As President Hakainde Hichilema prepares to appoint his new Cabinet, the health sector is hoping the person handed the Ministry of Health portfolio will not only occupy the office, but also listen to those working on the frontline.
Resident Doctors Association of Zambia president Dr Paul Chibwe says the next Health Minister must come into office as a “mother or father” of the health sector, with a willingness to engage health professionals, address longstanding challenges and ensure that concerns raised by the sector are not repeatedly ignored.
Speaking to Zambian Business Times-ZBT in an exclusive interview, Dr Chibwe said the past five years had highlighted weaknesses in engagement between the Ministry of Health and professional associations.
Dr Chibwe said the health sector had observed the performance of different ministers over the past five years, with one of the major concerns being limited collaboration with professionals.
“I think we saw the past five years of ministers, which showed from the people that were by the offices, I think we had issues with that partly showed lack of collaboration and engagement between the Ministry of Health and the sector,” he said.
According to Dr Chibwe, the problem was particularly evident when professionals and associations were left out of discussions despite being the people responsible for delivering healthcare services.
“But the issues that stood out, all the issues that were, I think, is lack of engagement,” he said.
“If you look at it, mostly it was the ministry leaving out the people that are supposed to deliver information and speak on their behalf in these facilities and these associations.”
He said while there were later attempts to sit down with stakeholders, engagement had not always been at the level expected by the sector.
“I think later on we saw sitting down and what not, but I think the fact wasn’t as expected,” Dr Chibwe said.
With the new minister expected to inherit these challenges, he said the RDAZ was less concerned about naming a preferred candidate and more interested in seeing a leader who would work closely with health professionals.
“For us as an association, we don’t have a name we say to submit or who should be the head of the sector,” he said.
“Our prayer is whoever comes in, I think, should come as a mother, a father of the sector, actively engage leaders of the profession and also make sure the issues that we have raised before by the sector don’t repeat.”
Dr Chibwe said the incoming minister should also pay attention to equipment and ensure that decisions made by the ministry properly reflect the views and needs of people working in the sector.
“I think the key issues are, first of all, the sector would want equipment that is straightforward and fair and they represent the opinions of the sector itself,” he said.
He also pointed to corruption within the health supply chain as an issue that requires continued attention, saying problems in the system have had consequences for patients.
“Of course, we saw ZAMMSA, which is corruption in the supply chain,” Dr Chibwe said.
He added that government reforms should introduce stronger systems capable of monitoring processes and ensuring that resources are properly managed.
“It depends on the government doing reforms and introducing mechanisms that are able to monitor the process and make sure the right things are done,” he said.
Dr Chibwe linked weaknesses in the supply chain to shortages of medicines in some health facilities.
“I think it’s because of this that led to shortages of drugs in some facilities,” he said.
Beyond medicines and equipment, Dr Chibwe said the next minister would also need to address Zambia’s dependence on external funding for critical health programmes.
He said the threat and eventual withdrawal of some external funding had demonstrated the risks of relying heavily on donors to sustain essential programmes.
“The other issue, I think, was government dependence on external funding,” he said.
“I think that exposed a lot of loopholes when the US threatened to withdraw funding, of which, after withdrawal, I think some of the key projects suffered.”
Dr Chibwe said programmes dealing with HIV, malaria and tuberculosis need to continue because thousands of citizens depend on them.
“At the moment we have projects such as HIV, malaria and TB control. I think these are projects that need ongoing because we have a lot of citizens that are depending on those projects,” he said.
He specifically pointed to people living with HIV who depend on antiretroviral treatment and other services.
“If it’s HIV, we have a lot of citizens that are depending on their ARVs and all these things,” he said.
Dr Chibwe therefore believes Zambia needs to gradually move away from heavy dependence on donor funding and build a health system that can sustain critical programmes using domestic resources.
“The country needs to move from donor funding to the country now standing on its own and be able to support these key projects,” he said.
The debate over the next Health Minister has also focused on whether the ministry would be better served by a medical professional, particularly after some health professionals were elected as Members of Parliament.
Dr Chibwe said there was already public discussion on the issue, with some people believing that a minister with a professional health background could better understand the sector.
“I think among the conversations we’ve seen in public, a good number of people think ministers that have a professional health background serve better in the ministry,” he said.
He acknowledged, however, that there are also people who believe the ministry does not necessarily have to be headed by a medical doctor.
“And then, of course, we have another number, a good number, that says no,” he said.
Dr Chibwe said Zambia now has several parliamentarians with medical backgrounds who could potentially be considered, although the final decision remains with the President.
“I think we have a good number. I think we have about three medical doctors,” he said.
He also referred to other individuals with health-sector experience who could potentially be considered for leadership positions.
For Dr Chibwe, professional experience could make it easier for a minister to understand the language, priorities and challenges of the health sector.
“I think the background works best for the sector because we have people that have understood the sector, the people that know the agenda of the sector,” he said.
“You know they know the language of the sector, so you find that from the get-go, I think now they even relate with everyone else a bit easier.”
As the country awaits the composition of the new Cabinet, Dr Chibwe says the health sector’s priority is ultimately not about a particular name, but about having a minister prepared to listen, engage and act.
Article by Karen Ngulube.
