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ZIMBABWE: Health system unravels
IRIN News
October 24, 2003

JOHANNESBURG - The decline of Zimbabwe's health system, once one of the best in the region, has been underlined by the unravelling of its national immunisation programme.

The government's Expanded Programme on Immunization (EPI) is now in urgent need of additional support to ensure that vaccines, cold chain equipment and technical expertise are available to reach all children, the UN Children's Fund (UNICEF) said in a statement.

Until 2001, immunisation coverage for most antigens was over 70 percent. But coverage in some districts has now dropped to 44 percent, and the number of children dying before their first birthday has increased from around 56 per 1,000 live births in 1999 to around 65 per live 1,000 births in 2000.

The British Department for International Development (DFID) on Thursday pledged US $3.3 million to UNICEF Zimbabwe to secure urgently needed vaccines and logistical support for the EPI during January to June 2004.

"The funding comes at a time when the health system, once one of the best in the region, is deteriorating, as the combination of the HIV/AIDS pandemic, the economic crisis and the severe food shortages have left drugs and health workers in short supply and unable to cope with growing needs," the UNICEF statement said.

"With more and more children weak from hunger and exposed to disease, immunization is crucial for their survival," UNICEF Representative Festo Kavishe was quoted as saying. "We are grateful for this generous donation. It is vital we work together to guarantee that the gains made in immunization coverage during the last two decades are not lost."

In an interview with IRIN, the chairman of Zimbabwe's Parliamentary Portfolio Committee on Public Health and Child Welfare, Blessing Chebundo, said the health sector would need a budget allocation of at least Zim $500 billion (US $6.4 million) to resuscitate critical areas of service delivery in the 2003-04 period. There were critical problems related to drug procurement, crumbling infrastructure, the retention of skilled personnel and fuel shortages.

"The health care sector is presently so paralysed that we need not less than Zim $500 billion to get it back to a semblance of working order. In actual fact, it needs close to Zim $800 billion [US $10.3 million], but we are also aware that the country is in an economic crisis, so it cannot meet some of these financial obligations, despite the need," said Chebundo.

He said his committee had just concluded a survey of the critical components of the health sector and found that only 30 percent of the equipment at public hospitals was functioning, while drug store levels had remained below 40 percent of the national requirement since 2000.

"We also found that the health sector is operating at 45 percent of normal personnel levels, only 30 percent of the ambulances and critical sector transport is working, and that 36 percent of recorded deaths are now occurring at homes," Chebundo added.

He said the government was devoting too much time to castigating skilled personnel leaving the country for greener pastures as "unpatriotic", instead of addressing the real causes of the brain drain. "These people are professionals. They want salaries that are comparable to their status and experience, they want job security and they want personal security. But the present scenario in Zimbabwe provides none of that."

Chebundo noted: "In terms of the present drug crisis, government is to blame for failing to honour the terms of a drug purchase agreement it entered into with the Ministry of Health early this year. It had agreed that it would supply US $4 million per month to the National Pharmaceutical Company for the importation of essential drugs. But the government has only managed to give out US $3 million in the past nine months."

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