Zimbabwe: Covid-19 Raises Questions Over Underfunding of Health Sector

The perennial underfunding of the health sector by the government has severely weakened the fight against Covid-19.

The pandemic has claimed more than 1 000 lives, including Foreign Affairs minister Sibusiso B Moyo, Transport minister Joel Biggie Matiza, Agriculture minister Perrance Shiri and Manicaland Provincial Affairs minister Ellen Gwaradzimba.

The impact of the coronavirus -- the virus that causes Covid-19 -- which is thought to have emanated from Wuhan in China, has been devastating with countries such as the United States, Italy, Spain, United Kingdom and France being the hardest hit in terms of fatalities. This is coming at a time the country's health sector has deteriorated over the years due to gross underfunding and rampant corruption.

Nothing encapsulates this more than the number of demonstrations by health workers in public hospitals over lack of personal protective equipment (PPE) and other consumables to treat the increasing number of patients infected by the respiratory disease.

Nurses at public hospitals in Harare and Bulawayo earlier this month downed tools after being forced to work without PPE. This came after a matron at Sally Mugabe Central Hospital in Harare succumbed to the disease.

Last year the Health ministry admitted, in a High Court case in which the government was sued by health workers for failing to provide essential materials to treat patients affected by the coronavirus, that they are yet to receive the US$200 million from the Treasury to purchase materials crucial for health workers.

Health practitioners have also demonstrated over poor working conditions, a development that has become commonplace in public hospitals. This adds to the woes of poorly resourced public hospitals that have become death traps without basics, including painkillers. This has resulted in the political elite going outside the country for treatment abandoning local health facilities.

The parlous state of the health sector has been further stretched by the pandemic with hospitals overwhelmed by the number of Covid-19 infections. The private hospitals put in place for Covid-19 infections are charging between US$500 and US$3 000 for admission, which is unaffordable to most ordinary Zimbabweans.

The underfunding of the health sector has left the country woefully unprepared to fight the pandemic, according to business consultant Simon Kayereka.

"Our health sector has been underfunded for decades leading to decay in infrastructure and frustrated staff. It is one thing to build hospitals, but quite another to maintain and equip them. Most of the money allocated to the sector has gone to recurrent expenditure leaving very little for anything else," Kayereka noted.

"It is known that Third World countries carry 27% of the disease burden and yet they are underfunded. For us to be talking about PPEs for health staff after nearly a year since the outbreak signals the mess we are in. Places like India, South Africa, China and Malaysia have become popular destinations for our elites. We are not prepared to deal with Covid-19. They say your health is your wealth, but in Zimbabwe the reverse seems to apply."

Government has consistently failed to fund the health sector according to the Abuja Declaration. In April 2001, African Union countries pledged to allocate at least 15% of their annual budget to improve the health sector and urged donor countries to scale up support. Even with the country ravaged by Covid -19, the government only allocated 13% of the total budget to the health sector.

Economist Prosper Chitambara said the struggle by the underfunded health sector to control the Covid-19 pandemic indicates the unfolding disaster.

"The underfunding of the health sector has hindered our response to the Covid-19 pandemic. Those countries which could have assisted us have also been affected by the pandemic," he said.

"This is a wake-up call for us to take our health funding seriously. We have not attained the benchmark of the Abuja Declaration. With Covid-19, we should work towards achieving that target."

The fight against Covid-19 has been blighted by corruption. Then Health minister Obadiah Moyo awarded a US$60 million Covid-19 supply contract to a shelf company, Drax, without going to public tender. This led to the arrest of Moyo as well as three executives of the state-owned National Pharmaceutical Company.

President Emmerson Mnangagwa, whose family was implicated in the scandal, then fired the minister who was replaced by Vice-President Constantino Chiwenga.

Zimbabwe National Chamber of Commerce chief executive Christopher Mugaga said the poor state of the health sector is a culmination of the country's economic decline.

"It is not only the health sector which is underfunded, but the economy as a whole," Mugaga pointed out. "The budget is not catering for the economy, but just a fraction of the whole economy. The health sector has been underfunded since Independence and the gap has widened ever since."

Mugaga warned that the foreign currency auction system is under threat as the need to import drugs will supersede the need to import inputs for export as the Covid-19 pandemic continues to wreak havoc.

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