By Beverly Bizeki
As Zimbabwe grapples with the effects of the withdrawal of USAID funding for its health sector, researchers have suggested the adopting a hybrid taxation model, tapping into the country’s corporate sector to help address the crisis.
Speaking at an All Stakeholders Meeting on the state of healthcare in the province hosted by TellZim in collaboration with ZIMCODD, Dr. Ramphal Sillah emphasized the importance of shifting from a funding model to a resourcing model, where both corporations and citizens contribute not just money, but tangible resources.
“When it comes to the budget side of things in healthcare financing in Zimbabwe, statistics have shown that there has always been a shortfall. We also have bureaucratic inefficiencies whereby, despite underfunding, the health sector fails to spend the little that it is given. There is a need to consider decoloniality, where we develop a fit-for-purpose approach to our systems. The first step in doing away with coloniality is to reject money because as much as it is easy to raise money, it is also easy to embezzle it,” said Dr Sillah.
Dr. Sillah said government funding alone was insufficient, citing Masvingo General Hospital’s bid for an equivalent of US$9.9 million budget of which only 13 percent was allocated leaving a significant deficit for the hospital.
To address this shortfall, he suggested a hybrid taxation model, where businesses directly contribute to hospitals instead of just paying traditional corporate taxes.
“With salaries covered by the government, Masvingo province has 25 registered pharmacies, and these could provide the 30 percent required for drugs. Pharmacies could contribute commodities like drugs because they are already trading in the sector,” he explained.
“Private pharmacies are supposed to pay corporate taxes, and this can be done in the commodity they are trading in. To ensure compliance, the government can make it a policy to renew operating licenses only for pharmacies that contribute to the hospital. In addition to that, departments like ZIMRA and the Ministry of Health can form a committee to ensure accountability.”
Dr. Sillah also suggested that fuel stations could contribute to the health sector by providing fuel for hospital ambulances.
“Fuel stations are mushrooming, clearly showing that there must be something there. For a 280-bed hospital like Masvingo Provincial Hospital, calculations based on international standards showed that 21 ambulances would be required to service the hospital, with an estimated 9,125 liters of fuel required monthly,” he said.
“Zimbabwe has 1 048 registered fuel stations, up from 733 in 2020. These fuel stations are trading in billions of liters per year and can pay their taxes through the commodities that they trade,” said Dr Sillah.
He further proposed that the 18 registered motor vehicle insurance companies in Zimbabwe finance health services by covering the costs of servicing hospital vehicles.
“Zimbabwe has 1.58 million registered vehicles, and around US$27,000 is required to ensure that vehicles at Masvingo Provincial Hospital are properly serviced, if each vehicle owner contributed just one dollar, the hospital fleet could be maintained at US$300 per vehicle for the next five years.”
Dr. Sillah also pointed to the informal sector as a potential contributor to healthcare financing.
“Statistics from VISET show that 5.2 million people are in the informal sector, with 480,000 vendors in Masvingo province. Instead of playing cat-and-mouse games between vendors and authorities, we could introduce a Health Contributor Green Card, where informal vendors contribute something to the health sector—either in cash or in kind—and their contribution is registered,” he suggested.
“The card would eventually allow vendors to secure better trading spaces in the city and receive reductions in levies paid to the local authority.”
One of the participants at the meeting, Rejoice Maridza, supported the idea, highlighting how it could assist in financing health services specific to women.
“Formalizing the informal sector could assist the government in collecting taxes from women, which can, in turn, finance health services that are related to women.
“There are specific diseases that affect women, such as cervical cancer, breast cancer, and mental health wellness, and women vendors can also contribute toward financing the provision of such services,” said Maridza.
However, another participant, Anoziva Muguti, raised concerns about adding more taxes to an already struggling business sector.
With donor funding diminishing, Zimbabwe faces the urgent task of finding innovative and self-sustaining solutions to finance its health sector.
