The Parliamentary Committee on Health and international charity Oxfam have said the government should reconsider its approach to health financing following United States (US) president Donald Trump’s decision to partly freeze aid for health interventions.
The US president does not want sexual reproductive health services such as pregnancy termination to benefit from his country’s financial support, at least until initiatives it funds globally are reviewed within 90 days.
Trump’s orders have drawn mixed reactions within the country.
Committee chairperson Mathews Ngwale said the suspension of aid underscored the need for Malawi to have control of its healthcare funding.
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‘Many people are not happy about what has happened in the US but we must remember; it is their country, their president and their decision.
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“Instead of lamenting, we should see this as an opportunity to rethink our approach and find sustainable solutions,” Ngwale said
According to Ngwale, the committee suggested a mandatory health insurance scheme for all government employees.
Under this plan, civil servants would be required to enrol in health insurance programmes, allowing government hospitals to claim reimbursements from insurers.
“The biggest employer in Malawi is the government. If every civil servant is on health insurance, the Ministry of Health can claim funds from insurance providers, which would help pay for drugs, equipment and health worker salaries,” Ngwale said.
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The proposal was previously met with scepticism, with only about 12 percent of government employees voluntarily opting into the scheme.
He, however, said, with external funding in question, the initiative should be revisited as a potential solution to strengthen the country’s healthcare service delivery system and move toward universal health coverage.
“For those who cannot afford insurance, the government would identify them through national identity cards and ensure they continue receiving free healthcare,” Ngwale said.
Health Minister Khumbize Kandodo Chiponda has said the government is closely following the US’s new policy decisions.
‘We are developing a health sector strategy; we will let the debate and discussions on domestic health financing continue as we are looking into the matter,” Kandodo Chiponda said
Oxfam Country Director Lingalireni Mihowa said Malawi should strive for economic independence, as this is the only way the country could insulate itself from shocks that come from foreign policy shifts of donor countries, as has been the recent case of US policy on its aid.
“While health budgets in Malawi have historically been among the top three allocations in the national budget, they have been falling short of the 15 percent national budget allocation recommended by the Abuja Declaration, which Malawi is party to.
“We need to ensure that we grow the economy to generate resources that go into essential sectors such as health. We need to make the sector more efficient and spending should be directed to the point of impact. More investments [are needed] in prevention,” Mihowa said.
Meanwhile, health expert Anne Phoya has said the government should push for a proposed Act on national health contribution system.
“The proposed act stipulates that every Malawian, regardless of income level, would contribute a small, affordable amount towards healthcare services, as this would ensure that funds were always available for essential medicines and medical staff salaries,” Phoya said.
The Act proposes that businesses invest in hospitals and clinics through tax incentives, making healthcare not just a public responsibility but a shared effort.
It suggests that local communities establish health funds that could be used to support clinics, especially in rural areas where government resources were scarce.
The Act also suggests that to prevent misuse of funds, the Act would introduce a transparent tracking system, ensuring that every Malawian knew exactly where their contributions were going.
