Hon Folks, the health sector is where Malawi is bagging kudos. Life expectancy was at 63.7 years in 2016 from 39.4 years in 1967 and researchers say things are better by 0.97 percent annually, hurray!
Malaria prevalence dropped to 33 percent in 2014 from 43 percent in 2010 (latest data is likely to reveal more gains), HIV prevalence was at 9.2 percent in 2016 from 15 percent in 1997 and TB incidence dropped to 159 cases per 100 000 in 2016 from 396 cases per 100 000 in 2002.
Infant mortality was at 38.9 deaths per 1 000 live births in 2016 from 208.1 deaths per 1 000 live births in 1967. Child mortality was at 55.1 deaths per 1 000 live births in 2016 from 347.5 deaths per 1 000 deaths in 1967.
If savouring the figures is causing headache, just remember one thing: we’re living longer as the battle against some of the major killer diseases that needlessly dispatched our beloved ones to their graves earlier is being won left, right and centre.
Which bird is laying the golden egg? We need to identify it so we can lavish on it special care, not just for its own sake but more so for our own.
Folks, our enviable strides in the fight against Aids, TB, malaria, malnutrition and other diseases that made the past generations die in their 30s is largely due to donor aid. The Nation of 17 October, 2018 lays bare the fact that 62 percent of the funding for public health sector is from donors.
The story also shows that Malawi is the pacesetter in spending on nutrition in the entire Sadc region. Yet, disaggregating the funding shows that for the nutrition of every child, government allocates a paltry $2.42 (K1 815) annually whereas donors contribute a whopping $30.68 (K23 010)!
Put differently, donors are responsible for 92.7 percent of the nutrition budget whereas government chips in a meagre 7.3 percent.
The figures have alarmed various stakeholders who question the sustainability of the funding model for our health and nutrition. They rightly press on government the challenge to increase its funding in these key areas. I can’t agree more!
Donors shouldn’t be responsible for our health and nutrition. We pay taxes to our government which, in turn, has the duty to provide us with such public services. Donors have their own citizens to cater for.
But the truth is that left to ourselves, even if government were to eliminate wasteful spending, our economy is far too small to sustain the levels of good health and long life we are enjoying right now. Our GDP per capita is the third lowest in the world, much too small to sustain a population of 18 million and growing.
APM has on a number of occasions boasted that “we’re managing just fine without aid” but it’s also a fact that twice on his watch the budget had to be recast downwards because the economy simply could not yield the targeted revenue. This year, we’ve already been warned that government would have no choice but to recast again unless World Bank gives it a K60 billion grant.
Again, since 2014, economic growth projections are always much higher than the actual. Sometimes the variance is by more than 2 percentage points! Yet we know the fact that unless the economy grows by 6 percent or more, we can only share poverty and deprivation.
What do we learn from all this? First, donor aid isn’t a curse but a blessing. We need to treat it like a delicate egg. The freezing of budgetary support worsened poverty and our indebtedness. Not only are we the third poorest country by GDP per capita but our debts at K3 trillion are more than two national budgets! Yet it’s only in 2006 when donors wrote off much of our foreign debts with the hope we would channel the savings to education and health.
Second, we need to up the game on public finance management, good governance and on transparency and accountability to regain donor confidence in our economy. We need it to retain their funding on health and nutrition as long as possible while we are doing our best to grow the economy.
When donors stopped giving us budgetary support, a 40 percent funding gap was created in the recurrent budget which Government tried to fill by reducing the delivery of public goods and services. We’ve at least survived so far.
Should we mess up and they hit again by reducing or freezing their funding to health and nutrition, we’ll revert to dying in our thirties as was the case with the past generations.