Thousands of Zimbabweans returning from South Africa amid rising anti-migrant tensions are facing difficulties accessing life-saving HIV medication, raising concerns about treatment interruptions and pressure on Zimbabwe’s healthcare system. Many migrants who had been receiving free antiretroviral (ARV) treatment in South Africa were forced to leave their communities after experiencing discrimination, threats and barriers to accessing healthcare services. Several returnees reported becoming seriously ill after missing medication for extended periods while trying to leave South Africa or find healthcare support after arrival. One returning migrant, Renious Gumbi, had lived in South Africa for two decades and relied on regular HIV treatment from local health services. Zimbabwe’s healthcare system is already under pressure, with a large population dependent on HIV treatment programmes.