Chicago Tribune - November 7, 2005
Paul Salopek, psalopek@tribune.com

Nzou, 34, a shy, painfully thin street peddler and 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 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 exactly the fate that confronts not just Nzou, but millions of other HIV-positive people in Zimbabwe, a once-prosperous African state sinking ever deeper into mass hunger, economic ruin and authoritarian rule.

Haunted by one of the world's highest incidence rates of AIDS, Zimbabwe would face 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, UN 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 anti-retroviral drugs that are prolonging life elsewhere in AIDS-plagued Africa.

In the last three months, according to a UN report, hyperinflation has jacked up the cost of a monthly cocktail of generic AIDS drugs from $7.70 to $17 or more--a fatal hike in a country where the average laborer earns the equivalent of $20 a month.

Just obtaining enough food has become a struggle for untold thousands of Zimbabweans weakened by AIDS. The nation's farming output has been slashed by drought and a disastrous land-reform policy. And in the cities, the poorest AIDS victims have stopped taking their medicines due to Operation Murambatsvina, or "drive 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 ZANU-PF party maintains a tighter political grip. Food aid distribution in the cities has been restricted to keep displaced slum dwellers from returning.

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. Like many health workers, he asked not to be identified because of the political sensitivity of the subject.

"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 anti-retroviral 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 required potable 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 anti-retroviral 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 AIDS patients. But the funding for such programs is woefully inadequate. A national drug rollout announced last month, for example, 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 UN says. In Zimbabwe, those infected receive $4.

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

Three weeks ago, the nation's main manufacturer of anti-retrovirals, Varichem Pharmaceuticals, ceased producing anti-AIDS pills because it lacked U.S. dollars to pay for medical raw materials from India.

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

Nzou, the wraithlike 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 quietly 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 gingerly out into the harsh sunlight and set off to 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.

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