By Staff Reporter
HARARE – As Zimbabwe grapples with declining donor funding for health, experts have raised
the alarm over a deeply ingrained cultural paradox. While millions of Zimbabweans invest in
funeral policies and burial societies, the majority remain unwilling or unable to pay for their own
healthcare, leaving the burden of a collapsing system to fall on the poorest households.
The warning came during a webinar organised by the Community Working Group on Health
(CWGH) and the African Health Federation (AHF), titled “Financing Zimbabwe’s Health
Future: Domestic Resource Mobilisation in an Era of Declining Donor Support on July 7.
Speakers from across the health, labour, youth, and parliamentary sectors painted a grim picture
of a health system at breaking point, and pointed to a fundamental mismatch in national
priorities.
Presenting on behalf of the Consumer Council of Zimbabwe (CCZ), Taremedzwa Moyo, said the
decline in donor funding has had a significant impact on consumers, patients, and households,
with the burden falling squarely on ordinary citizens through higher out-of-pocket costs.
“As donor-funded medicines, diagnostics and services become less available, patients have had
to pay for issues such as consultations, lab tests, medicines, medical supplies and hospital fees.
“When donor support declines without a full replacement by our own local resources, it means
that the service chain breaks and it’s really a struggle for our consumers,” said Moyo.
She highlighted the devastating ripple effects, including shortages of medicines and medical
supplies, reduced access to rural health services, longer waiting times, overcrowded facilities,
and greater financial vulnerability for households.
“You find consumers sometimes opting to borrow money or to reduce spending on food and
education, falling into debt, so that they can be able to pay for their healthcare. This deepens
poverty and inequality issues that then come into play,” she said.
Despite the Government allocating ZiG30.4 billion to health in the 2026 National Budget,
representing 15 percent of total expenditure in line with the Abuja Declaration target, the CWGH
has previously warned that the allocation remains “not comprehensively adequate” to address
urgent primary healthcare needs.
Out-of-pocket spending continues to rise, and approximately 90 percent of Zimbabwe’s
population, some 16 million people, lack health insurance and must pay medical costs out of
pocket.
A recurring theme throughout the webinar was the stark contrast between Zimbabweans’
willingness to pay for death versus their reluctance to invest in life.
According to a 2022 FinMark Trust report, 72 percent of insured Zimbabweans hold funeral
insurance policies, while only 30 percent have health insurance.
Funerals typically cost between US$800 and US$3,000, depending on the city, the number of
attendees, and the type of service. Health insurance, by contrast, can cost around US$200 per
month, a prohibitive sum for most families.
Executive Director of Women Action Group Tambudzai Loveness Rukuni, who presented on a
topic titled“Leaving no one behind: women’s perspective on equitable health financing,” said
women and girls bear the heaviest burden when health systems fail, often sacrificing their own
care to prioritize children and elderly relatives.
Natasha N. Dube, representing the International Youth Network, echoed these concerns, noting
that young people were disproportionately affected by unemployment and cannot afford rising
healthcare costs.
“We are young, we are unemployed, and we cannot pay for healthcare that should be free. The
Government must prioritize young people in health financing decisions.”
Luckmore Pamhidzai, from the Young People’s Network on Health and Well-being, added that
the decline in donor funding had hit youth-focused HIV and sexual and reproductive health
programmes hardest.
“We are seeing programmes that were keeping young people alive shutting down. If we do not
act now, we will lose a whole generation.”
Head of the Organising Department for Occupational Safety and Health at the Zimbabwe
Congress of Trade Unions (ZCTU), Michael Kandutu, called for the urgent establishment of a
National Health Fund to pool resources and reduce out-of-pocket expenses.
“Workers are paying for healthcare twice, through taxes and again at the point of service. We
need a National Health Fund that guarantees free access to essential health services for all
Zimbabweans,” said Kandutu.
Professor Davison Munodawafa of Midlands State University warned that the current trajectory
was unsustainable.
“We cannot continue to rely on donors who are walking away. Domestic resource mobilization is
not an option, it is a necessity.”
Parliamentary Portfolio Committee on Budget, Finance and Economic Development member,
Edwin Mushoriwa, said Parliament was seized with the matter and was exploring policy options
to increase domestic health financing.
“We are looking at ring-fencing health-related taxes, including sugar taxes and the AIDS Levy,
to create a predictable and sustainable funding stream for health. But we need public buy-in.
Zimbabweans must be willing to invest in their own health,” said Mushoriwa.
Acting Deputy Director of Policy Planning and Health Economics at the Ministry of Health and
Child Care Gwati Gwati, assured participants that the Government was committed to
strengthening domestic resource mobilisation and had already established mechanisms, including
the AIDS Levy and earmarked health-related taxes.
“We are fast-tracking the National Health Insurance Scheme, which will guarantee free access to
essential health services from consultations to surgery, with contributions raised through targeted
taxes,” Gwati said.
