A pet peeve of mine is the woefully low levels of investment in Africa’s public healthcare sector – a reality that doesn’t seem to trouble the ruling elites, who hop on the next overseas-bound flight at the slightest hint of ill health. Many – the Robert Mugabes of this world and their ilk in places such as Ethiopia, Gabon, Guinea-Bissau and Zambia – breathed their last far away from home, returning as cargo for burial.

Illustrating just how removed they are from the struggles that we, the hoi polloi, frequently encounter, a Cabinet Minister in Zimbabwe triggered a continent-wide debate in early May when, after visiting a hospitalised relative in Harare, he described conditions at the government-run facility as “painful to witness” in a social media post.

The comments by Tinomuda Machakaire, the country’s Youth Minister and a senior member of the governing Zanu-PF party, painted a bleak picture: a lack of basic medications, overwhelmed staff and decaying infrastructure. Pleading with President Emmerson Mnangagwa to visit medical facilities to see for himself, he wrote: “The outcry over healthcare is not exaggerated. This is the reality faced by many of our people.”

That the Minister has only now become aware of the parlous state of Zimbabwe’s public hospitals just shows how out of touch the high and mighty are. Outsiders seem better informed about the dysfunction in the healthcare sector. South African Health Minister Dr Aaron Motsoaledi, for example, has lamented ad infinitum how Zimbabweans, desperate for the medical attention they cannot get in their own country, are overwhelming South African public hospitals.

He is on record as saying that about 70% of women giving birth at Musina general hospital are from Zimbabwe. However, this figure could not be independently verified by a fact-checking organisation.

Thinking aloud, Motsoaledi suggested in 2024 that foreign governments be made to pay for the medical treatment their citizens receive in this country.

But Zimbabwe is not the only African country that does not sufficiently invest in healthcare. As far back as 2001, the continent’s Health Ministers, meeting in Abuja, the Nigerian capital, committed to allocating at least 15% of their national budgets to health.

Only three countries – Rwanda, Botswana and Cabo Verde – have consistently met or exceeded this target, with 30 others remaining well below 10% and some spending as little as 5% to 7%.

In a report last month, the African Union’s Africa Centres for Diseases Control (CDC) lamented what it described as the unprecedented financing crisis facing the continent’s public health systems. Among the key causes in recent times, it noted, is the 70% decline in official development assistance (ODA) from 2021 to 2025. There is a simple English phrase for ODA; it’s ‘foreign aid’, which US President Donald Trump has announced he will be cutting, suggesting the situation is likely to further deteriorate.

This is not good news for our already fragile health systems, given that ODA is considered the backbone of critical health programmes such as pandemic preparedness, maternal and child healthcare services, and disease control initiatives. All these are now at risk, threatening the achievement of the UN’s Sustainable Development Goal 3, which focuses on universal health coverage.

As the Africa CDC highlights, the situation is compounded by Africa’s spiralling debt. Countries on the continent are expected to service $81-billion by the end of this year – a figure that surpasses anticipated external financing flows, further shrinking the fiscal space for healthcare investment.

Then there is the not-so-little matter of corruption. According to an article published in The Lancet medical journal in 2023, an estimated 10% of the $7-trillion spent on healthcare globally every year is lost to this scourge. This figure exceeds the amount required to achieve universal coverage by 2030.

While the article does not indicate how much of this loss occurs in Africa, it’s safe to assume it’s significant. What we do know – from a Wits Centre for Health Policy study – is that corruption is rampant, involving not only politicians but also doctors, procurement officials and medical aid companies.

Fixing this is within our power. Curbing corruption would free up desperately needed resources that could be redirected into our hospitals and clinics.