EDLIZ 2025: What Zimbabwe's Pharmacies and Clinics Need to Know About the 9th Edition

The Ministry of Health and Child Care recently released the 9th Edition of the Essential Medicines List and Standard Treatment Guidelines for Zimbabwe (EDLIZ 2025), replacing the 2020 edition. Having worked through the changes in detail, here's a practical breakdown of what's shifted and why it matters for day-to-day practice whether you're running a pharmacy, a clinic, or a hospital pharmacy department.

See WHO Zimbabwe's official announcement of the EDLIZ 2025 launch here.

(Views here are my own, based on general pharmacist knowledge not an official position of any employer.)

The Big Structural Shifts

A few chapters have been reorganised in ways that reflect where national health priorities are heading:

• Viral Hepatitis now has its own standalone chapter, no longer buried under general GI conditions a sign of how seriously elimination targets are being taken.
• COVID-19 is no longer a standalone chapter. It's folded into Tropical Diseases, with outbreak management now handled through dynamic MOHCC circulars and the outbreak watch-list has expanded to include Mpox and Marburg virus.
• Paediatric HIV has been elevated to its own full chapter, positioned right after adult ART ,a practical improvement for anyone who found the old subsection format hard to navigate quickly.
• Diabetes, Endocrinology and Metabolism got a broader name and scope, making room for newer drug classes.
• Specialist-level medicines are no longer tucked away at the back of the book they're flagged inline throughout the main tables, which honestly should make day-to-day referencing faster.

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The Changes That Actually Affect Prescribing Today

Asthma: no more Salbutamol alone.
This is a real practice shift. Salbutamol monotherapy is out ,every asthmatic patient now needs a controller with an inhaled corticosteroid, whether that's ICS alone or an ICS/LABA combination. The rationale is straightforward: SABAs handle the acute bronchospasm but do nothing for the underlying inflammation, and that gap is linked to worse outcomes over time.

Gonorrhoea treatment just got a much bigger dose.
First-line Ceftriaxone moves from 250mg to a full 1 gram IM ,a fourfold increase, driven by rising resistance patterns in Neisseria gonorrhoeae regionally and globally. Persistent urethritis after second-line treatment now warrants a formal look at Mycoplasma genitalium.

Heart failure management has "four pillars" now, not three.
Sacubitril/Valsartan and Dapagliflozin join the classic Loop Diuretic + ACEi/ARB + Beta-Blocker + MRA combination, at Specialist level. Worth knowing even for community pharmacists, since patients will be coming in with these prescriptions from specialists more often.

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HIV and PMTCT protocols have shifted meaningfully.
The Dolutegravir weight threshold for standard adult regimens drops to 20kg, and a 10mg dispersible tablet is now approved for infants under 3kg from 6 weeks old. For mother-to-child transmission prevention, the old risk-stratified model is replaced by universal triple prophylaxis (AZT + 3TC + NVP for six weeks, stepping down to NVP alone), with birth testing now mandated within 48 hours. Tenofovir alafenamide is preferred over TDF for patients over 50 or with renal/bone concerns. On prevention, event-driven 2-1-1 PrEP and long-acting injectables (cabotegravir, lenacapavir) are now part of the toolkit.

TB and malaria protocols are simplifying and standardising.
Drug-resistant TB moves to the standardised six-month BPaLM regimen. Malaria elimination zones now require a single low-dose primaquine alongside standard ACT to clear transmission, and rectal artesunate is formally available at community level for severe cases where referral will take more than six hours.

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The Bigger Picture: A "Post-Antimicrobial" Era

EDLIZ 2025 deliberately widens its framing from "post-antibiotic" to "post-antimicrobial" covering resistance across antibacterial, antiviral, antiparasitic, and antifungal drugs. Reserve-group antibiotics (Imipenem, Meropenem, Vancomycin, Colistin) now strictly require susceptibility testing before use. It's a clear signal that stewardship isn't optional anymore it's built into the prescribing rules themselves.

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Sources: MOHCC / NMTPAC, EDLIZ 9th Edition (2025). This summary reflects the author's own reading and analysis of publicly announced changes and is intended for general awareness. Always consult the full EDLIZ 2025 guideline document for complete prescribing information.