Zimbabwe’s
health
sector
remains
heavily
dependent
on
donor
funding,
which
has
been
steadily
declining,
raising
concerns
about
the
country’s
ability
to
sustainably
finance
essential
health
services.
Earlier
this
month,
the
WHO
urged
governments
to
increase
taxes
on
sugary
drinks,
tobacco
and
other
unhealthy
products,
warning
that
weak
tax
systems
are
keeping
harmful
products
cheap
while
fuelling
obesity,
diabetes,
heart
disease,
cancers
and
other
non-communicable
diseases
(NCDs).
The
UN
health
agency
said
well-designed
excise
taxes
can
reduce
harmful
consumption
while
generating
much-needed
revenue
for
health
systems
under
growing
financial
pressure.
“Health
taxes
are
a
cost-effective
but
still
underutilised
tool
that
can
save
lives,
reduce
disease
and
mobilise
much-needed
domestic
resources
for
health,”
Community
Working
Group
on
Health
(CWGH)
executive
director
Itai
Rusike
told
CITE.
“At
a
time
when
official
development
assistance
is
declining,
countries
like
Zimbabwe
have
very
few
options
left
if
they
want
to
sustainably
finance
their
health
systems,”
he
added.
Rusike
said
several
countries
had
already
demonstrated
that
earmarked
health
taxes
can
deliver
both
public
health
and
economic
benefits.
“South
Africa
introduced
an
excise
tax
on
sugary
drinks
in
2018
and
reported
a
significant
reduction
in
purchases
of
taxed
beverages.
Botswana
followed
with
a
sugar
tax
in
2021,
while
Ghana
increased
tobacco
taxes
in
2023
and
earmarked
part
of
the
revenue
for
health,”
he
said.
Zimbabwe
has
also
taken
steps
towards
domestic
health
financing
through
mechanisms
such
as
the
AIDS
Levy,
the
Health
Levy
and,
more
recently,
the
Sugar
Tax.
The
sugar
tax,
officially
known
as
the
Special
Surtax
on
Sugar
Content,
was
introduced
in
2024
and
targets
sugar-sweetened
beverages
to
fund
cancer
diagnosis
and
treatment.
Initially
set
at
US$0.002
per
gramme
of
sugar,
the
tax
was
reduced
to
US$0.001
in
February
2024
following
objections
from
the
beverage
industry.
While
welcoming
the
policy
intent,
Rusike
raised
concerns
about
governance
and
transparency
in
the
use
of
the
revenue.
“The
sugar
tax
is
collected
by
ZIMRA
and
deposited
into
the
Consolidated
Revenue
Fund.
That
creates
a
real
risk
that
the
money
can
be
diverted
to
other
government
expenses
instead
of
cancer
services,”
he
said.
“To
protect
public
trust,
there
must
be
enabling
legislation
to
ring-fence
these
funds
so
that
every
dollar
goes
where
it
was
promised.”
He
added
that
stakeholders
were
increasingly
questioning
whether
money
raised
through
the
sugar
tax
was
being
used
efficiently
and
whether
communities
were
seeing
tangible
improvements
in
hospitals
and
clinics.
The
tax
has
also
had
ripple
effects
along
the
sugar
value
chain,
with
beverage
manufacturers
and
sugar
producers
reporting
declining
volumes
and
revenues.
However,
Rusike
said
the
broader
public
health
context
should
not
be
overlooked,
arguing
that
the
long-term
benefits
of
reduced
disease
burden
and
stronger
domestic
health
financing
outweighed
short-term
economic
adjustments.