Rampant unemployment, skyrocketing inflation, food shortages, and political instability has continued to wrack Zimbabwe. Up to three million people are believed to have fled to neighbouring countries in recent years among a population of 12 million.

The national health care system, once viewed as one of the strongest in southern Africa, now threatens to collapse under the weight of this political and economic turmoil with the most acute consequences potentially for the 1.8 million Zimbabweans living with HIV/AIDS.

Currently, less than one-fourth of the people in urgent need of life-extending antiretroviral (ARV) treatment receive it. This translates into an average of 3,000 deaths every week. And the prospects for a further scale up of the national AIDS program are dim.

Trained medical professionals are leaving the country, the government program for HIV/AIDS treatment is oversubscribed, and the lack of ARV supplies has stifled further expansion. Patients often face obstacles to reach hospitals or clinics because of high fuel and transport prices.

Through programs in Bulawayo, Tsholotsho, both in Matabeleland North province, Buhera, Manicaland province, Epworth, Mashonaland East province, and Gweru, Midlands province, MSF provides free medical care to about 29,000 people living with HIV/AIDS - 16,900 of whom are receiving ARV treatment.

MSF's ability to care for more people in need is hindered by the lack of trained health workers, restrictions on which staff can prescribe ARV drugs, and stricter administrative requirements for international staff to work in the country.

At the same time, Zimbabweans are feeling the health impact of degraded or nonexistent water-and-sanitation systems. In recent weeks MSF has been addressing cholera cases in Mudzi, in Mashonaland East province, where about 250 patients have been treated so far.

In Kariba, Mashonaland West province, MSF has provided medical material and training to local health personnel in order to help respond to a cholera outbreak. MSF is currently working with a little more than 400 field staff in Zimbabwe and has been present in the country since 2000.