Online Reporter
Oliver Kazunga
Senior Reporter
SOUTHERN African countries are racing to overhaul healthcare financing as dwindling donor support outpaces governments’ ability to adapt, prompting calls for a landmark SADC Declaration on Health Financing to secure the sector’s future.
The call emerged in Harare yesterday as senior Treasury and Health officials from across the region began deliberations on strategies to expand fiscal space for healthcare amid declining global development assistance and mounting pressure on public health systems.
Addressing the inaugural joint meeting of senior officials of Finance and Health, Permanent Secretary in the Ministry of Health and Child Care, Dr Aspect Maunganidze, said external funding for health was shrinking at a pace that demanded urgent policy action.
“Our theme is the expansion of fiscal space in a changing financial landscape. Let us be clear about that landscape. External financing for health is declining faster than our countries are able to plan its transition,” he said.
Dr Maunganidze said governments could no longer rely on traditional donor support and needed to mobilise sustainable domestic resources to guarantee quality healthcare.
“So, the question before us is practical and urgent: where, realistically, is the fiscal space to be found?
“It will come from several places at once — from domestic revenue and the political will to direct it towards health; from public financial management reforms that turn approved budgets into actual spending in communities; from the efficiency gains we leave on the table every year through fragmentation and duplication; and from innovative financing such as blended financing, debt restructuring or extension, and pooled financing arrangements such as pooled procurements and our progressive health provisions that stretch each dollar further.
“No single one of these is sufficient. Taken together, they provide a critical path to sustainable financing.”
In a major policy proposal, SADC Deputy Executive Secretary for Regional Integration, Ms Angèle Makombo N’Tumba, urged member States to elevate the health financing agenda to the highest political level by considering a regional declaration dedicated to sustainable healthcare financing.
“It is our expectation that your deliberations will contribute towards the development of a common regional approach to health financing and the attainment of universal health coverage. Indeed, I am convinced that we should already seek to elevate this dialogue by extending it to our Heads of State and Government, with the possibility of adopting a SADC Declaration on Health Financing.”
She said as global development financing continued to decline, member States needed to treat healthcare not merely as a social service but as a strategic investment that underpins economic growth and regional development.
“By bringing your two sectors together, we are taking an important step towards strengthening coordination in addressing the region’s health financing priorities.
“As global development financing continues to dwindle, it is becoming increasingly important that we strengthen domestic investment in health.
“I say investment — because health should not only be viewed as a social service, but also as a strategic investment that supports economic growth and development,” she said.
Ms N’Tumba said the region should explore innovative financing instruments, including debt-to-health swaps, regional pooled procurement of essential medicines and support for local pharmaceutical manufacturing to strengthen regional supply chains and reduce dependence on external markets.
Chief Director for Economic Affairs in the Ministry of Finance, Economic Development and Investment Promotion, Mr Joseph Mverecha, said the region’s difficult economic environment required coordinated responses from finance and health authorities.
“We convene at a time when the regional and global economic landscape remains complex and dynamic, presenting both significant challenges and emerging opportunities.
“Our economies continue to contend with persistent inflationary pressures, rising public debt, climate-induced shocks, constrained fiscal space, global financial volatility and geopolitical uncertainties, while at the same time striving to accelerate sustainable and inclusive economic growth,” he said.
Mr Mverecha said recommendations from senior officials would shape ministerial decisions and should therefore be rigorous, practical and evidence-based.
The joint meeting has brought together senior finance and health officials from SADC member States, central banks, the SADC Secretariat, development partners and international organisations to craft recommendations that will feed into the Ministers’ Outcome Statement tomorrow, with sustainable health financing expected to dominate the regional agenda.
