The perennial problems that dog the Malawi health sector are petrifying, and almost catastrophic. The K50 billion that was allocated to the health ministry in the 2013/14 budget last July represents 7.5% of the national budget.
Yet, despite such a seemingly inspiring commitment by the government towards the health sector, cases of Malawian hospitals running short of basic medicine have become so rampant that they do not even make news.
For one to properly understand how this is deeper than the eye can see, cases of medical bankruptcy in public hospitals cannot be reported in isolation but in this context.
Two weeks ago, the Malawian media was awash with news of how a low ranking government clerk had been found with K120 million (about $360,000) in cash for which he could not account, driving the police to believe that he had been siphoning the cash from government coffers. In Malawi, K120 million is not spare change; an entire government department can run for an entire year on that sum.
Prior to that, the media had also been reporting about how a government appointed valuer had established that former president Bingu wa Mutharika had accumulated over K61 billion in cash and property over his eight reign. If this figure is to be believed, at the time of his death, the ex-President’s wealth was one tenth of the Malawian national budget.
Yet amidst such wanton looting of public funds, the health sector – the single most important ministry in Malawi – is wobbling and ailing down to its knees so much that the public has lost trust in the health system. Corruption is a major problem hampering healthcare delivery. The Auditor General’s 2009 report shows that a large percentage of drugs went missing that year.
The Malawian scenario is replicated across the African continent where rampant corruption in the health sector has directly led to needless deaths. The best way of dealing with the ill is to put in place mechanisms that ensure that government resources are used prudently, especially in key areas such as healthcare.
Fighting poverty needs more than just political rhetoric; it requires governments to put emphasis on budgets and to develop a culture and discipline that ensures that this annual financial plan of action is followed to the latter. As an annual master plan, the budget is an excellent document, if only it fulfils half of what it pledges to.
The lack of mechanisms and oversight institutions that ensure that the government is held accountable on how it spends public funds has led shocking abuses of funds. And because there is a lack of public interest and, resultantly, public policing of how these funds are abused and whether they are being used as stipulated in the budget, the government does not care about ensuring that priorities are met or that key areas of poverty reduction are paid attention to.
Lessons from the recent history show that there are fewer cases of abuse of government resources in countries with strong institutions and a vibrant citizenry whereas where such an establishment is non-existent or weakened; the government will use that opportunity to dig into the public purse.
Countries with vibrant democracies and, resultantly, a vibrant civil society and a participatory citizenry such as Botswana and South Africa has witnessed negligible cases of public funds abuse when compared to other countries on the continent.
It has been joked across Africa that when public watchdogs look away for a second, millions of dollars go missing at the national treasury.
Meanwhile elsewhere, Liberia has been lauded by stakeholders attending the G7+ meeting in Washington, D.C., United States of America for instituting what they called key reforms into the country’s economy. A dispatch from Washington D.C. named the Open Budget Initiative and Tax Reforms as programs that have placed Liberia on an irreversible path to achieving its goals.
The stakeholders at the meeting noted that the Open Budget Initiative by the Liberian government shows a strong commitment in the fight against corruption and introduces transparency and accountability in its operations. According to the dispatch, stakeholders believe that holding public officials accountable is cardinal to the successful implementation of the new deal.
If countries on the African continent are to fight poverty with the earnestness and zeal that this initiative deserves, the need for an open budget system cannot be over-emphasised. Checking government abuse will ensure that resources and finances are used to usher the citizens from the pangs of poverty instead of diverting funds elsewhere. This also puts pressure on governments to treat the budget with the seriousness it deserves.
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