Online Reporter
THE second and final pair of cancer radiotherapy machines bought with the extremely modest sugar tax introduced just over two years ago are due to arrive today by air cargo, completing the full order of four funded through the tax, with two each for Parirenyatwa Group of Hospitals in Harare and Mpilo Hospital in Bulawayo.
While the tax is small, one tenth of a US cent for every gramme of sugar in bottled beverages sold in Zimbabwe, regardless of whether the beverages are locally produced or imported, it raised just over US$30 million in the first year and this was spent on the order for the four cancer machines.
The huge sums raised highlight just how much sugar is in these beverages, and just how much in the way of sugary drinks we consume between us each year. But the tax on each litre of sugary drinks has so far been absorbed by manufacturers, or at least absorbed to the extent that the sugared versions of each drink are the same in price as the “diet” versions that use artificial sweeteners instead.
These complex and very expensive machines are not bought off the shop floor. Each has to be made specially once the order, and payment, are received, hence the extra year required for delivery. Even then there is a complex installation process required since the first pair arrived in February this year.
The opportunity was taken to make sure the second pair were the most advanced models using multiple energy sources for the more complex cancer cases. As part of the Government’s stress on spreading services equally across the country, both hospitals will have one machine from the first batch and one from the second batch, with patients sent to the hospital nearest to them that has the capacity.
The installation process for the first pair is now complete, with just the final checks needing to be made before they are commissioned. The installation of the second pair should be faster than the three months for the first pair, since the Zimbabwean technical teams now have a lot more experience and can move more surely and more quickly.
But it is important that the installation is done properly, that the medical staff who will use the equipment are very familiar with what they need to do, and that the local installation teams can handle at least the routine maintenance and resupply of consumables, although presumably they have a direct link with the designers and manufacturers to help out.
The older machines at the two hospitals are being decommissioned and sent to the larger provincial hospitals, so that patients outside the two biggest cities who do not need the top-of-the-range equipment can be treated closer to home, and only travel to the two largest cities if they need more advanced or complex equipment for their treatment.
There was some doubt in some quarters when the Government proposed the tax, and Parliament gave the necessary legal approval to activate the tax, that the money would be assigned in full to buying the cancer treatment equipment. The arrival of all four machines is the direct answer to that challenge.
Most people do not mind paying these taxes on sugar in beverages, on cigarettes and alcoholic drinks, or in the latest move on a range of less-healthy fast foods and take-aways. It is a fairly painless way of feeling that warm glow when we are helping to cure the sick.
Zimbabwe was excessively reliant on donor funding from development partners for health, especially for capital equipment and consumables. The Government did not wring its hands as these funds started drying up, rather it started taking action so we as a people and nation pull our full weight. Those four cancer machines are just the first example with plenty of other modern equipment needed.
The World Health Organisation thinks taxing less healthy foods and drink, along with tobacco products, to help fund health services is a great idea. It is now encouraging countries, especially those like Zimbabwe that could otherwise suffer from diminished donor funding, to introduce or increase such taxes as a relatively painless way of raising more money for health. There could be some complications, so that any rise in the Zimbabwe sugar tax would probably have to be matched by a new tax on non-nutritive sweeteners to maintain equivalent pricing, but these are just details.
The main point is that we are buying and paying for what we need in the way of imported equipment and drugs, and are building up our own manufacturing capabilities for pharmaceutical and health consumables, even when we need to import some raw materials and components. Our sick deserve to be able to get the support and care they need, even if they are not rich and unable to afford the thousands of dollars often needed by private practitioners and hospitals.
A decent public health system, and the Second Republic has been taking practical and effective steps to fund, create and maintain such a system, should be natural right.
It also needs to be open to all, wherever they live and whatever they earn. So Zimbabwe is on the right track, using innovation, tight administration so the money is there but not wasted, and willing to do what is needed.
