Bad Politics, Corruption and Decaying Sanitation Standards Could Hinder Zimbabwe’s Fight To End Neglected Tropical Diseases-Report

ZIMBABWE’s goal of eliminating and reducing its rates of both schistosomiasis and soil-transmitted helminthiasis (STH) by the year 2030 could be jeopardised by the country’s toxic political environment, decaying water and sanitation standards and decreased access to basic hygiene.

By Michael Gwarisa

This was revealed in a report by The Economist Intelligence Unit (The EIU)  which is the research and analysis division of The Economist Group, the sister company to The Economist newspaper through sponsorship from The End Fund. The report is titled Breaking The Cycle Of Neglect: Reducing The Economic And Societal Burden Of Parasitic Worms In Sub-Saharan Africa.

According to the report, “Zimbabwe’s development over the past two decades has been defined by political turmoil coupled with dramatic climate change. Corruption and mismanagement of government resources has seriously impacted the economy, as well as the once-thriving health system. This has been compounded by a prolonged drought, which has limited the ability of farmers to grow crops commercially.

As the agriculture sector employs nearly two-thirds of the workforce, this has slowed economic recovery. The amount of people in extreme poverty in the country rose by nearly 1m from 2018 to 2019, with the prices of basic commodities rising sharply. Health-sector funding has been cut in recent years, leaving the nation struggling to meet the most basic health and social needs of its citizens. Zimbabwe’s health expenditure as a percent of GDP is approximately 6.6%, which surpasses the sub-Saharan Africa average of 5.2%,” said the report.

The report added that government would need to continue investing in the health system, as international organisations and foreign governments have been reluctant to invest in Zimbabwe for decades.

“The dire economic conditions in Zimbabwe have left a gap in access to healthcare whereby neither households nor the government can afford to fund health services adequately. Despite its challenging social and economic context, Zimbabwe has achieved progress in reducing the percentage of the population practising open defaecation, from 30% in 2000 to 25% in 2017.

“However, the percentage of the population with access to at least basic sanitation7 has also fallen, dropping from 46% in 2000 to 36% in 2017. This reflects in part the lack of investment and capacity in the sanitation sector as a result of Zimbabwe’s economic plight. This reduction in access to objectives to improve population health as well as move towards Sustainable Development Goal 3.”

Meanwhile, as for Soil-transmitted helminthiasis (STH) and schistosomiasis management in Zimbabwe, there has been steady progress but an uncertain future Four NTDs that are treatable through preventive chemotherapy are known to be endemic in Zimbabwe: schistosomiasis, STH, lymphatic filariasis and trachoma.
“The status of other NTDs is unclear, as mapping has not been completed for all NTDs. The 2009-2013 National Health Strategy noted that progress on schistosomiasis had been slow owing to drug costs and more deadly diseases and natural disasters taking priority.

“This was despite schistosomiasis increasing in prevalence and being one of the top-ten causes of hospital consultations in Zimbabwe at the time. The strategy mandated a national survey of schistosomiasis as one of its top-ten areas of focus, highlighting the government’s interest in understanding the distribution and burden of the disease.”

The report however added that  government has successfully been able to allocate funding for NTDs through providing salaries for essential community health workers who are able to carry out control and elimination strategies.
“These workers make it possible to complete activities such as MDA and surveillance. The increasing focus on NTDs was reflected in the National Health Strategy 2016-20, which included reduction in morbidity due to schistosomiasis and STH and other NTDs by 50% by 2020 as one of its objectives. There are signs that this goal could be achieved.Zimbabwe’s rates of STH have fallen by almost a third since 2000, with 12.7% (1.8m) of the population affected in 2017.17 Its rate is the second lowest among our four countries. Zimbabwe’s progress against schistosomiasis has been greater.
“It has the highest coverage of preventive chemotherapy against schistosomiasis among our countries (64.5% nationally) and prevalence rates have fallen by almost two-thirds since 2000. About 5.2% (0.6m) of the population were affected in 2017, the lowest rate of any of our countries.
“The reduction in rates is likely to also be in part down to the prolonged drought, which has reduced survival among the water snails which are needed for the schistosome life cycle.18Zimbabwe’s progress towards elimination could be at risk. While coverage of preventive chemotherapy treatment (PCT) had been increasing (nearly 5m treatments for NTDs were distributed in 2017), the latest WHO estimates indicate that Zimbabwe did not administer any PCT for schistosomiasis or STH in 2018.”
Access Full Report Here

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