NOW that President Emmerson Mnangagwa’s new, leaner Cabinet has been sworn-in, Zimbabweans eagerly expect the team and the 350 policymakers to hit the ground running, with the 2018 National Budget statement, which is due tomorrow, being their first port of call.
Distribution of the national cake has always been a contentious issue for many years, as social services such as developmental and infrastructural needs of the economy have always been neglected in pursuit of consumptive expenditure.
One key area, which has largely remained underfunded, is the health sector.
Although the Constitution recognises equal access to health as a basic human right, that right is just on paper, as successive Zanu PF governments, since Independence, have not prioritised the sector in the allocation of the country’s scarce resources.
It’s a public secret that security ministries and the Office of the President always got the lion’s share of the spoils, as former President Robert Mugabe prioritised his own security and foreign travels, apparently often for his personal medical check-ups in far-away countries.
Mnangagwa should bear in mind that he has inherited a country with a torn social fabric and should, therefore, prioritise social service delivery rather than adopt Mugabe’s style of leadership.
Health minister David Parirenyatwa has already sounded the clarion call, saying his ministry requires at least $1,1 billion to fully finance health services.
This might sound outrageous and overambitious, but we believe Parirenyatwa’s demands are justified given the poor state of the health sector.
As a country, we cannot continue to run along a path, where health is a preserve for the rich and greedy politicians, while the poor majority are left to die of such simple diseases such as typhoid, malaria and cholera.
Mnangagwa should spare a thought for the millions of Zimbabweans, who do not have the privilege of flying abroad for treatment.
The new government should not only look at funding provision of drugs per se, but related infrastructure such as medical equipment, water and sewer equipment, roads and also general stress-related ailments triggered by economic challenges.
Given the current fiscal constraints, the government should prioritise and focus on cost-effective health programmes and interventions, increase access to health care services, reduce inequalities between different socio-economic groups and geographic areas and increase immunisation coverage and child nutritional status.
Basic health infrastructure in urban, informal, resettlement and rural areas need improvement to cut down on the unbearable long distances travelled by the poor majority to access primary health care facilities.
Government also needs to increase the capital budget for the construction of public hospitals, clinics and waiting mothers’ homes and review the health sector’s staff complement so that it’s in tandem with the population size.
It makes no sense to continue using the staff establishment of 1983, when the country’s population was only 7,5 million and has since doubled and the disease burden has also increased.
Therefore, there is urgent need to review the medical staff population in order to reduce work overload and burnout and increase domestic funding for operational costs and avoid a situation where employment costs far outweigh operations costs and capital programmes.
Donor dependency for drug procurement and other health-related services should be an exception rather than a priority.