A new Transparency International Zimbabwe (TIZ) report has exposed persistent procurement failures and financial inefficiencies crippling Zimbabwe’s public health sector warning that weak governance and opaque tendering continue to drain vital resources from hospitals and clinics.
The Trend Analysis Report on Procurement Performance in Zimbabwe’s Health Sector (2020–2024) released by TIZ this week paints a disturbing picture of systemic mismanagement, under-spending and corruption risks that have plagued the Ministry of Health for five consecutive years.
TIZ’s analysis, drawn from Auditor General data, shows that the Ministry of Health consistently failed to spend its full budget allocation.
Between 2020 and 2024, under-spending rates ranged from 10% to over 22% with the worst recorded in 2021 (22.8%) and 2024 (21.4%).
Despite significant increases in overall allocations much of the funding never reached frontline health services.
“Zimbabwe’s health sector is suffering not from lack of money, but from weak financial management and accountability. Billions in allocated funds remain idle while hospitals struggle with drug shortages, broken equipment and stalled projects,” TIZ said.
The watchdog reported that between 2020 and 2022, the Ministry conducted major procurements without the approval of the Procurement Regulatory Authority of Zimbabwe (PRAZ).
Although compliance improved to 73% in 2024, TIZ warned that the progress was largely on paper with ongoing delays, inflated contracts and incomplete documentation undermining real accountability.
“This is compliance by form, not by function. Procurement rules are being followed in appearance, but operational integrity remains weak,” the report states.
TIZ highlighted repeated supplier failures, including undelivered medicines, overpricing, and non-completion of major projects.
In 2021, Greenwood Pharmacy was paid for drugs that were never delivered to Gwanda Hospital.
In 2022, the government procured 16.95 million COVID-19 vaccine doses but received only 16.2 million.
Meanwhile, Lupane Provincial Hospital, under construction since 2003 remains unfinished despite years of budget allocations.
“These incidents reveal a culture of impunity among contractors and weak enforcement by authorities,” TIZ observed.
The report described the Ministry’s record management as in disarray noting missing invoices, destroyed stock cards and incomplete delivery records across multiple facilities.
This failure, TIZ said, has become the single most persistent governance problem in the health sector, creating fertile ground for corruption and waste.
Audit opinions for the Ministry of Health remained qualified in 2020–2021 and adverse from 2022 onwards indicating a continuous decline in financial accountability.
Institutions such as the Government Analyst Laboratory, Harare Dental Centre and Gweru Hospital were repeatedly cited for poor internal controls and unsupported expenditures.
TIZ urged the government to adopt a more transparent and digitised procurement system, improve professional capacity within the Ministry and prioritise completion of long-stalled infrastructure projects.
“Procurement failures are costing lives. Zimbabwe cannot achieve universal health coverage while its procurement system remains a black hole of inefficiency and weak oversight,” the organisation warned.
The watchdog also called for independent monitoring of public health contracts, stronger enforcement of the Public Procurement and Disposal of Public Assets Act and publication of all major tenders to enhance transparency.
