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Donor Aid Backbone of Zimbabwe's Health Sector as State Coffers Almost Run Dry

Donor funds are disbursed through various programs.

Zimbabwe’s public health sector is in crisis as the government fails to adequately fund it, leaving external donors and foreign countries to chip-in with $147 million support against the state’s meager $53 million allocation for this year.

Despite the external support, the funds are still fall far short of the $303 million the health ministry had requested in the 2015 national budget to effectively run its operations.

A perusal of the government’s 2015 budget shows that the health ministry, through the donor funds and the government meagre contribution, received $300 million for use this year with $177 million going towards employment costs, $53 million for operations and $28 million for capital expenditure.

Of the $53 million set aside for operations, only $8 million was allocated for all the public hospitals in the country, against total requirements of $142 million.

A senior official in the Health Ministry, Martin Matongera, recently told a Health Forum meeting for journalists, organized by the Zimbabwe Lawyers for Human Rights, that the budget allocation for 2015 was grossly inadequate, making it difficult for nurses and doctors to run the country’s public hospitals.

Matongera said there’s need for the government to step-up domestic support for health services in the country, adding though the treasury had authorized hospitals to retain money charged for services provided, funds remain largely inadequate to meet the nation’s health requirements.

He said hospitals are expected to collect $35 million from service fees though this appears to be highly unlikely given the economic meltdown being currently experienced in the country.

As at the end of July, hospitals in the country had collected slightly more than $210,000 only, a mere drop in the ocean compared to the expected income.

Community Working Group on Health director, Itai Rusike, says it’s unfortunate that the bulk of Zimbabwe’s health funding is now coming from donors.

But most worrying, Rusike says, is that not all the allocated funds in the budget are disbursed.

He adds that donors should come in to complement government efforts in the provisions of health services.

Zimbabwe Doctors for Human’s chairperson, Doctor Rutendo Bonde, agrees, noting that the government is the primary custodian of public health and it is its constitutional mandate to look after its citizens.

She adds that the public health delivery system will remain in a crisis as long as there is insufficient domestic financing of the health care system.

Donor funds are disbursed through various programs. For example one of the major donors, Global Fund, will fund malaria programs in the country to the tune of $10.6 million and HIV/AIDS initiatives will receive $6.9 million. The American government spends millions of dollars on HIV/AIDS programs under the President's Emergency Plan for AIDS Relief in Zimbabwe every year.

Harare resident, Tobias Dewa, says it is time the government prioritized health sector funding as people are dying needlessly from preventable diseases like diarrhea.

Health journalist, John Cassim, says the situation in the health sector is bad, adding it’s the poor who are most affected as they cannot afford to pay for health care at private hospitals or travel abroad for medical check-ups and treatment as is done by President Robert Mugabe, his ministers and top government officials regularly.

With no public health insurance scheme, most Zimbabweans rely on government-owned public health hospitals while only 1.2 million of Zimbabwe’s 14 million people are covered by private health insurance schemes.

Medical aid companies last year paid out claims of over $400 million against a national budget of $340 million.

Normally, the health budget used to come second after education in terms of budgetary allocations but this year it was pushed to fifth position. Dr. Bonde said this was largely because social service ministries lack the political clout to demand their fair share of the national budget.

Zimbabwe’s 2015 budget misses the Abuja Declaration target by 4.4 percent in terms of prioritizing the health and other social service ministries.