The health sector may have received the second largest allocation in the current budget, but the funding remains too insufficient and donor-dependent, leaving the poor who rely on public health services in mortal danger.
The United Nations Children’s Fund (Unicef), in its health budget analysis published this month, has highlighted that out of the K550 billion health sector budget in the 2024/25 fiscal plan, about K308 billion or 56 percent is from donors and the Malawi Government is putting in K197 billion.
Health sector financing has remained significantly donor-dependent for years and the report notes that an average of 54.5 percent of total health expenditures was funded by donors between 2016 and 2022.
It also highlights that donor funding for health sector development projects has increased from K55 billion in 2023/24 to K190 billion in 2024/25. On the other hand, the government’s contribution has declined from K11 billion to K7 billion during the same period.
Reads the analysis: “The current funding situation threatens destabilising funding in the event of changes in donor priorities or funding availability, potentially leading to provisional gaps in essential health services.
“Hence, a balanced and diversified financing strategy that strengthens government capacity and promotes financial independence is necessary for achieving sustainable health outcomes in the long-term.”
The K550 billion allocation to the health sector in the K5.98 trillion 2024/25 National Budget is an increase from K368 billion in 2023/24 and K243 billion in 2022/23 fiscal year.
However, at an equivalent of 9.2 percent of the total budget, the current health sector budget is below the Abuja recommendation which calls for African States to allocate at least 15 percent of the national budget to health.
In Malawi, trends show that the country has consistently missed the Abuja target as the health budget has remained below 10 percent of the total budget since the 2020/21 financial year.
The report said the dire economic situation characterised by high inflation, climate-induced disasters and debt servicing costs could lead to diminishing access to essential healthcare services, particularly for vulnerable population.
In the budget brief, Unicef has encouraged the Ministry of Health to prioritise investments in low-cost, high impact interventions in the shortest term, including expanding universal health coverage through primary health care.
Reads the report: “This urgent action will accelerate wider coverage of primary health care access and address the most pressing health developmental needs. The urgency of this need cannot be overstated and immediate action is required.”
In the 2024/25 National Budget, K57.4 billion was allocated to procuring medicines and medical supplies with K26.5 billion for four central hospitals and K30.9 billion for district hospitals
Commenting on the report yesterday, Malawi Health Equity Network (Mhen) executive director George Jobe said Malawi has made headway in HIV, malaria and tuberculosis treatment and prevention because of donor funding.
He said there is need for the government to increase investments in the health sector.
“The danger with reliance on donors is that our health sector can crumble if the support is withdrawn and that is why the government needs to increase funding,” said Jobe.
In a separate interview, health rights activist Maziko Matemba said external health financing has already started slowing down due to the global economic downturn; hence, the country should make sure that it is self-sustaining.
Ministry of Health officials were not available to comment on the analysis.
The World Health Organisation recommends an annual per person expenditure of $86 (K150 000) to effectively improve universal health coverage targets, but Malawi spends $16 (K28 000) per person.
