A surge in malaria cases in Zimbabwe is exposing fragile health systems and growing treatment shortages in rural areas.

Harare, Zimbabwe – Precious Mvundura woke up with joint pain, a high fever and a pounding headache on a chilly autumn morning in eastern Zimbabwe.

The 37-year-old initially thought it was just the flu. But when the headache persisted for three days, she became worried.

Her five-year-old son had also fallen ill and was sweating heavily.

In early May, the pair sought help from a village health worker in Chishakwe, a rural farming community outside Zimbabwe’s third-largest city, Mutare. Both tested positive for malaria.

“I felt relieved,” Mvundura told Al Jazeera.

“From the moment I took that medication, I started getting better.”

Her son has also recovered and is back in school.

Their ordeal comes as malaria cases and deaths surge across Zimbabwe after US funding cuts disrupted key malaria control programmes.

Shortly after returning to office for a second term in 2025, US President Donald Trump slashed foreign aid funding, including programmes backed by the United States Agency for International Development (USAID). In Zimbabwe, the cuts disrupted tuberculosis, HIV/AIDS and malaria research, prevention and treatment programmes.

Among the affected initiatives were the Zimbabwe Entomological Support Programme in Malaria (ZENTO) at Africa University in Mutare, which provided scientific research to support the country’s National Malaria Control Programme, and the Zimbabwe Assistance Programme in Malaria II (ZAPIM II), which helped strengthen malaria diagnosis, treatment and prevention in high-burden districts.

USAID had disbursed $270m for health and agriculture programmes in Zimbabwe in 2024.

Malaria cases jumped to 65,399 between January and April 2026, up from 36,000 recorded during the same period in 2025 and 17,000 in 2024, according to Zimbabwe’s Ministry of Health National Malaria Control Programme weekly surveillance report.

Deaths have also risen sharply, reaching 174 between January and April 2026, compared with 85 during the same period last year and 34 in 2024.

Mvundura and her son survived because they sought treatment early. In many other cases, the disease has been fatal.

Thomas Chuchu, the health programme lead at Save the Children Zimbabwe, said several malaria elimination activities previously supported by ZAPIM II had been disrupted.

“In practice, elimination has continued through government and other partners, but with weaker operational capacity and slower implementation,” Chuchu told Al Jazeera.

The ZAPIM II programme ran through Zimbabwe’s Ministry of Health system in 11 districts across the provinces of Central and East Mashonaland and the province of Matabeleland North.

Before falling ill, Mvundura said she had not been using mosquito nets or repellents.

“I only started using a mosquito net a friend shared when I fell sick,” she said.

In December 2025, Caroline Mawombedzi was diagnosed with malaria while living in Burma Valley, a farming community about an hour’s drive from Mutare.

She had last contracted the disease in the late 2000s while still a child.

In mid-May, her five-year-old daughter was also diagnosed with malaria by a village health worker in Chishakwe after suffering severe headaches and stomach problems.

Although her daughter received treatment, Mawombedzi said she could not afford preventive measures such as mosquito nets.

“I am unemployed. I cannot afford to buy a mosquito net. We have not been sleeping under a mosquito net for years,” she said.

Virginia Chakandinakira, a village health worker serving Chishakwe, said malaria diagnostic kits and drugs are now in short supply.

“I used to get plenty of malaria test kits and drugs. But in 2025, they did not give me. I referred everyone showing malaria to a nearby Chitakatira clinic,” she said. Chitakatira is a rural settlement about an hour’s drive from Chishakwe.

“I only received test kits and drugs in February. However, the supplies are limited. The authorities told us they were only distributing them to hotspot communities.”

Professor Sungano Mharakurwa, the director of Africa University’s Malaria Institute, said the abrupt withdrawal of US support had worsened the malaria outbreak by affecting the programme.

ZENTO was contributing data from the surveillance of malaria-carrying mosquitoes, which guided strategies employed by the National Malaria Control Programme to control malaria transmission, he said.

The Trump administration’s funding cuts have also effectively put a stop to the US President’s Malaria Initiative (PMI), launched in 2005 by former President George W Bush to control and eliminate malaria worldwide. Mharakurwa said the PMI had played a major role in funding malaria medications, and communities had been left exposed without it.

He said the Malaria Institute later secured funding from the United Methodist Church General Board of Global Ministry, but it fell far short of previous US assistance.

Zimbabwe’s dependence on donor funding for essential medicines, diagnostic kits and mosquito-control supplies has left the country vulnerable.

Itai Rusike, the director of Zimbabwe’s Community Working Group on Health, said the government needed to strengthen domestic health financing to reduce dependence on foreign donors.

“It is risky for a country to depend substantially on external partners, as donors can withdraw financial support anytime should their interests shift,” he said.

Experts say climate change is also driving the spread of malaria and other vector-borne diseases across Africa.

Rising temperatures are allowing malaria to spread into higher-altitude areas, which were once less vulnerable to outbreaks.

Zimbabwe experienced El Niño between 2023 and 2024, a climate phenomenon marked by unusually warm temperatures in the Pacific Ocean, which typically disrupts rainfall patterns across Southern Africa.

Heavy rainfall followed in 2025 and 2026, creating ideal breeding conditions for mosquitoes.

Chuchu, from Save the Children Zimbabwe, said that the current spike in malaria cases was closely linked to the heavy rains during the 2025–2026 season.

“The rains created favourable breeding conditions for mosquitoes, particularly in already endemic provinces such as Mashonaland Central, Manicaland, Mashonaland East and Mashonaland West,” he said.

“The effect of heavy rains is likely being amplified by weakened prevention systems, including reduced mosquito-net coverage, delayed vector-control activities, reduced community surveillance, and challenges with timely testing and treatment following the discontinuation of ZAPIM,” he added.

Professor Mharakurwa, meanwhile, said that above-normal rainfall required equally strong preparation and resources to contain malaria transmission.

Zimbabwe aims to eliminate malaria by 2030, in line with the target set by the African Union.

Over the years, the government, working with international donors and aid organisations, has relied on indoor residual spraying, mosquito-net distribution, mass testing and public awareness campaigns to contain outbreaks, particularly in rural communities.

Health workers continue to carry out indoor spraying campaigns in malaria-prone areas, while village health educators use community meetings and radio programmes to encourage early testing and treatment. Authorities have also expanded surveillance and rapid-response systems in high-risk districts.

But some of these efforts have weakened following the disruption of donor-funded programmes. Key malaria elimination activities previously supported by ZAPIM II included active case tracking, targeted distribution of long-lasting insecticidal nets and district rapid-response systems.

For years, the government and aid organisations distributed mosquito nets annually to vulnerable communities, such as Chishakwe. But since the US funding cuts, shortages have become increasingly common.

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