Minister Atupele Muluzi on meeting the health needs of Malawi

His Excellency, President Prof Arthur Peter Mutharika has honoured me with a new role in the recent changes to his Cabinet, that of Minister for Health and Population. This is a great responsibility, one that both challenges and excites me at the same time.

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The Health sector in Malawi remains one of the most important but also one of the neediest sectors of our economy. The greatest asset we have in Malawi is our people and we need to invest more in ourselves to ensure a healthy, productive citizenry that will in turn increase the growth of our economy in the short, medium and long term.

Health is clearly one of the most important issues across Malawi, and it is important to note that our Government has made significant progress in recent years, but there is still much to do. The recent launch of the National Community Health Strategy, which follows the revised Health Sector Strategic Plan (HSSP II) for 2017-22, offers a strong blueprint for the future.

However, the objectives that have been articulated in these comprehensive documents will be challenging to deliver within our current fiscus. The health sector has received almost 12% of the national budget, and we continue to receive significant support from our many international development, NGO and CSO partners. This though, is not enough to cover the true cost of supporting the health needs of our people, particularly as our population continues to grow at such a rapid pace.

Our needs are significant and our public purse is narrow meaning that we need to find ways to do more with what we already have. This means in the short term living within our means and exploring new ways to generate extra finance for the implementation of activities within the health sector in the long term.

We therefore need to work ever more closely with our development partners and all other organisations working within the healthcare sector to ensure that we are maximising the value of their generous investment. We want to ensure that we continue to build the trust of our partners and we intend to do that through hard work and clear governance ensuring we make as much as we can of what we currently have.

A recent independent study of our health sector gauged that up to 30% of our drugs are being stolen before they even reach the hands of health care professionals. Often these drugs are then sold back to health centres illegally. Unfortunately, our stock control systems and information management systems are not sufficiently sophisticated to recognise this corrupt crime.

The problem gets worse as the criminals do not appreciate the importance of storing the drugs in the correct conditions. The outcome is that they are selling a product that is at best ineffective and at worst potentially dangerous for consumption. This is causing a significant cost to the health sector and one that directly impacts the lives of people across the country.

The ministry recently established the Drug Theft Investigation Unit, which has proven to be highly effective. However, it is limited by resources meaning we also need the help of the people of Malawi to tackle this crime. We are also looking at ways to enhance the unit’s investigative, auditing, prosecution and enforcement capacities. We will also work harder to coordinate with the Police and the Ministry of Justice to more effectively prosecute the criminals.

We therefore need to work much harder to enhance transparency and accountability as well as tighten the control of the drugs supply chain from supplier to patient. We need to better manage public, donor or charity investment using modern procurement systems and technologies.

The delivery of effective healthcare needs qualified, motivated professionals. Our doctors, nurses, clinicians, pharmacists, technicians and many others should be commended for all their excellent hard work despite the sometimes less than optimum working environment. Our health service has also invested a great deal of money in training staff that we cannot currently persuade all to stay and serve in our hospitals and health centres. Some have migrated to other countries where they can earn more and work in better conditions.

It is estimated that over the last 10 years we have trained upwards of 700 doctors, yet today only 284 doctors are currently employed in Malawi. Salaries do not reflect the commitment and skill required to work in our healthcare system. This is something we believe must change across the full range of the medical profession such that we have people motivated and committed to looking after our sick and vulnerable.

The gap in our funding, and finding adequate resources will be a challenge. As such we will need to think differently about how we incentivise our health care providers in our health service. There is also a need for us to think differently about how we offer free health care services to those people who need it most, whilst at the same time ensuring that the service is of a quality standard.

Finally, we need to improve the connection between citizens and the Ministry. We all have a stake in our national healthcare and as such we must have a stronger dialogue on the issues. Women are generally the carers in our communities and often have the best understanding of the small improvements that can be made to effect real change. There is a need therefore to establish a forum that can harness this understanding and integrate it into our policies and delivery strategies. Furthermore the Ministry is in the process of formulating a customer service charter that seeks to improve service delivery across the health sector.

Our initial core set of four “building blocks/levers for change” have been identified and that which we would like to see implemented by our Ministry team over the coming months:

• Review how we are using our resources such that we learn to do more with what we already have.

• Reduce the levels of theft and corruption of our medical drugs

• Identify ways to increasing and retaining the staff within our health system

• Establish citizen engagement to improve the accessibility and oversight of healthcare services

I conclude with the assertion that in my new role as Minister of Health, I have the privilege to work with an excellent and dedicated team of people who have chosen a vocation as a career, to care for our sick, infirm and vulnerable. We will of course do our upmost best to consolidate the excellent work that has already been achieved while also identifying ways to further improve the services for Malawians across our country and the future of our people.

The priorities outlined may take time to realise their full impact, but where possible we will expedite actions to achieve the changes we need in our healthcare services. We will be organising various forums so my team and I can engage with both healthcare workers and you the public across the country to discuss these issues further.

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