Blog item by Melody Mukundwi (Jointed Hands Welfare Organization – Advocacy, Communication and Resource Mobilization Liaison Officer) Duke Otieno and Ibrahim Kimani (KELIN)
There is a room in Zimbabwe where women who have survived tuberculosis gather. Some of them were abandoned by partners when they fell ill. Some kept their diagnosis secret for months, swallowing medication in the dark so no one would ask questions. Some came close to stopping treatment entirely, not because the medicine was unavailable, but because the weight of isolation made it impossible to keep going.
And then they found each other.
“If it wasn’t for this support group, I would never be alive today. These women have become true friends who have walked with me and my family. I don’t know where I would be.”
— Member, Network of TB Champions Women’s Support Group, Harare, Zimbabwe.
A recent visit to one of the women’s support groups within Zimbabwe’s Network of TB Champions was a profound reminder of why community-led responses to tuberculosis are not simply complementary to the health system, but that they are essential to it. These women are TB survivors, peer supporters, advocates, and friends. They bring laughter and tears in equal measure. They hold one another’s children, sit with one another in clinics, and call each other at 3am when the side effects become unbearable. They are doing the work that no drug regimen, however effective, can do alone.
The Numbers Behind the Stories
| 211 TB cases per 100,000 people in Zimbabwe World Bank, 2023 | 40.9% of people with TB report stigma and discrimination Zimbabwe Stigma Index, 2024 | 50% of TB households experience loss of livelihood PLOS Global Public Health, 2024 |
Zimbabwe remains one of only 30 countries in the world classified as high-burden for TB/HIV co-infection, and multidrug-resistant TB (MDR-TB). With an incidence rate of 211 cases per 100,000 people (World Bank, 2023), the disease continues to touch nearly every community across the country.
The numbers only tell part of the story. A 2024 survey measuring the TB Stigma Index in Zimbabwe found that 40.9% of people living with TB report experiencing stigma and discrimination, a figure that helps explain why so many people delay seeking care, hide their diagnosis, or abandon treatment before completion. In rural communities, the same survey found that more than half of participants said they would avoid contact with a person who had tested positive for TB (The Union, Zimbabwe KAP Survey). This is a social problem as well as a clinical barrier.
Research consistently shows that women bear a disproportionately higher burden of TB stigma than men (PLOS Global Public Health, 2024). For women, a TB diagnosis can trigger fear of abandonment, economic dependence on partners who may withdraw support, and the impossible task of continuing to care for others while managing a debilitating illness. The stigma is compounded when TB intersects with HIV: in Zimbabwe, approximately half of all TB patients are co-infected with HIV (Zimbabwe Ministry of Health, 2024), layering one form of discrimination onto another.
TB and Gender impact on women
Tuberculosis does not stay in the body. It moves into households, stripping them of financial stability and social capital at precisely the moment families are most vulnerable. Ninety four percent (94%) of households living with drug-resistant TB are below the poverty line , managing disease and survival at the same time
For women, this burden lands differently. A TB diagnosis does not just mean illness; it can mean losing a partner, income, and support system all at once. The loss of income during TB treatment, which typically lasts six months for standard TB and up to 20 months for drug-resistant TB, creates a cascading set of crises that outlast the illness itself.
This is the reality that the women in Zimbabwe’s support groups navigate every day. And it is the reality their peers help them survive.
What Community Support Actually Does
The evidence base for peer support in TB treatment is unambiguous. The WHO’s TB Knowledge Sharing Platform recognises community champions, people who have themselves been cured of TB, as a critical component of effective TB programmes, noting that peer support reduces the psychological burden of treatment, builds skills to cope with stigma, and improves treatment completion rates.
But the women gathered in that circle in Zimbabwe represent something beyond evidence. They represent what it looks like when a health system works with its communities, rather than for them. They have turned their own experience of surviving TB into a gift they offer others freely: the knowledge that it is possible to get through this, the presence of someone who genuinely understands, and the practical solidarity of people who show up.
One thing became unmistakably clear in that room: the TB journey cannot be taken in solitude. It requires community, real dedicated support, and sustained accompaniment through medication and all that comes with it, the side effects, the emotional and social turmoil, the physical exhaustion, and the long, unglamorous work of simply continuing.
Why This Work Needs Sustained Investment
Zimbabwe recorded a 90% TB treatment success rate in 2024, a significant achievement that reflects years of investment in health systems, diagnostic tools, and community engagement. But treatment success requires patients to be found, retained, and supported across the full duration of their treatment. Without addressing stigma, without economic protection, and without community-level peer support, even the best clinical programmes will lose people along the way.
The women of the Network of TB Champions are not a programme add-on. They are the infrastructure of care. They are the reason some of their peers are alive today.
Investing in community-led TB support, in training, stipends, transport, and the dignity of being recognised as essential health workers, is not a soft investment. It is one of the most cost-effective, evidence-backed, and human interventions available in the global TB response.
The TB Champions are not expensive. But they are not free. The question is not whether we can afford to sustain this work, but whether we can afford not to.
“These women have become true friends who have walked with me and my family.”
— TB Champion, Zimbabwe.
The data matters. The stigma index matters. The incidence rates matter. But behind every number is a person who needed someone to sit with them. Who needed to know that survival was possible. Who needed a friend. Zimbabwe’s TB Champions are proving, every day, that it is.
Sustaining Zimbabwe’s TB response will require more than medicine. It will require sustained investment in the people who make that medicine possible!
SOURCES
World Bank (2023). Incidence of Tuberculosis, Zimbabwe (per 100,000 people).
The Union (2024). KAP Survey: Action Needed to Reduce TB Stigma in Zimbabwe.
Timire et al. (2024). Higher loss of livelihood and impoverishment in households affected by tuberculosis in Zimbabwe. PLOS Global Public Health.
WHO Global Tuberculosis Report (2025). TB and Gender. World Health Organization.
Zimbabwe Ministry of Health and Child Care (2024). TB Programme Annual Review.
WHO TB Knowledge Sharing Platform. Care and Support Interventions to Enable TB Treatment Adherence.
