Mantoe Phakathi
MBABANE , Mar 16 2010 (IPS) – Her swollen feet are a constant reminder to Sanele Matsebula that she needs to take her medication.
Swaziland’s Finance Minister Majozi Sithole delivers his budget speech to parliament. Credit: Mantoe Phakathi/IPS
The 26-year-old HIV-positive mother of two says the swelling of her feet are side effects from the antiretroviral treatment (ART) she began two years ago.
I m always told that diclofenac (tablets for treating swollen feet) is out of stock at the hospital, she said.
Government provides Matsebula with free ARTs, but she has to buy the drugs for her swollen feet from the pharmacy.
Matsebula is unemployed and she cannot afford the six dollars the tablets cost every month. She has to wait until her elder sister gives her money to buy the drugs. And this is not a regular occurrence because her sister works as a domestic worker and does not make much money.
Drug shortages are one of the many serious challenges faced by the Kingdom s public health institutions. Insufficient staff especially in specialised fields poor medical facilities, and overcrowding in hospitals are some of the problems that characterise Swaziland s public health system, said the director of the Coordinating Assembly of Non-Governmental Organisations (CANGO), Emmanuel Ndlangamandla.
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As the Minister of Finance, Majozi Sithole, delivered his budget speech to parliament on Feb. 26, he called upon all ministries to reduce their budgets by 14 percent. But an exception was made for the ministries of health and education.
We are, however, emphasising that they (ministries of health and education) should strive to improve efficiency of use of their existing resources before they bid for more, said Sithole.
The country was forced to reduce this year s national expenditure by 14 percent, following the 62 percent decline in the Southern African Customs Union (SACU) revenue. More than 60 percent of the country s national revenue came from the SACU.
The ministry of health received 13.7 percent of the national budget of about 1.3 billion dollars, far less than the 15 percent stipulated in the Abuja Declaration of 2000. The Abuja Declaration is a pledge by African heads of state to spend at least 15 percent of their national budgets on health.
But this was an increase from last year s 10.5 percent. In fact, Swaziland has never been able to meet the universally-accepted standard of budgetary allocation for public health.
In a memorandum dated Dec. 31, Sithole told ministers that Swaziland has applied for budget support for the 2010/2011 financial year from the African Development Bank.
Swaziland used to receive 1.2 billion dollars from the SACU, this year the receipts fell to only 262 million dollars. Sithole said this year s budget deficit stands at 13 percent.
This calls for a concerted effort from all, both tax payers and recipients of government services to bring this situation under control. I will soon be presenting to cabinet a fiscal adjustment roadmap, which seeks to bring back the fiscal balance to sustainable levels, said Sithole.
Sithole said this year should be viewed as abnormal for Swaziland because it has been hit by the global economic crisis with revenue declining to unprecedented levels.
Ideally we could have asked for deeper cuts than the 14 percent, said Sithole. We asked for this minimum because we did not want to adversely affect government s development programmes.
The ministry of education, the only other department not affected by budget cuts, remained government s first priority and received 22.5 percent of the national budget, an improvement from last year s 20 percent.
The reduction of the SACU receipts comes at a time when the Kingdom is in the process of meeting its constitutional obligation of introducing Free Primary Education (FPE). This entails providing free education for grades one to two in 2010, and grades one, two and three in 2011. Government will spend about 108 million dollars.
With no end in sight to these economic problems, Sithole admitted that as an additional expenditure FPE is not sustainable. He maintained that this year s budget includes recommendations from all stakeholders including NGOs, the private sector and government.
Valuable contributions were made and these have helped shape the budget, said Sithole. CANGO s Ndlangamandla concurred with Sithole about government s consultation with the public.
Initially, government did not welcome our role, Ndlangamandla told IPS. However, over time we have seen government s positive consideration in some of the recommendations we made such as the increase in the health budget.
But government has fallen very short in meeting the food security needs of the nation. The government saw fit to award the ministry of agriculture only 4.9 percent of the national budget, in a country where two thirds of the total population of one million people live on less than a dollar a day,
African heads of state pledged in Maputo to spend at least 10 percent of their national budget on agriculture. Swaziland has so far failed in this regard.
But as a consolation to rural farmers who have no access to loans, they will receive assistance from an eight million dollar fund.
This is an amount we have obtained from the International Fund for Agricultural Development for implementation for a rural finance project, said Sithole. This project aims at facilitating access to financial services for the rural communities in the country.
As for Matsebula, whose problem is lack of access to drugs it seems as if something will be done about this. In his budget speech, Sithole acknowledged the problems in the procurement and distribution of drugs in the country.
It is for this reason that we have embarked on an extensive reform programme that looks at our procurement and distribution process of medical supplies, said Sithole.
But it is Matsebula who will confirm whether Sithole s words are translated into actions.
