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Zambia 2017 | HEALTH & EDUCATION | REVIEW: HEALTH

Local authorities agree that improving the healthcare sector through promotion, education, and investment is the first step toward making Zambia a middle-income country by 2030.

ike many emerging economies, Zambia is aware that a healthy population is the key to boosting productivity and national wealth. In 2017 the government will continue carrying out an aggressive agenda to solidify the healthcare sector under the guiding principles of six key pillars: health services delivery, human resources for health, the health supply chain, information systems, infrastructure and medical equipment, and leadership and governance.

As a signatory of the Abuja Declaration, Zambia is committed to working toward supporting the local healthcare sector with at least 15% of the national budget. So far, Zambia has managed to dedicate 10%, or ZMK5.8 billion, with every intention to keep working toward increasing that amount. While the required amount of financial resources remain difficult to secure, the government has taken action in other areas, specifically in terms of ensuring that there are enough healthcare personnel employed in the country. In 2017, Zambia's Ministry of Health recruited 7,400 healthcare workers and assigned them throughout the country. In 2016, that figure reached just 2,000. Meanwhile, the government has increased the budget for the pharmaceuticals industry, by 30% since 2016.

PUBLIC LEADERSHIP

At a macroeconomic level, the Ministry of Health has recognized that there are factors in several sectors that impact the health of the local population. Accordingly, these “social determinants" have come into view as a primary focus for the government as areas to improve before the healthcare sector can reach its true potential. Critically, water, nutrition, education (especially for female students), road infrastructure, household income, housing, and sanitation need to be addressed. “Nutrition will solve 60-70% of our health problems," Hon. Dr. Chitalu Chilufya, the Minister of Health of Zambia, told TBY. Additionally, sanitation, including access to clean water, is expected to reduce the number of diseases among rural children.
With new attention toward preventative care, education, and the promotion of a healthy lifestyle, the ministry has shifted the entry point to the health system from hospitals to the home. Now, the government can deliver solutions to communities around Zambia with high-tech drones, e-learning initiatives, and community ambassadors. “We want to emphasize that we are making a balanced investment, with plans to boost health promotion, disease prevention, hospital services, rehabilitation services, and curative services," Minister Chilufya said. Decentralizing healthcare services from urban areas into various regional hubs has also been carried out to shorten the distances between transporting medicine from central areas and rural communities, simultaneously improving access, solidifying security, and increasing efficiency. The public sector is spearheading a number of innovative training programs, including e-learning and distance learning, in addition to accrediting more hospitals as training institutions. The ministry has worked to accredit 11 existing hospitals, but is also building entirely new facilities. Since 2011, the government has established 14 new hospitals and three new training institutions, expanding infrastructure in a host of other healthcare areas. “We invite those who are interested in partnering with us to re-equip and modernize our tertiary institutions," Chilufya emphasized. “We have backed an innovative and sustainable program to raise money to finance healthcare, with the introduction of a social insurance program for the public sector." The program has already been approved at the policy level, and is expected to pass in parliament and become elected as law by YE2017.

PRIVATE AMBITIONS

Many have already taken up the government and the Ministry of Health on their invitation to do business in Zambia.
Fairview Hospital has identified a niche in specialty care, especially surgical oncology, laparoscopy, neurosurgery, and ear, nose, and throat diseases, all of which lack attention from both public and private healthcare providers. The hospital also boasts the most high-tech intensive care units and operating rooms, unique in the private sector. According to Dr. Jabulani Munalula, Medical Director of Fairview Hospital, the company faces stiff competition and is actively expanding in Zambia in response. “The Zambian market is becoming much more sophisticated. Because of this, our competition is not just local private hospitals and clinics, but also facilities in India or South Africa," he said in an interview with TBY. “The growth of the middle-income segment in Zambia has an impact on private healthcare, as we see more individuals with access to us through their employers." In developing its growth strategy, the hospital has targeted the Copperbelt and Northern Zambia, noting that these areas have been marked by a lack of healthcare services. In 2017, Fairview Hospital is looking at opening up a series of new diagnostic centers around the country. “Restricting ourselves to Lusaka with just one center does us a disservice," Munalula concluded.

Bringing in advanced medical techniques is one way that the private sector is contributing to Zambia's healthcare system. However, medical equipment and machinery is also in high demand, and the private sector is well positioned to provide it.

Although its main focus is on dialysis-related products, B. Braun produces a variety of equipment for general hospital use, including anesthesia products, wound care tools, and surgical instruments. In addition to providing products for Fairview Hospital, B. Braun services CFB Hospital, Forest Park Hospital, and Italian St. Paul's Hospital in Lusaka. “After only a few months of operations, our products have already found their way to many end users," Nimrod Njamba, Head of Sales and Marketing in Zambia for B. Braun, told TBY. Apart from providing much-needed hospital products, B. Braun seeks to participate in a knowledge transfer in Zambia. “We learn from the doctors here while simultaneously providing our own know-how. We support various Zambian medical organizations and associations by bringing in doctors from across the world to host workshops and seminars," Njamba said. Though the company does not manufacture in Zambia, plans to start local production are in the pipeline. “We want to have our manufacturing as close as possible. We currently produce in Johannesburg, and it is likely that a similar operation could open in Zambia," he concluded.

PHARMACEUTICALS

Zambia's pharmaceutical imports have steadily increased since 2010, reaching a value of over USD220 million in 2015. The country's top five sources of medicine were South Africa, India, UK, Denmark, and the US. The Zambian Medicine Regulatory Agency (ZAMRA) enforces the quality of the pharmaceutical products sold in the country and aims to attract investment. Although the country has battled illicit medicine sales for years, new supervisory policies and cooperation with private sector players is expected to curb unauthorized activity and make supply chains more efficient. However, for many, access to pharmacies and essential medicines is limited because the majority of licensed pharmacists are based exclusively in urban areas. Moreover, clinics around the country are frequently undersupplied. The government's efforts to streamline this process by allowing clinics to place orders directly with the central distribution center should result in better access to products nationwide. “Our main objective is to bring medical services to the people through shops that will be accredited by ZAMRA officials," ZAMRA Director Bernice Mwale told the press in 2016.