Community Working Group on Health

Robin Muchetu, Health and Gender Editor

THE High Court’s landmark ruling that struck down key parts of Zimbabwe’s restrictive abortion law as unconstitutional has drawn strong reactions from public health advocates and gender-rights organisations, who say the decision marks a long-overdue step towards protecting vulnerable women.

Justice Sylvia Chirawu-Mugomba ruled that Section 4(a) of the Termination of Pregnancy Act (Topa) of 1977, as well as the definition of “unlawful intercourse” under Section 2(1), are unconstitutional and invalid.

Parliament now has 18 months to amend Topa to align it with the Constitution and to incorporate protections required under the Mental Health Act.

Justice Chirawu-Mugomba decision followed an application by the Community Working Group on Health (CWGH) and Member of Parliament Nyasha Batitsa, who argued that the law unfairly excluded women with mental illness from accessing legal termination, even in cases of sexual exploitation.

The judge found that the decades-old Act fails to recognise that women with mental health conditions may be unable to consent to sexual activity and are therefore at heightened risk of abuse. By excluding them, the judge ruled, the law violates constitutional guarantees of equality, dignity, humane treatment and bodily autonomy.

“The statutory omission creates a discriminatory regime, forcing women to carry pregnancies that cause grave mental-health consequences,” Justice Chirawu-Mugomba said.

Although the affected provisions have been declared invalid, the order has been suspended for 18 months while Parliament amends the law. The ruling has also been referred to the Constitutional Court for confirmation.

Justice Sylvia Chirawu-Mugomba suspended for 18 months from the date of the order to enable the respondents to amend the provisions in the Termination of Pregnancy Act as cited to include mental health and conduct proscribed in Section 106 of the Mental Health Act.

“The above declarations of constitutional invalidity are suspended until such time as the Constitutional Court has confirmed the same in terms of section 167(3) of the Constitution of Zimbabwe. The above order of constitutional invalidity is referred to the Constitutional Court for confirmation in terms of section 175 (1) of the Constitution. There shall be no order as to costs,” she ruled.

CWGH executive director Mr Itai Rusike said the judgment marks a reflective shift in the country’s reproductive-rights landscape.

“It shifts the legal framework from a narrow, biomedical model of abortion, centred solely on physical survival, to a constitutional model grounded in dignity, equality and holistic health,” he said.

“Recognition of mental-health risk as a standalone indication for lawful termination modernises an area of law historically shaped through punitive colonial codes that disregarded women’s lived realities.”

Mr Rusike noted that the ruling elevates mental health within the country’s constitutional right to health and may have wider implications for health-sector reforms.

“This opens space to challenge insurance exclusions on psychiatric services, the chronic underfunding of mental-health care, and policies that treat mental health as secondary,” he said.

Mr Rusike said the decision also aligns Zimbabwe with regional and international obligations under instruments such as the Maputo Protocol and Cedaw.

Women’s rights groups said the court’s recognition of the vulnerability of institutionalised or mentally ill women, particularly under Section 106 of the Mental Health Act, is a major advance.

They argued that previous legal provisions offered little protection to women who cannot consent to sex yet were denied legal termination if they fell pregnant through abuse or exploitation.

Women’s Action Group (WAG) programmes officer Ms Vimbai Nyika said the ruling places new responsibility on the media to ensure accurate, sensitive coverage of abortion and sexual and reproductive health rights (SRHR).

“We want to strengthen the capacity of journalists to report ethically and sensitively on safe abortion and SRHR. With unsafe abortions happening around us, media narratives matter,” she said.

“They influence public understanding, policy debates and ultimately national productivity. The media has the power to educate, inform and support rights-based approaches to these issues.”

Zimbabwe’s current abortion law, passed in 1977 during the Rhodesian era, allows termination only when a woman’s life or physical health is in danger, when the foetus faces severe disability or when the pregnancy results from “unlawful intercourse”. Mental-health grounds are not recognised.

Applicants in the case argued that this omission violates constitutional rights to dignity and health, noting that mentally ill women cannot consent to sex and therefore must have access to legal termination.

—@NyembeziMu

… Ruling significantly expands access to legal abortion for mentally ill women and victims of institutional sexual abuse

By Staff Reporter, 17 November 2025

Human rights lawyer Tendai Biti argued for women with mental health challenges to be granted the right for legal abortion

By Staff Reporter, 17 November 2025

HARARE — The High Court has delivered a landmark ruling declaring parts of Zimbabwe’s abortion law unconstitutional, finding that provisions of the Termination of Pregnancy Act violate several fundamental rights, particularly the rights of mentally ill women and victims of sexual abuse in mental health institutions.

Justice Slyvia Chirawu-Mugomba, handing down judgment, ruled that section 4(a) of the law governing the circumstances under which a pregnancy may be lawfully terminated “to the extent that it excludes mental health” fails to meet constitutional standards and unjustifiably limits key rights such as dignity, equality, and the right to health.

The applicants, the Community Working Group on Health and Member of Parliament Nyasha Batisa, challenged the constitutionality of the law, arguing that it discriminates against mentally ill women by permitting pregnancy termination only under narrow physical-health exceptions.
They sought declarations that both s 4(a) and the definition of “unlawful intercourse” in s 2(1) of the Act are unconstitutional.

In a detailed 25-page ruling, Justice Chirawu-Mugomba found that the law’s failure to recognise mental health as a basis for accessing safe and lawful abortion imposes a discriminatory and unconstitutional burden on women with mental health challenges.

The judge noted that the applicants had “well-articulated the impact of the exclusion of mental health as a ground to access safe abortion,” concluding: “Therefore, s 4(a) in my view, to the extent that it excludes mental health, does not meet the standards enunciated in the constitution…
“It is clear that women with mental health challenges are treated differently when it comes to the permissible health-related grounds for termination.”

Justice Chirawu-Mugomba rejected the argument by the minister of health that mental health risks were already implicitly covered under “life-threatening” physical conditions, holding that such an interpretation would be “not explicit” and left vulnerable women without clear legal protection.
She emphasised that mental health is integral to overall health, citing evidence of “genuine challenges women experience with mental health, including those that may arise after childbirth.”

The judge also held that the definition of “unlawful intercourse” in s 2(1) is unconstitutional because it fails to include sexual abuse defined under s 106 of the Mental Health Act, which criminalises sexual intercourse with mental health patients.

The judge said in the November 11 ruling: “Excluding mental health in the definition of unlawful intercourse, as proscribed in s 106… denies women in such circumstances access to safe abortion services.”

She found that the omission violates multiple constitutional rights, including the right to life (s 48), dignity (s 51), equality (s 56), and reproductive health (s 76), noting that mentally ill women “face legal and procedural barriers to accessing necessary reproductive healthcare.”

The judgment sharply criticised the inconsistency between the Termination of Pregnancy Act and the Mental Health Act, observing: “The inconsistency between these legislative frameworks undermines the principle of equality before the law.”

While acknowledging parliament’s primary role in law-making, the judge said that courts are constitutionally required to intervene where rights are unjustifiably limited.

She noted: “Judicial intervention is necessary to uphold constitutional rights, fill legal gaps, or develop the law in line with evolving social values.”

The court considered whether to “read in” new provisions – a remedy used where a statute is unconstitutional due to an omission – but concluded that the applicants had not framed their requested relief with sufficient precision.

The judge ultimately declared portions of s 4(a) and s 2(1) unconstitutional but suspended the declarations, as required by section 175 of the constitution, pending confirmation by the Constitutional Court.

The judge ordered: “The above declarations of constitutional invalidity are suspended until such time as the Constitutional Court has confirmed the same… The above order… is referred to the Constitutional Court for confirmation.”

No order as to costs was made.

Rights lawyer Tendai Biti brought the application on behalf of Batitsa and the Community Working Group on Health. – ZimLive

By Gamuchirai Nyamuziwa | Oct. 31, 2025

The deficit is crippling the country’s ability to provide even the most fundamental services, the CWGH said.

ZIMBABWE’S public health system is facing a catastrophic shortage of nearly 58 000 skilled workers, a deficit so severe it requires the government to hire an average of 9 758 new staff annually until 2030 just to achieve basic health coverage, a new health sector position paper claimed this week.

The report by the Community Working Group on Health (CWGH), which lays out critical priorities for the 2026 National Health Budget, warned the current health worker establishment is out of line with the nation’s growing population and escalating disease burden.

The deficit is crippling the country’s ability to provide even the most fundamental services, the CWGH said.

It claimed as of 2023, Zimbabwe’s health workforce stock stood at just 47,5% of the national need, representing a “need based shortage of 57 543 health workers”.

This chasm between the required and actual staff levels has extensive implications on health outcomes, pushing the system to the brink of collapse, analysts also warned.

The report underscored the urgency for a resilient and motivated health workforce, a goal that remains elusive under current conditions.

“Therefore, it is essential to ensure availability of a resilient, motivated, and fit-for purpose health workforce,” the paper asserted, directly linking the staffing crisis to Zimbabwe’s inability to deliver on its universal health commitments.

To bridge this gap, the CWGH is making an unprecedented call for massive and immediate budgetary action.

“The government needs to demonstrate its commitment to expand MoHCC (Ministry of Health and Child Care) staff establishment by an average of 9 758 workers per year up to 2030 to meet the projected Health workforce need-based shortage,” the report stated.

This level of recruitment is deemed necessary to achieve 80% Universal Health Coverage and 99,1% disease burden coverage, targets that are foundational for the nation’s aspiration to become an Upper Middle-Income society by 2030.

The paper said termination of contracts for USAid-supported health workers had exacerbated the crisis, leaving critical gaps in health facilities and negatively impacting the quality of services.

The CWGH argued that the 2026 budget must not only fund new positions, but also absorb key roles previously supported by donor funds onto the government payroll to ensure sustainability and protect primary healthcare services for the most vulnerable. – Zimbabwe Independent.

Loyce Maturu in maroon floral skirt poses for a photo with health advocates

By Michael Gwarisa

When Otilia Tasikasni learned she was HIV positive in 1991, she believed her life was over. The diagnosis then was not just a medical statement; it was a countdown. Doctors told her she had only two or three years to live, and every day felt like borrowed time.

“At one point, all I would think of was dying,” recalls the 59-year-old, her voice steady but her eyes betraying memories of that period. “Even though I was not sick then or showing any signs of illness, I was just waiting for my day to come… but the day never came.”

At the time, there was no antiretroviral therapy (ART) in Zimbabwe. For years, Otilia remained healthy, but in 2004 her condition worsened, and she was also diagnosed with tuberculosis (TB). She completed TB treatment before finally starting ARVs, a lifeline made possible through the Global Fund’s support to Zimbabwe’s HIV programme.

Today, Otilia has watched her children grow, seen her grandchildren born, and lived decades beyond the expiry date once stamped on her life.

In Bindura, Mashonaland Central, 33-year-old Loyce Maturu’s experience with HIV is different. Diagnosed at the age of 12 with both HIV and TB, she began treatment immediately, a privilege her elder never had. Her journey, however, began in loss. In 2000, she lost both her mother and younger brother to AIDS-related illnesses within the same week. Soon after, she fell seriously ill and was taken in by an aunt who ensured she received care.

Initially, her diagnosis was kept from her, but with the help of Global Fund-supported health workers, her aunt eventually disclosed the truth.

When I found out, I thought I would die just like my mom and brother,” she says. “I lost all confidence. I never thought I would finish school, have a family, or get a job. But thanks to the Global Fund, I accessed TB and HIV treatment, and today my life is full.”

Loyce is now married, a mother to two HIV-negative children, a university graduate, and holds a stable job. She says living with HIV is not without its challenges. “It is not easy taking medication every day, but I am committed to it because I know what is at stake for me and my children,” she says. “I am proud to say I am one of the 65 million lives saved by the Global Fund.”

From Otilia’s struggle in an era when HIV meant certain death to Loyce’s life shaped by early intervention and consistent treatment, their experiences underline a shared truth: access to ARVs transforms HIV from a death sentence into a manageable condition.

This progress is something the Ministry of Health and Child Care (MoHCC) says it is determined to safeguard. Early this year, many countries suffered setbacks in their HIV programmes following the cessation of United States government funding for the majority of HIV initiatives. Zimbabwe, however, has managed to maintain adequate drug stocks through the AIDS Levy and other contributions.

“We made orders using two companies to provide more ARVs. Those stocks are now in place to cover us up to the end of the year,” said Minister of Health and Child Care, Dr. Douglass Mombeshora. He added that while some batches had already landed in Zimbabwe, others were still being delivered, and steps were underway to procure additional stocks in advance to take the country through to the first half of 2026.

These stories and commitments are part of a nationwide transformation made possible by sustained investment in HIV prevention, treatment, and care. Behind every life saved is a network of health workers, community advocates, and international partners working together to sustain Zimbabwe’s HIV response.

It is this collective effort that the Global Fund Advocates Network (GFAN) seeks to protect. Across Africa, GFAN is uniting community voices and civil society organisations to ensure the Global Fund remains fully funded. The goal is to save 23 million more lives and prevent 400 million new HIV infections by 2029.

Mr. Itai Rusike, the GFAN focal person in Zimbabwe poses for a phot with Otilia Tasikani and Edinah Masiiwa a renowned health advocate and feminist