The Zimbabwean healthcare crisis

The crisis in Zimbabwe has long since reached epic proportions and the situation worsens by the day. Millions of Zimbabweans have fled their country, seeking asylum in neighbouring countries but are often rounded up like criminals and carted off – back to the dangerous and inhospitable territory that has become Zimbabwe. All the while African leaders have sat back and watched the crisis slowly unfold, refusing to intervene or even criticise the current regime. Through their complacency African leaders have implicitly, and sometimes explicitly, condoned the Zimbabwean government’s actions to the detriment of the country’s people.

Life expectancy at birth has plummeted from 60 years in 1990 to an estimated 34 years and according to the World Bank’s African Development Indicators gross domestic product per capita in real terms was lower in 2004 ($457) than it was in 1980 ($599). For several years unemployment has been reported to be over 80 per cent, although recent estimates suggest it is actually closer to 100 per cent. In 2005, the Economist's Quality of Life Index ranked Zimbabwe last among 111 countries surveyed. The countries were judged according to their gross domestic product, health delivery systems, unemployment rate and political stability.

Malnutrition is rife throughout the country and hundreds die on a daily basis from diseases that are entirely preventable and often curable with simple medications. It is estimated that between 3,000 and 3,500 die every week from HIV/AIDS and related opportunistic infections. As a result of starvation, malnutrition-related diseases, such as kwashiorkor, are increasing at astounding rates. A recently released report by the Harare City Council’s Department of Health states that cases of kwashiorkor, increased by approximately 44 per cent in 2006 over the previous year’s figures.

In response to the economic crisis, the Zimbabwean Reserve Bank has frenetically printed money to support the corrupt and failing government-owned enterprises and to sustain minimal government services. The high growth in money supply has resulted in hyperinflation, conservatively reported by the Zimbabwean Central Statistical Office to be 7,634 per cent in mid-August 2007. The imposed price controls have simply emptied shops of food and hospitals of basic medicines and other essential devices to perform rudimentary operations.

The hyper-inflationary conditions make it impossible to make any rational economic decisions. Average wages are around 1 million Zimbabwean dollars a month but a loaf of bread, when its available, can set one back Z$160,000. Under these circumstances travelling to and from work is simply not economically viable. Indeed, most medical staff can no longer afford to reach their posts since transport fares exceed monthly incomes. The official exchange rate is approximately Z$30,000 to US$1 but on the black market a US dollar can fetch anything between Z$350,000 and Z$400,000 – a great opportunity for arbitrage for those that are politically connected.

While the current government blames ex-colonial powers and western governments for the present problems, in truth the economic and healthcare crisis lie in the government’s policies that have destroyed property rights, individual liberties and the institutions of a free society. In order to restore basic healthcare needs to Zimbabweans and to rebuild the public healthcare system, some dramatic and far-reaching political and economic reforms will be needed.

In responding to the growing outrage and alarm at the collapse of the healthcare system, Minister of Health, David Parirenyatwa acknowledged that the health system was bankrupt. However, in one of the state-controlled newspapers he appealed to businesses and corporate interests to "rescue" the service stating, "it is a question of social responsibility”. It is however somewhat ironic for a senior government official to claim that it is the “social responsibility” of the private sector to “rescue” the health system.

Through its various policies and actions the government itself has destroyed the healthcare system and if there is any responsibility for the state of the system, it must surely lie with the government. Under changed circumstances there could potentially be an opportunity for the private sector to re-enter the system and re-build Zimbabwe’s healthcare system in partnership with a new government that acts in a rational manner. The subsequent government should expand the private sector’s role in healthcare and should explore ways of using vouchers so that poor families can access quality healthcare in an efficient and effective way.

The Zimbabwean government has systematically undermined the rights of the private sector and has made it all but impossible for it to conduct business in Zimbabwe. Price controls must be removed immediately and the Zimbabwean dollar must be replaced by a stable currency, so as to curb hyperinflation. Zimbabwe’s only chance of economic survival, and a return to a normal life for its people, is to change its current policies – this can be achieved by allowing greater economic freedom and by restoring the institutions, such as the protection of private property rights, that are essential if private enterprise is to function.

Author: Jasson Urbach is an economist with the Free Market Foundation and a director of Africa Fighting Malaria. This article may be republished without prior consent but with acknowledgement to the author. The views expressed in the article are the author’s and are not necessarily shared by the members of the Free Market Foundation.

The full study published by Africa Fighting malaria on which this article is based is available at

FMF Feature Article/ 25 September 2007
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