2025 Mid-Term Budget Falls Short of Abuja Health T...

2025 Mid-Term Budget Falls Short of Abuja Health Target Despite Modest Gains

Michael Gwarisa

Zimbabwe’s 2025 Mid-Year Budget Review has once again underscored the country’s persistent failure to meet the Abuja Declaration target of allocating at least 15 percent of the national budget to health, despite a modest improvement in the sector’s share of Gross Domestic Product following a rebasing exercise.

According to the review presented by Finance Minister Mthuli Ncube, the Ministry of Health and Child Care was allocated ZiG$27.8 billion for the year, translating to approximately US$1.039 billion using the official exchange rate of US$1 to ZiG$26.7654.

While the document quotes US$772 million, this discrepancy appears to stem from shifting exchange rates and contextual variances within the multi-currency budget environment.

Nonetheless, the sector’s allo;cation represents just 10.1 percent of the total ZiG$276.4 billion national budget, falling 4.9 percentage points short of the Abuja target. The Abuja Declaration, signed by African Union member states in 2001, commits signatories to dedicating at least 15 percent of annual national budgets to health.

By the end of June 2025, the government had spent ZiG$7 billion of the health budget. Of this amount, ZiG$5.7 billion, or 82 percent, went toward salaries and wages. The remaining funds were divided between ZiG$1.1 billion for goods and services and a mere ZiG200 million for capital expenditure.

This wage-heavy spending continues to leave little room for investment in essential healthcare services, including medicines, diagnostics, cancer treatment equipment, and hospital infrastructure.

The budget review also reveals Zimbabwe’s continued dependence on donor support, with US$95.8 million disbursed by development partners in the first half of 2025.

These funds supported key areas such as HIV and AIDS, tuberculosis, and maternal and child health services. While donor funding plays a crucial role in sustaining essential health services, experts warn that over-reliance undermines the sustainability of the country’s health system.

Despite modest improvements in the health sector’s share of GDP from 2.1 percent to 2.5 percent after rebasing, the review highlights worrying delays in critical health infrastructure upgrades and medical equipment procurement. Facilities continue to operate with aging cancer treatment machines, and progress on hospital rehabilitation projects remains slow.

The mid-year budget review paints a clear picture. Zimbabwe’s health sector remains underfunded and overly reliant on donor support, with most domestic funds absorbed by recurrent costs.

To address these structural challenges, analysts and health advocates recommend that Zimbabwe raise the health budget to at least 15 percent of the national budget in line with Abuja commitments. They also emphasize the need to rebalance expenditure toward procurement of medicines, equipment, and infrastructure development.

Furthermore, investing in health system resilience, including public health surveillance and emergency preparedness, is seen as critical. There is also a growing call to leverage public-private partnerships and explore domestic health financing innovations to ensure the sector’s long-term sustainability.

As Zimbabwe prepares for the full 2025 budget later this year, the call is growing louder for a more equitable, responsive, and sustainable approach to health financing that moves beyond rhetoric to deliver real change on the ground.