HARARE, Zimbabwe — As Ebola continues to spread across West Africa, compromising nearby nations’ and their citizens’ health, Zimbabwe, a southern African nation, is facing a health crisis of a substantially different kind. Zimbabwe’s national health system—due to its current economic crisis—is failing, as the government can’t afford to properly fund it. Because of this, many individuals are being denied treatment at hospitals if they can’t afford the price of care despite the urgency of their needs, and many hospitals and health centers across the nation are facing shortages of both essential medicines and drugs.
Currently, Zimbabwe’s unemployment rate is estimated at 80 percent, causing many Zimbabweans to seek work as street traders in the informal economy, or outside the nation. During past economic crises, millions of Zimbabweans have left the nation. It seems another mass exit may be in the near future, as the Associated Press reports that thousands of Zimbabweans are lining up outside passport offices, determined to find work elsewhere on the continent.
This latest economic crash occurred after the most recent re-election of Robert Mugabe as president in July 2013. Mugabe, a key figure in Zimbabwe’s struggle for independence from Britain, has been president of the nation for the past three decades since first being elected in 1980.
Economic troubles have been persistent under Mugabe’s tenure, with an exceptionally bad economic crisis occurring in 1998. However, for the years immediately prior to 2013, the economy was showing signs of improvement. From 2009 to 2013, Mugabe and his Zanu-PF party shared power with the opposition party, Movement for Democratic Change (MDC), for the first time. Though this partnership was at times strained by non-cordial relations and occasionally fraught with controversy, Mugabe and the new MDC prime minster, Morgan Tsvangura—who initially ran for president in 2008 until he dropped out, complaining of intimidation—seemed to guide the country toward some semblance of financial and economic stability during their shared tenure.
However, in 2013, after 89-year-old Mugabe won re-election and his party Zano-PF received 75 percent of the parliamentary seats, any power sharing agreement was rendered null and void. And after this, the economy has once again begun its downward trend.
Many aid agencies blame the weak economy and reoccurring food shortages in Zimbabwe on the land reform program that Mugabe imposed during his presidency in the early the 2000’s. It was a program that leads to the forced seizure of “almost all-white owned farms,” according to the BBC. This was done in an effort to help landless, black Zimbabweans and address the racial inequalities that persisted from the forced colonization by Britain. However, despite these motives, the main results of the seizures have been a decline in crop production and the harming of the agricultural-based economy.
The Zimbabwean government blames the difficulties in agricultural production on a long-running drought in the region. The U.S. currently holds sanctions against Robert Mugabe and several of his associates due to concerns over human rights abuses. The EU has also held sanctions against Zimbabwe since 2002, but has eased them in recent years in an effort to encourage political reform.
From these economic troubles has come a severe inhibition of the government’s ability to efficiently manage the nation’s health system. In 2014, the cabinet gave $330 million to the public health sector, a decrease of 77 million from 2013. By the end of July this year, less than 20 percent of this money allocated by the budget has been disbursed to the public health sector. Public hospitals have been given $25 million for operations, a negligible sum considering they already owe suppliers $33 million.
Because of this, government inability to properly fund public health programs, outside donors have stepped in to provide financial aid.
One donor community is the Health Transition Fund (HTF). Run by the UN Children’s Fund, or UNICEF, this is a $435 million pooled fund. The fund works to improve the maternal and child health, as well as nutrition in the nation. It also provides essential medicines, vaccines and basic medical equipment for the people of Zimbabwe. Currently the HTF pays for 98 percent of the available medical drugs in the nation.
Since 2003, Zimbabwe has also received more than $707 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. This no doubt is a large reason HIV rates in Zimbabwe have dropped by 34 percent from 2005 to 2013.
Ruth Labode, a doctor who heads the Zimbabwean parliamentary committee on health, said, “Without the donor committee, our public health system would have virtually collapsed given that it is funding the majority of out health programs.”
However, the financial commitments of outside donors have not entirely solved the health crisis currently facing Zimbabwe. Many hospitals are still facing critical shortages of nurses, doctors, pharmacists and vital medicines.
Roughly 50 percent of rural medical facilities lack the medication they need for continued operations. There also have been reports of hospitals keeping expired drugs and syringes due to the lack of new supplies, a practice which puts patients’ health at risk.
Furthermore, outside donor investment typically focuses on combating the nation’s communicable diseases. This leads to a shortage of medication for non-communicable diseases, such as epilepsy, in Zimbabwe. The Epilepsy Support Foundation of Zimbabwe estimates that 86 percent of those with epilepsy are not currently receiving medication.
Dr. Stanley Midzi, a World Health Organization adviser, said, “The country is currently entangled in a serious economic quagmire such that drugs for non-communicable diseases like epilepsy has become a neglected condition.”
The current economic crisis in Zimbabwe is taking a toll on the nation’s health despite outside aid, and it dangerously inhibits the government’s ability to sustain national health programs.
– Albert Cavallaro
Sources: IRIN News 1, IRIN News 2, BBC, World Bank, National Geographic, ABC News, Reuters
Photo: UNICEF