Cholera Outbreaks and Depleted Pharmacy Supplies - How Corruption Plays a Role.

Introduction

During a recent conversation with a colleague, my spirits were dampened by their account of being unable to obtain medication for their child, not because of financial constraints, but because all pharmacies in the country had run out of the necessary drug. Additionally, news that five individuals had died from cholera in Budiriro and Glen-view led me to contemplate whether our country is genuinely impoverished to the extent that we cannot provide citizens with medication and safe drinking water, or if the government's attention is being misdirected. As an advocate for human rights and an opponent of corruption, I tend to connect the country's seemingly many problems to corruption!

The right to health

The right to health is classified as a socio-economic right, and although such rights are a fundamental aspect of human rights, they have not always been acknowledged as such in Zimbabwe. The prior Constitution of Zimbabwe, also known as the Lancaster House Constitution, did not identify socio-economic rights as essential rights. Therefore, the 2013 Constitution of Zimbabwe Amendment (No. 20) Act has been regarded as one of the most progressive constitutions in Africa because it incorporates a Bill of Rights in Chapter 4. Despite the recognition of the right to health as a socio-economic right and the government's duty to guarantee and promote human rights, the question arises as to why medication shortages in pharmacies and deaths resulting from cholera continue to persist in Zimbabwe.

I am inclined to agree with Udombana’s view that a “governments inability to implement socio-economic rights is a problem of nurture than nature”. In many African countries, corruption in the misappropriation of public resources undermines accountability and transparency, leading to the failure of governments to uphold their obligation to provide essential socio-economic rights. The international community recognizes that health is a vital indicator of human development and well-being, with improved health outcomes linked to economic growth. However, the effective delivery of quality healthcare is reliant on the efficient coordination of financial resources, human resources, and supplies, alongside the provision of timely health services nationwide. Therefore, while the global community acknowledges the significance of health in promoting economic development, various factors, including corruption, compromise the quality of healthcare provision in many developing nations such as Zimbabwe.

The World Health Report emphasizes that in contrast to other social systems like education, prioritizing fair financing and responsiveness is particularly crucial in the healthcare sector. This is due to the exorbitant costs of healthcare, which can result in financial ruin for individuals, and the unpredictable nature of healthcare needs. Therefore, there is need to protect citizens from having to choose between their financial stability and their health. According to the report, the most important role of a health system is stewardship, which leads to achieving the goals of the system. These goals include improving and promoting public health, ensuring quality and responsive healthcare services, and safeguarding citizens against the financial burden of illness, in Zimbabwe and other countries alike.

Impact of corruption on health care

The concept of stewardship within the healthcare sector is threatened by corruption, which deprives people of adequate and quality medical care and contributes to the emergence of drug-resistant diseases, ultimately leading to worsening health conditions. Corruption not only reduces the resources available for health services but also increases their cost, disproportionately affecting the vulnerable and poor. When public wealth is corruptly transferred to a select few individuals in positions of power and authority, at the expense of the poor and marginalized citizens, the cycle of deprivation and impoverishment persists, particularly for those who rely heavily on public services like healthcare.

Way forward in the fight against corruption - the National Anti-Corruption Strategy

As a party to the International Covenant on Economic, Social and Cultural Rights (ICESCR), Zimbabwe is obliged by Article 2(1) to take steps towards the realization of these rights. This means that the state must take action to remove any barriers that impede the fulfilment of socio-economic rights. Since corruption is one of the primary obstacles to the realization of these rights, it is my opinion that states have a fundamental obligation to take measures to combat corruption. The fulfilment of socio-economic rights is reliant on economic resources, and good governance that safeguards these resources against corruption is crucial for their effective delivery.

Since November 2017, the Zimbabwean government has introduced initiatives aimed at combating corruption. While these initiatives are commendable, I believe that it is necessary for the country to establish a National Anti-Corruption Strategy that consolidates and prioritizes the key issues affecting the nation, including corruption in the healthcare sector and its impact on public health.

The fight against corruption requires a multi-stakeholder approach, as no single person or institution can solve the problem alone. One of the main reasons why anti-corruption efforts in Zimbabwe have failed is due to the fragmented and weak efforts among various anti-corruption stakeholders. A National Anti-Corruption Strategy would provide a comprehensive and integrated approach to tackling corruption across the public and private sectors in Zimbabwe.

In addition to identifying key priority areas, the National Anti-Corruption Strategy must be grounded in human rights principles such as transparency, accountability, and the rule of law. I also believe that public institutions should develop sector-specific anti-corruption strategies to identify corruption vulnerabilities and risks within their sectors and implement effective solutions to mitigate them.

Strengthening governance and reducing corruption are essential interventions needed to improve Zimbabwe's healthcare system, which has been severely impacted by corruption.