MALGA demands 50% drug budget devolution, MK13bn for health infrastructure rehabilitation
Malawi Local Government Association (MALGA)—an umbrella body of all local authorities—has demanded that the central government should devolve 50% of the drug budget to local councils, saying the current 10 percent devolution is “meagre though it helped improve service delivery in health facilities overseen by councils”.
The 10% devolution means councils, for instance, got MK1.5 billion for drugs in the 2022/2023 financial year, which has increased to MK2 billion in the proposed 2023/2024 national budget, according to MALGA Executive Director Hadrod Zeru Mkandawire.
He made the sentiments in Lilongwe during a meeting with Members of Parliament (MPs) belonging to the local authorities and health, HIV and nutrition cluster for 2023/2024 budget.
Mkandawire said the MK2 billion increment is “nominal value and not real value” if devaluation and inflation are factored in.
“This is not much in terms of councils meeting the health facilities demands, more especially when the stock outs have arisen.
“We are, therefore, asking for a further devolution of the drug budget in terms of percentage both in nominal and real value.
“The way the 10% was used should be a yardstick and a template for the Central Government to devolve further,” he said.
Another pertinent issue, according to Mkandawire, is the devolution of funds meat for the rehabilitation of health facilities overseen by local authorities, pegged at MK13 billion in the 2023/2024 budget.
Mkandawire revealed that the government has, up to now, not devolved the amounts it allocated in the 2021/2022 and 2022/2023 financial years.
“We hope that this MK13 billion will really be devolved to local authorities. Otherwise all local health units—district hospitals, health centres and rural hospitals—are in sorry state, requiring immediate rehabilitation,” he said.
In his remarks, Co-chairperson for health, HIV and nutrition cluster, Matthews Ngwale, concurred with Mkandawire, citing an example of the Constituency Development Fund (CDF), which he noted was fully devolved and resulting in many development initiatives in communities.
Chief of WASH at UNICEF, Mougabe Koslengar, emphasized that “not devolving and investing in health, nutrition and WASH budgets could result in consequential implications on the general population”.
“Government must ensure that there is enough allocation for these sectors, which must be devolved and balanced in order to cater for all the needs, leading to efficient provision of services at the local level,” he said.
During the meeting, which was funded by UNICEF, all stakeholders agreed that fiscal devolution remains a big challenge on the part of the Central Government, more especially on the pretext that local authorities “do not have the capacity to handle huge flows of money”.
Otherwise, according to Mkandawire, councils have—through the World Bank funded Governance to Enable Service Delivery (GESD) project—proved their best performance in all aspects, including public finance management, “a template and architecture government can use to abandon its reluctant approach to fiscal devolution”.
In the 2023/2024 budget, K488 billion has been allocated towards local councils. The allocation, which includes MK19.3 billion CDF funds, will go towards recurrent and development budgets.