Donor fatigue threatens health sector
THE deepening economic crisis has paralysed the country’s public health sector that had become heavily dependent on donor funding.
Donor assistance, which had, over the years, become the backbone of the country’s health sector, has been drying up as a result of a global recession.
Over the years, Zimbabwe has failed to adequately fund its health sector, leaving external donors to fill the gap.
Instead of setting aside at least 15 percent of its national budget towards healthcare in line with the Abuja Declaration, Zimbabwe has consistently failed to do so for the past 14 years.
Instead, the country has abdicated this responsibility to donors.
Government’s 2015 National Budget amounting to US$4,1 billion allocated US$300 million towards the health sector.
Out of the US$300 million, US$177 million was for employment costs, US$53 million for operations and a paltry US$28 million for capital expenditure.
In the absence of donor funding, the public health system faces collapse since the majority of the country’s key health programmes were dependent on it.
Since 2003, Zimbabwe has been receiving assistance from the Global Fund to fight HIV and Aids, tuberculosis and malaria.
Unfortunately, the programme is expected to end next year.
A donor-driven US$435 million Health Transition Fund, which has transformed the face of the health sector since 2009, is also expected to come to an end in December.
What’s next after donor funding is the biggest question in everyone’s mind?
Countries that have been known to depend on donor funding have almost fallen into absolute poverty after their good Samaritans pulled the plug.
Zimbabwe might find itself in a similar situation.
Ideally, government should fund the majority of its health-related activities with partners bridging the gap.
With the majority of Zimbabweans now failing to afford basic health care services, at a time Treasury is financially crippled to subsidise services, it is high time government comes up with concrete plans to rescue the health delivery system.
Development specialist, Maxwell Saungweme, said Zimbabwe is now a charity case.
“We are indeed a charity case as most of our people cannot afford basics such as health care, education, food and so on. It is a very sad situation arising from bad governance which has seen the collapse of the medical sector and, in particular, reducing us to dependency on drug donations yet we used to produce most of the drugs we needed ourselves.
“The desperate situation with medical funding and drugs is reflective of all other sectors and facets of Zimbabwean life mainly due to bad governance and poor policies over the years,” he said.
Already most district and provincial hospitals are operating below 60 percent because of a shortage of drugs.
Low budget disbursements have also impacted negatively on the operations of major referral hospitals in the country.
Rising debts, outdated equipment, poor funding and maladministration have crippled the operations of hospitals.
For over a decade now, government has failed to provide an efficient and effective basic health care system.
A myriad of factors caused by poor governance and a collapsing economy have manifested themselves in the flight of qualified health practitioners, poor remuneration, insufficient funds for the Ministry to run health programmes, lack of drugs in health institutions and unaffordable health care.
Community Working Group on Health director, Itai Rusike, said it was unfortunate that the bulk of the funding was coming from donors.
“While government policies on essential drugs and on equity in health have significantly widened treatment access in Zimbabwe, there is evidence that drug access has fallen in recent years, and that drug availability is falling, most sharply at the clinic services that form the frontline of the health care system with the community.
“This represents an unfair cost burden on poor communities, but also opens the way for growth of private unregulated drug markets. Drug supplies at rural health centre level are also problematic and are a constant source of client discontent. The approximate 1 000 clinics in Zimbabwe are the last step in a long chain of drug procurement and distribution. Drug supplies that exist at national level are reported to take up to six months to be delivered to district and clinic level,” Rusike said.
Communities have had to spend scarce resources on security services to guard clinics from recurrent theft of drugs and other supplies, given that some of the facilities have no fencing, burglar bars or other forms of security.
“The cost of medications has increased significantly and medical costs have been the highest rising element of the Consumer Price Index for some time,” he added.