Online Reporter
The image is striking: Finance Minister Mthuli Ncube walking through the Radiotherapy Centre at Mpilo Central Hospital in Bulawayo, watching a new low-energy linear accelerator being installed, and pledging that Government will acquire the “full range of machinery required for cancer diagnosis and treatment.”
If delivered, this marks a turning point for a health sector where cancer patients have for years faced a brutal choice: pay exorbitant costs for treatment abroad, join months-long waiting lists for broken machines, or simply go without.
The commitment is backed by a concrete funding source: proceeds from the Sugar Content Tax on beverages. That linkage matters. It turns a public health tax into a public health investment, and it gives the US$30 million cancer equipment programme a narrative that citizens can understand. Pay more for sugary drinks today, get radiotherapy machines tomorrow.
The first batch of equipment has already arrived at Mpilo and Parirenyatwa Group of Hospitals, with installation underway. A low-energy linear accelerator for skin-proximal cancers should be operational by end of June. Higher-energy machines for deeper tumours are being prepared. That is progress, not just promise.
Cancer is no longer a “rich country disease” in Zimbabwe. Incidence is rising, driven by urbanisation, changing diets, ageing populations, and risk factors like tobacco and alcohol. Yet for years, the country’s radiotherapy capacity was collapsing. Mpilo and Parirenyatwa, the two main referral centres, operated with outdated machines that broke down frequently.
When a linear accelerator fails, treatment stops. Tumours do not pause. Patients travel to South Africa, India, or Botswana, spending life savings, or they miss critical treatment windows. The result is late-stage diagnoses and avoidable deaths.
Government’s stated objective, to establish a “comprehensive cancer treatment system capable of handling all major forms of the disease,” directly addresses this gap. Prof Ncube’s request for hospitals to specify needs for prostate and cervical cancer equipment shows an awareness that the burden is not uniform. Cervical cancer remains the leading cancer killer among Zimbabwean women. Prostate cancer is a growing threat for men. A “full range” must mean more than linear accelerators.
It must include brachytherapy for cervical cancer, diagnostic imaging like CT and MRI with contrast, pathology labs, and nuclear medicine where feasible. The value chain Prof Ncube mentioned must be real.
The Sugar Content Tax is instructive. Introduced to curb non-communicable diseases linked to sugary drinks, it now funds the very infrastructure needed to treat those diseases. That is good policy design. Too often, “sin taxes” disappear into general revenue with no visible return. Here, citizens can see the connection: a beverage tax buys cancer machines. That builds compliance and trust.
But sustainability is the test. Beverage companies will lobby, consumption patterns will shift, and revenue will fluctuate. Government must ring-fence these funds for health capital expenditure and publish annual reports showing exactly how many machines were bought, where they were installed, and patient outcomes. Transparency turns a tax into a social
Machines alone do not treat cancer. Three things will determine success.
Prof Ncube rightly told hospitals to ensure “the area for those machines” is ready. Radiotherapy requires shielded bunkers, stable floors, controlled temperature, and water. Mpilo’s Presidential Hospitals Rehabilitation Programme, with C Block due by August, must stay on schedule. Solar power installed at Mpilo with UNDP support is also critical. As the Minister said, “we cannot have machines going down in a hospital that should constantly provide services.” Power cuts cannot be allowed to interrupt a 30-fraction radiotherapy course.
Secondly, Zimbabwe has a small pool of radiation oncologists, medical physicists, radiotherapy technologists, and oncology nurses. Machines without staff are expensive sculptures. Government must accelerate training, retain specialists with decent conditions of service, and use tele-oncology to link Mpilo and Parirenyatwa with regional centres. Redistributing replaced equipment to provincial hospitals will only work if those hospitals have staff to run it safely.
Thirdly, a linear accelerator needs spare parts, quality assurance phantoms, and service contracts. Too many past donations became “white elephants” after two years because maintenance budgets were zero. The Sugar Tax revenue must cover not just acquisition but a 10-year lifecycle cost.
Mpilo will serve Bulawayo, Matabeleland provinces, and Midlands. Parirenyatwa covers Harare and the north. That is better than before, but it still means a patient from Mutare or Binga travels hundreds of kilometres for daily radiotherapy over six weeks. Government’s plan to redistribute replaced equipment to other institutions is welcome, but the bar must be high.
Cost is the other equity issue. Public hospitals must not turn new machines into profit centres. Cancer treatment is already catastrophic for household incomes. If the State is investing US$30 million, user fees must remain affordable, with exemptions for the poor. Otherwise, the machines will serve those who can pay, and the poorest will still die waiting.Prof Ncube is correct that hospital construction is job creation. Young people were visible at Mpilo’s construction site. But the bigger opportunity is in the ecosystem: training technicians, biomedical engineers, medical physicists, and oncology nurses. Partner with universities and the National University of Science and Technology in Bulawayo to build curricula around the new equipment. create apprenticeships with suppliers.
Over time, Zimbabwe should aim to service its own machines instead of waiting for foreign engineers.
The pledge by Prof Ncube is bold. The delivery so far is real.
Prof Ncube called this “an investment, not expenditure.” He is right. A healthy population is productive. A woman treated for cervical cancer at 40 can raise children, work, and contribute for another 30 years. A man treated for prostate cancer stays in the workforce. That is the return on investment.
Zimbabwe has made promises on health before. The difference this time is funding source, physical delivery of machines, and political attention at the Finance Ministry level. The Sugar Tax dividend is visible at Mpilo’s Radiotherapy Centre.
The task now is to complete the ecosystem. Build the bunkers, train the staff, guarantee the power, budget for maintenance, and keep treatment affordable.
If Government does that, the Sugar Content Tax will be remembered not just as a tax on drinks, but as the policy that gave thousands of Zimbabweans a fighting chance against cancer.
The machines are arriving. The commitment is on record. The next 24 months will show whether this is a headline or a healing.
For patients currently waiting, that difference is life and death. Bulawayo has the machines coming. The rest of Zimbabwe must follow, with the same urgency and the same accountability.
