Mozambique

The shift in HIV funding has severely disrupted Mozambique’s VTP program, significantly affecting services for pregnant and breastfeeding women (PBFW) and HIV-exposed infants. Approximately 65% of health facilities previously supported by PEPFAR were affected by the US government’s stop-work order, resulting in a sharp reduction in the health workforce. Various cadres—including nurse counsellors, clinicians, laboratory scientists, and technicians—were disengaged, leading to an overwhelming workload for the remaining government-employed staff.

Community-based health interventions were similarly impacted. Mentor mothers and other community health workers ceased operations, suspending peer-to-peer psychosocial support and interrupting mother-infant pair tracking, which is critical to retention in care and early diagnosis. Disruptions in HIV re-testing further compromised service delivery, including halted sample transportation for viral load and dried blood spot (DBS). These, coupled with reduced laboratory staffing, have increased turnaround times for early infant diagnosis and viral load test results. Coordination efforts, including the provision of technical assistance at the provincial level, were also diminished.

The supply chain was adversely affected, disrupting last-mile distribution of essential HIV commodities, including pre-exposure prophylaxis (PrEP) for PBFW. Although a waiver allowed most facility-based services to resume, significant challenges persist, particularly around sample transportation and commodity distribution.

In response, the government has stepped in to support transport and logistics; however, comprehensive emergency and sustainability plans to ensure long-term continuity and resilience of the VTP program are still under development.