Dear Professor Mthuli Ncube
In response to a question about funding for the health sector (at a breakfast meeting after you presented the 2025 national budget), you said that the health sector is healthily funded.
This is a reckless statement given the fact that the last time the country nearly met the Abuja Declaration target of 15% was in 2022 with an allocation of 14,9%.
However, after 2022, there has been a consistent decline to 10, 5% in 2023, a slight increase to 10,8% in 2024 and another decline in 2025 to a mere 10,2%.
Of course, disbursement is another story altogether, but the allocation is disappointing and an insult to the many Zimbabweans who rely on public health.
How is continued reduction in government spending on the health sector healthy?
Perhaps you were talking about funding from development partners, such as the Global Fund?
If so, is that funding not meant to augment government funding? It would appear that the government tends to forget that it has the primary obligation to provide health services to the nation.
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This is quite regrettable. As is the fact that you are re-introducing duty on some medical products at a time when one would have expected you to place more medical drugs and equipment in the duty-free category.
By the way, how exactly has the money from the airtime and sugar tax levies for the health sector been utilised?
I am displeased that the introduction of the taxes has not translated to improvements in the quality of services, or access to the same by particularly the vulnerable in our country.
Transparency and accountability are key components of any public finance management system.
How is the ministry introducing taxes, have the revenue collection arm collect said taxes and there is no information readily available to citizens on amounts and usage, at the very least?
In November this year, at the National Health Financing Policy Dialogue, your deputy is reported to have said “Treasury has so far raked in more than US$100 million from airtime and sugar tax levies that will go towards bolstering the country’s health sector.”
What does bolstering the health sector entail?
Strengthening the primary health care system so as to address congestion at referral hospitals, such as Mpilo and Parirenyatwa?
Perhaps the funds will contribute to increasing the US$15 monthly stipends of Village Health Workers (VHWs)?
Or perhaps the government will decide to absorb them into the government payroll system, as recommended by some stakeholders in the health sector such as the Community Working Group on Health?
According to the Community Working Group on Health, the country currently has 14 000 VWHs against a requirement of 30 000.
VHWs are a bridge between health facilities and communities with limited access to those facilities.
According to Unicef, after Cyclone Idai, VHWs played a crucial in teaching people about Covid-19 and also monitoring their compliance to the guidelines recommended by the Ministry of Health and Child Care.
Given the crucial role that the VHWs play in health promotion and disease prevention, this shortage is a cause for concern.
As a women’s rights activist, I am particularly worried about the implications of VHWs shortage on women’s right to health in general and sexual and reproductive health and rights (SRHR) in particular.
VHWs provide oral contraceptives to women, some of whom live 20-30km away from the nearest health facility.
Therefore, the shortage of VHWs is likely to result in unwanted pregnancies.
Speaking of which, are maternity waiting homes in district hospitals fully functional? If not, what is the government planning to do about this?
On the gender budget, ZiG196.9 billion is allocated to support gender-sensitive programmes and gender-specific expenditures in 2025.
What exactly are these programmes and expenditures?
Do these include any from health, for example, free cervical cancer screening at all health facilities? Is this figure adequate for the programs?
Honourable minister, I am afraid our health sector is far from being healthy.
I do not think that any government that takes the health of its nation seriously allocates 10, 2% of its national budget to the health sector, even if there is funding from other sources.
What kind of sovereign country are we if we depend on others to fund our health delivery system?
I am not convinced that you fully understand the state of our health delivery system, if the 2025 National Budget is anything to go by.
This sector might be in the high dependency unit and on its way to the intensive care unit if nothing is done as matter of urgency. T
he fact that you set aside ZiG593 million to support in the provision of health care services to the disadvantaged is baffling because the government devalued the ZiG in September this year.
What will this figure be worth in June or July 2025?
The budget is an important policy document from government. It tells us what government’s priorities are and what it intends to do.
More importantly, it tells us the direction the economy and by extension, the country is taking.
I am afraid the 2025 national budget does not provide direction for the health sector, or if it does, it certainly is not one that can be explained succinctly.
Let me end by pointing out that as a citizen, I was disappointed by the budget in general and the allocation to the health sector in particular.
I hope to see government actually doing something to improve our health sector.
Honourable minister, I wish you a Merry Christmas and a Happy 2025. I know a number of us will have neither because of the very limited disposable incomes.
Yours Sincerely,
Buhlebenkosi Tshabangu-Moyo,
Patriotic Zimbabwean
PS Your “healthily funded” statement somehow reminded me of you saying (about the price of bread in 2019) “It is whatever it is, so?”
