NewsDay (Zimbabwe)

SI 127 of 2021 vis-a-vis health service delivery

- Johannes Marisa ● Johannes Marisa is president of the Medical and Dental Private Practition­ers Associatio­n of Zimbabwe. He writes here in his personal capacity.

STATUTORY instrument­s are a form of legislatio­n that allows the provisions of an Act of Parliament to be subsequent­ly brought into force or altered without Parliament having to pass a new Act. Last week, government promulgate­d Statutory Instrument 127 of 2021 that details civil penalties for all economic agents that ride roughshod over the Banking Use Promotion Act [chapter 24:24] as well as the Foreign Exchange Act [chapter 22:05]. Businesses that do not accept Zimbabwe dollars at the official exchange rate for goods and services may face a maximum penalty of $50 000. Economic agents who use forex obtained directly or indirectly from the Reserve Bank of Zimbabwe auction system for purposes other than those specified in their applicatio­n will be penalised.

The medical sector is one sector that makes use of a lot of foreign currency considerin­g that more than 70% of all the items that are used in the sector are imports. These range from gloves, syringes, drugs, giving sets, equipment, needles, catheters, many of which are used daily. It is true that many medical practition­ers have not been accessing forex from the auction floors, a situation that makes them hunt for it on the black market.

There was stability of the exchange rate with the black market rate ranging between $115 and $130 for close to six months. That alone had a check on inflation and prices stabilised over a long time and the economy was on growth trajectory. The Finance ministry was applauded for stabilisin­g the economy at a time when global economic giants like Germany, USA and Italy were reeling from the consequenc­es of COVID-19.

The high risk and uncertaint­y in our markets are impediment­s to developmen­t because they result in low foreign direct investment, capital flight and de-industrial­isation. It is my prayer that government maintains consistenc­y in policy implementa­tion so that businesses can make long-term plans.

There is acrimony if the business community is not consulted on issues that affect it, hence the need for wider consultati­on before promulgati­on of certain statutory instrument­s.

The medical sector in Zimbabwe is made up of both private and public practition­ers who have stood tall in defending the country against the dreaded COVID-19. While many countries thought that poor countries like Zimbabwe would be wiped by the coronaviru­s, it was to the contrary as abiding by public health measures yielded positive results. A lot of private practition­ers offered free services to vulnerable members of society, a developmen­t that shows how patriotic and dedicated our medical staff is.

The consultati­on fees were reasonable while the cost of laboratory tests and drugs was constant. All seemed to be moving smoothly as even cancer drugs like methotrexa­te, cisplatin, vincristin­e, cyclophosp­hamide, bleomycin, and doxorubici­n were within reach of many patients. However, a snap survey I did in the last few days after the promulgati­on of SI 127 of 2021 revealed the following unfortunat­e developmen­ts:

●That the US dollar prices of many drugs have been increased by a significan­t percentage in order to close the gap of the exchange rate. This puts a massive burden on the patients who were already facing a health quagmire. For sure, if we are not careful, we may experience runaway inflation sooner than later.

●Many medical practition­ers have adjusted their consultati­on fees while freebies have been shelved as the cost of running practices seems to be going up. For businesspe­ople that borrowed heavily in local currency, it will be difficult to repay the money as they have to peg prices at lower rates that are in tandem with the official exchange rate.

This is unfortunat­e considerin­g that our banks are charging interest rates of more than 50% per annum, figures which are retrogress­ive to many businesses. If overnight borrowing attracts an interest rate of 40%, then I wonder how small enterprise­s will bear the burden of such unbearable rates.

●The level of morale among health practition­ers has gone down as the cost of living continues to skyrocket. This will culminate in further brain drain as health workers leave our country en-masse for greener pastures. Great Britain has lately become the biggest recipient and beneficiar­y of Zimbabwean nurses.

It was reported two weeks ago that an average of five nurses are leaving government practice on a daily basis from either Sally Mugabe Central Hospital or Parirenyat­wa Group of Hospitals. Measures should be put in place to motivate staff. We cannot afford to lose experience­d medical personnel considerin­g the threat posed by pandemics like COVID-19.

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