because of Operation Murambatsvina, or “clean out the filth,” Mugabe’s massive urban renewal program.

Over the last four months, bulldozers have leveled entire shantytowns in Zimbabwe. Human-rights groups accuse Mugabe of trying to drive the restless urban poor back to the countryside, where his ruling party, Zimbabwe African National Union-Patriotic Front, maintains a tighter political grip. Distribution of food by aid groups has been restricted in the cities to keep displaced slum dwellers from returning.

But some humanitarian groups have reacted by slipping HIV-positive township dwellers clandestine rations of corn.

“We’re seeing a flood of new referrals because people can’t afford their drugs anymore,” said a doctor at a clinic in Harare, the capital. Like many health workers, he asked not to be identified because of possible political repercussions.

“They will lie, cheat, do anything to get these drugs,” he said. “I don’t blame them. I would too.”

One woman who was forcibly relocated outside Harare walked six hours back to a city clinic to maintain her antiretroviral drug regime, he said. Another HIV-positive woman, dumped at a remote farm, braved police beatings to reach a nearby well. She did this for her infected baby, who needed water to drink with his pills.

“The [slum cleanup] destroyed all these feeding centers for people with HIV who were just beginning to learn to take antiretroviral drugs,” a foreign aid worker said. “They needed that food to take along with their drugs. Now those people are probably dying, or are at least in a critical state.”

The Zimbabwean Health Ministry still offers subsidized drugs to a few lucky HIV/AIDS patients. But the funding for such programs is woefully inadequate. A national drug rollout announced with fanfare last month has a budget of less than $2 million -- a sum that will hardly dent the needs of 200,000 to 400,000 Zimbabweans with full-blown AIDS.

International AIDS funds also have dried up in Zimbabwe. Mugabe’s regime distrusts outside humanitarian groups.

The average HIV-positive patient in neighboring Zambia gets $184 in foreign aid, the U.N. says. An infected Zimbabwean receives $4.

Meanwhile, even the tiny fraction of Zimbabweans who can afford drugs at commercial pharmacies are finding empty shelves.

In October, the nation’s main manufacturer of antiretrovirals, Varichem Pharmaceuticals, ceased producing anti-AIDS pills because it lacked U.S. dollars to pay for raw materials from India.

Zimbabwean dollars, which are officially exchanged at about 26,000 to the U.S. dollar, are losing value so fast under the nation’s 350% inflation rate that few foreign banks will accept them.

Nzou, the fruit seller, tries to remain optimistic. Now barred by the government from hawking bananas and oranges, she has no hope of obtaining drugs to control her disease.

“Food is my only medicine now,” she said at a private feeding center that was supplying the sick with corn. “When I eat, I feel stronger. I must remain strong for my girls.”

Hefting a small sack of grain, she stepped out into the harsh sunlight and set off for a distant plot of land crammed with other homeless slum families -- a frail woman swallowed in the folds of her faded dress.

She kept to the back streets, to avoid the police.