Malawi drug budget dwindling

Allocation to the drug budget has for the past three years been on the decline amid shortages of essential drugs in public hospitals.

Health experts fear the fall in the government’s share of total health expenditure as the country’s health sector is becoming increasingly dependent on donors.

For instance, in the 2019/20 financial year, the drug budget was 25.6 percent or about K25.9 billion of the health budget of K101 billion. The sector budget itself represented 9.4 percent of the total fiscal year budget.

In the 2020/21 fiscal year, the drug budget percentage dropped to 14.4 percent or K28 billion of the total health budget of K195.3 billion. The sector allocation represents 9.7 percent of the national budget.

In 2021/22, the drug budget dropped further to 10.7 percent or K20 billion out of the K187 billion health budget, which represented 9.4 percent of the country’s total budget.

This year, in Minister of Finance Sosten Gwengwe’s budget statement presented in Parliament last Friday, the drug budget has been slashed further to 9.8 percent or K27.7 billion of the health budget.

The minister kept the health budget at K283.57 billion, which represents 10 percent of the 2022/23 National Budget.

The sharp fall in the drug budget has since irked the Pharmaceutical Society of Malawi who have stressed that drugs and medical supplies are the backbone of health service delivery.

The society’s president William Mpute and secretary general Jeremiah Kabaghe said in a statement yesterday that with the growing population, disasters, pandemics and public health emergencies, there is always a corresponding demand for drugs and medical supplies.

“As the cost of living and prices of commodities are rising, the cost of drugs and medical supplies go likewise. For the past few years, the drug budgets have failed to sustain district councils to the end of the financial years,” reads part of the statement.

The society has also expressed dissatisfaction with the health sector allocation in general as it has been falling short of the Abuja Declaration.

The Abuja Declaration entails that African countries must allocate at least 15 percent of the total budget to the health sector.

But despite Malawi being party to the international instrument, the country has never met its target in allocations towards the health sector.

Public health expert Dr Titus Divala said the decline in the drug budget is a huge concern and further expressed worry on the overall health budget that continues to fall below the Abuja Declaration.

He said: “The [Covid-19] pandemic presented to all of us the challenges and weaknesses of our health system, and there was no better time for making the right and bold decisions.”

On his part, Health and Rights Education Programme executive director Maziko Matemba concurred with Divala, saying the drug budget allocation is worrisome, especially in the wake of pandemics.

He said the emergence of pandemics itself is a sign that the country’s health system is not resilient due to inadequate financial resources.

In a separate interview, public health practitioner Dr Bridget Malewezi said it is important for government to prioritise the drug budgets, considering that other drugs are procured by Malawi’s partners.

With a population of around 19.13 million people as of 2020,  according to World Bank statistics, donors contribute about $250 million annually towards the country’s health sector.