The health sector’s overdependence on donors has resulted in the Ministry of Health (MoH) losing control over how donor funding is being utilised in the sector, authorities say.
MoH Principal Secretary Dr. Dan Namarika told the Budget and Finance Committee of Parliament meeting in Lilongwe yesterday that donors in the health sector had not reported to the ministry what they had spent and that they were reportedly not willing to have the information reflected in the budget.
He said: “The revised amount does not tally with the K1.5 billion expenditure because some donors are not willing to have their support reflected in the budget because that would seem like budgetary support. But it is true that what they [donors] reported remains low.”
However, Namarika said that the expenditure reported could reach K3 billion and would still fall short of pledges expected to be injected in the sector.
“For example, the prefab laboratory and pharmacies project is not under the Ministry of Health control. We can determine where the support should go, but we have no control over funding and how it is spent,” he said.
Namarika, however, touted the Global Fund for Tuberculosis, HIV and Aids and Malaria as transparent because it involves the government in planning and indicates how much funding has gone towards commodity purchases.
“Due to the loss of trust [in government systems], they [donors] have created a project implementation unit which directly reports to the ministry and the Secretary to the Treasury,” he said.
Namarika’s response baffled committee members who surmised that perhaps the MoH had completely lost the trust of the donors.
“The revised figure gives the impression that the donors are helping the ministry but what is spent does not reflect this. May I know what motivates you to entertain this? What is it that donors don’t trust about the Ministry of Health?” Dowa West member of Parliament (MP) Alexander Kusamba Dzonzi (Malawi Congress Party-MCP) asked.
Nkhotakota North East MP Martha Lunji (independent) wondered how the MoH could verify that the money had been spent on the health sector if what was reported was a small percentage of what they had planned to spend.
In his response, Namarika said the off-budget financing modality was happening across all sectors as a result of Cashgate exposed in 2013 after which the donors described the public finance management system as a leaking bucket.
His response was not specific to what was happening in MoH relationship with donors.
The ministry has since engaged the donors to align their support through the Health Sector Strategic Plan in a bid to strengthen the coordination.
The Malawi Government contributes 23 percent to the health sector with 77 percent coming from non-government support.
In the 2016/17, government had expected K13 billion during the Mid-Year Budget Review from donors, but by the end of the financial year, only K1.5 billion was reportedly spent, a situation the Budget and Finance Committee queried.
A 2016 World Bank Malawi Economic Monitor report estimated that off budget financing had reached 70 percent in the 2015/16 financial year, in contrast to 51 percent prior to the Cashgate scandal of 2013. n