Mozambique: Cholera outbreak declared again in Moma district
Maputo Central Hospital. [Photo. Jornal Domingo]
The health sector has long been regarded as the poor relative when it comes to the allocation of financial resources to meet its needs, especially operating and investment expenditure. (The so-called repressive sectors of the state continue to top – almost always, looking at the tendency – successive budget allocation.)
Since the beginning of last year (2020), the country has faced a lethal Covid-19 pandemic, which brought to light in starkly practical terms the disinvestment to which this key sector has been subjected.
This year, 2021, with a rapid increase in the number of positive coronavirus cases, the National Health System (SNS) has not had the best time. In practical terms, it is on the verge of collapse. In fact, health authorities are already considering adopting the so-called ‘catastrophe medicine’ protocol, which essentially consists of choosing who should live and who should die. In the private sector, there is no longer any hospital capacity at all.
By this Monday, health authorities had registered a total of 319 deaths from the disease. They had also notified 11,447 active cases, 224 inpatients and 21,011 persons who have recovered countrywide since the beginning of the outbreak.
So how much has this sector received since the onset of Covid-19 in the country?
In 2020, from the State Budget, before the rectification, the sector was allocated 26.7 billion meticais. Of the total, 24,663.3 million meticais corresponded to the internal component and the remaining 2,052.7 million to the external component.
Initially, the 2020 State Budget had a total expenditure of 445,381,800.31 thousand meticais. Operating expenses were estimated at 228,348,653.31 thousand meticais, investment expenses at 70,991,726.69 thousand and financial operations 46,041,420.00 thousand. The deficit was set at 109,791,513.90 thousand meticais.
To cope with the multiplier effects of the Covid-19 pandemic, the executive launched a plea for international support, estimating needs at US$700 million. The request was “promptly” granted by international partners, and by August 25, 2020, US$448,540,347.59 had already been disbursed.
From this “cake”, the Ministry of Health received US$79,540,347.59; US$43,894,897 in cash and US$35,645,450.98 indirectly. According to the Head of State’s report at the end of the State of Emergency, the amounts were applied to purchasing inputs for the treatment and prevention of Covid-19, including personal protection equipment (PPE) and payment for goods and services.
With regard to the (US$43.8 million) cash value, US$29.1 million was under the direct management of the Ministry of Health (MISAU) and the rest was made available through partner mechanisms for direct payments, namely the World Bank, Global Fund and GAVI.
Also according to the aforementioned report, of the US$448,540,347.59, the Ministry of Gender, Children and Social Action (MGCAS) received US$20,000,000.00, the National Investment Bank (BNI) US$15,000,000.00, and the Ministry of Economy and Finance (MEF) received US$98,389,982,10 to offset the loss of revenue in July and August due to the downward revision of gross domestic product (GDP).
In November 2020, the government submitted to the Assembly of the Republic a proposal to revise the State Budget for that economic year. The budgetary adjustment aimed at incorporating an additional 28.7 billion meticais in resources, of which approximately 5.4 billion meticais was sourced internally and 21.3 billion meticais externally.
Due to the adjustments made to the revenue and expenditure component, the budget deficit rose from the previous 109.7 billion meticais to 159.9 million meticais, and the health sector’s share of the cake increased by 33%, rising from the previous 26.7 billion meticais (before rectification) to 35.4 billion meticais.
For 2021, state expenditure is set at 368,595,063.58 thousand meticais. Of this, 238,290,489.10 thousand meticais corresponds to operating expenses; 83,782,049.56 to investment expenses; and 45,522,524.92 thousand meticais to financial operations. The budget deficit is estimated at 102,998,961.10 thousand meticais.
The allocation to the health sector stands at 37,415.0 million meticais, an increase of 5.6% on the previous financial year. Of the global amount, 30,614.7 million meticais comprises the internal component and 6,800.3 million refer the external.
Of the total amount (37,415.0 million meticais) allocated to the sector, 72% is allocated to operating expenses and the remaining 28% to support the item referring to investments.
By Ilodio Bata
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