Finance and Investment Promotion minister Mthuli Ncube must stick to a regional pact compelling governments to allocate 15% of their budgets to health if Zimbabwe is serious about rebuilding crumbling hospitals and averting a staff exodus, a lobby said in a paper presented to government.

Zimbabwe fell four percentage points short of this target in the 2023 National Budget after allocating 11% of the overall spending plan to health.

Ncube is expected to present the 2024 budget later this month.

But he will walk a tight rope, given the scale of desperation in health facilities, amid a cocktail of macroeconomic shocks highlighted by foreign currency shortages and a gruelling power crisis.

In a position paper spelling out its views on the budget, the Community Working Group on Health (CWGH) reminded Ncube of the human cost of laxity and damages already inflicted by waves of cholera outbreaks to the bleeding system.

“The country has made some progress in terms of ensuring healthy lives and promoting the well-being for all at all ages, but challenges like inadequate and depleted healthcare workforce, high disease burden, resurgent cholera outbreak, inadequate and poor maintenance of healthcare infrastructure and ill-equipped hospitals remain,” CWGH added.

“This should entail allocating at least 15% of the National Budget to the health sector in line with the Abuja Declaration target.”

At Abuja in 2001, African Union member states signed what is now known as the Abuja Declaration, pledging to devote at least 15% of their budgets to the health sector.

However, fulfilling this pledge has been a struggle for Zimbabwe, where bigger allocations have sometimes been devoted to defence and recurrent expenditures for globe-trotting leaders.

But apart from cholera, the country’s health system was paralysed by Covid-19 between 2020 and 2022, with tailwinds of the pandemic still being felt.

How Ncube will manoeuvre on the health front will be keenly followed by millions of Zimbabweans, 49% of whom are living under extreme poverty and excluded from crucial provisions like medical insurance.

In an interview with the Independent, health expert Hamadziripi Dube said among critical issues, to be tackled in Ncube’s spending plan, should be combating non-communicable diseases.

“The focus should be to fund the prevention, diagnosis and treatment of the biggest killers, which are non-communicable diseases (NCDs),” Dube said.

“The budget of the Ministry of Health and Child Care for the year 2024 must be increased in a way to achieve the 2025 set targets by the World Health Organisation (WHO), which all nations must comply with.

“Ncube must prioritise the Ministry of Health to improve the budget of NCDs by more than 1,9% of 2020. We must show the international community that we comply and that we can achieve the set goals by WHO.

“Wages and salaries must be improved as well as the capital budget, which will improve the operations of hospitals which are deteriorating. The capital budget maintains or improves the face of the hospitals,” Dube added.

Medical/Dental Private Practitioners Association of Zimbabwe president Johannes Marisa also raised concerns on the state of the country’s health sector.

“It's a pity that the budget for NCDs has been reduced at a time when we are supposed to increase that budget. NCDs are contributing to three-quarters of global deaths every year,” Marisa said.

“We should be focusing more on NCDs because they are contributing 75% or three-quarters of all global deaths alone. So, it is a serious issue and if this is not corrected, our mortality and morbidity rates will not go down because we are lacking focus on what is taking lives from this world.

“So we expect that budget to increase and we need action.  We need more action in the field of research, in the field of health education, in the field of epidemiology, in the field of health promotion. We need more activity, which means more funding,” he said.