By politicizing the health sector, Hon. Masebo has sentenced to death everyone who solely depends on public health institutions.
By Mpandashalo Mwewa | Chief Editor.
Lusaka, Oct. 2 – In this article, I look at why the health sector requires clearly thought through bipartisan policies that must cut across other sectors because health is apolitical. We must ensure that we unite and confront disease using stronger health systems.
Also Read: Politics frustrated ZAMMSA procurement of essential medicines.
When African Union member states met in Abuja in April 2001, they committed to allocating 15% of their government budgets to health because more resources were required to address the pressing health challenges of the day, including HIV and AIDS, Malaria and Tuberculosis.
This commitment is referred to as the ‘Abuja Declaration’ and it has become a rallying call to mobilize more resources from government coffers for the health sector.
Although only a handful of countries have met this target in any given year, many African countries have increased health spending overall. Over time, the big question here has shifted from who has reached the 15% target because as a wise person once said, a “10% of a cow is not the same as a 10% of a duck”. Our economic strengths vary.
But any government’s effort towards realising this 15% allocation must result in real progress in health indicators, and ultimately in people being healthier and more prosperous!
And this is where the new dawn government is losing it, having failed to even understand the need for essential medicines in public health institutions.
Following Zambia’s strong health reforms over the last two decades, with the help of cooperating partners, life expectancy at birth has tremendously improved by 18 years from 44.5 years in 2000 to 62.5 years by 2019.
In terms of expenditure on health, under the Patriotic Front regime, Zambia achieved expenditure on health of 5% of GDP, compared to an average of 4.2% in other low to middle income countries. In 2020, expenditure as a share of GDP went up to 5.6%.
Although politics downplayed this trajectory, the health sector was on its way up under the Dr. Chitalu Chilufya led Ministry of Health.
Also Read: Hichilema must be commended for heeding Dr. Chitalu Chilufya’s counsel in the health sector!
Zambia’s expenditure in the sector as a percentage of the GDP under the new dawn government, however, has deteriorated compared to the previous regime for its failure to build on the successes of the previous regime especially the progressive Health In All Policy Initiative.
In 2022, the new dawn government increased funding to the health sector in Kwacha terms by allocating K13.9bn but as a percentage of GDP, this was a decrease to 3.0% of the GDP and the 2024 health budget still falls below the average allocation of 4.2% by low to middle income countries at 3.2% of the GDP.
The new dawn government has failed to understand that low government spending in the health sector hurts ordinary people the most and results in high out-of-pocket spending and an inequitable health system that only guarantees access to those who are able to pay.
To address this issue, the National Health Insurance Management Authority (NHIMA) was created by the previous regime but because of the failure to understand the purpose of NHIMA as a primary health care financing system to support Universal Health Coverage (UHC), the new dawn government even removed it from the Ministry of Health.
The previous regime, by introducing NHIMA, had clearly understood that reaching spending targets was less important than ensuring health systems were adequately resourced and resources were used optimally.
The new dawn government ought to understand that increased prioritization of the health sector and increased health spending are the most feasible approaches to increasing resources for health and NHIMA must be at the core of this resource mobilisation and management.
This kind of thinking is deep because it requires policies beyond monetary figures when money is not available by ensuring that people remain healthy and resourceful.
It’s for this reason that the former Minister of Health, Hon. Dr. Chitalu Chilufya, shifted the interface with which people had with the Ministry of Health from the hospital bed right to their homes, prioritizing preventive measures to manage hospital resources prudently for those who had to be admitted.
The Ministry of Health developed advocacy partnerships with other social sectors to prioritize food security, water, sanitation, and education, that impacted the population’s well-being and improved human development indicators.
This required, amongst other things, an in-depth understanding of the need for a multisectoral approach to managing the health sector and the alignment of key stakeholders around some key common objectives.
In the absence of the much needed funds, there’s need for the new dawn government to move from focusing on spending targets to redirecting its policy formulation to looking at what level of resourcing achieves improvements in population health and UHC. Attaining UHC must resonate in all policy formulation.
Ultimately, the Ministry of Health must manage NHIMA, take up a key resource mobilisation role, with strong and clear arguments to invest in health as a productive sector that builds human capital, reduces poverty and inequity, safeguards health security from pandemics, improves workforce productivity and provides employment.
This may require a few new heads at the Ministry of Health, including the Ministerial position itself.
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