• Zimbabwe’s Gamble: Can new taxes fund care?
• Health Divide: Will NHI reach every Zimbabwean?
• Private Power: Partnership or profit over patients?

Harare- In a country where a visit to the doctor can still mean a choice between healing and hunger, Zimbabwe’s plan to launch its National Health Insurance (NHI) in June 2026 represents more than a policy milestone. It is a test of moral and economic imagination.

After decades of donor reliance and fragmented service delivery, the Ministry of Health and Child Care now promises a scheme that could transform access to care for the 87 percent of citizens without medical aid. Minister Dr. Douglas Mombeshora has called it “the next frontier in Universal Health Coverage,” assuring that under the NHI, citizens will no longer have to pay out-of-pocket for consultations, tests, or surgeries.

If successful, the reform could mark the beginning of a new social contract, where health becomes a public right, not a privilege purchased through income.

A Long Road to a National Promise

For years, the idea of national health insurance was trapped between policy drafts and political hesitation. Meanwhile, families were financing illness through debt, donations, or despair. Only about 13 percent of Zimbabweans, mostly in the formal sector, enjoy private health insurance. The remaining millions pay cash, or go without.

Now, the government says the financing model will pool funds from earmarked taxes, including levies on sugar and airtime, which will be “ring-fenced” specifically for healthcare. It’s a departure from the old Treasury-absorbed health budgets, often diluted by competing fiscal pressures.

This comes at a time when international aid for health has begun to taper off, exposing the fragility of a system once sustained by global generosity. Dr. Aspect Maunganidze, the Health Secretary, recently warned that the reduction of U.S. and Global Fund support for HIV, TB, and malaria programs has left a “funding crater,” urging Zimbabwe to see health funding as an investment, not a cost.

Beyond the Numbers: A Human Imperative

At the heart of this reform are human faces, nurses in under-resourced clinics, mothers who lose newborns due to transport delays, and informal traders who skip medication to feed their children.

While Zimbabwe’s maternal mortality has dropped sharply, from 651 deaths per 100 000 live births in 2015 to 212 in 2024, neonatal deaths have risen to a record 37 per 1 000 births, a painful reminder that progress can coexist with tragedy. Life expectancy, too, has improved modestly to 64.4 years, but behind these averages lie communities still struggling for the basics: electricity, clean water, and consistent medical supplies.

The NHI is therefore more than fiscal reform. It is about restoring trust in public institutions, proving that a national fund can deliver equity where markets failed and where foreign aid proved temporary.

Private Players: Partners or Predators?

However, the reform will unfold in a space long dominated by private medical aid societies. They have infrastructure, networks, and experience, but they also have incentives that don’t always align with universal coverage.

For private players, NHI could mean new opportunities: contracting as providers, administering claims, or supplying technology. But it also means stricter oversight and limits on profit margins. Without clear regulation, private participation could deepen inequality ,“cream-skimming” the wealthy while leaving the poor to a thin public package.

The balance must be deliberate: partnership without capture, efficiency without exclusion.

The Missing Framework

Zimbabwe still lacks a comprehensive legal and institutional framework for Universal Health Coverage. The coming National Health Insurance Bill, now in its final drafting stage before Parliament, is expected to set that foundation, establishing the NHI Fund, contribution structures, and governance mechanisms.

Experts argue that without transparent oversight, the fund could fall prey to the same fiscal leakages that have haunted other social programs. To succeed, it must be insulated from political expediency and run with the professionalism of a financial institution, not the bureaucracy of a ministry.

There are also questions about readiness. Many rural facilities lack diagnostic equipment, power, or trained staff. Introducing an insurance card won’t change outcomes unless supply-side investment comes first.

A System Reborn, If Done Right

If executed with integrity, Zimbabwe’s NHI could be the defining reform of the decade, a social and economic equalizer that revitalizes public confidence.

Economically, it would reduce catastrophic health expenditure, freeing household income for education and food. It would create demand for local pharmaceutical and diagnostic industries, and possibly catalyse impact investment into health infrastructure. Socially, it would signal a commitment to equity, a state finally rediscovering its duty of care.

The coming National Development Strategy 2 (NDS2), expected in November 2025, is likely to codify this ambition. If NHI becomes its flagship pillar, Zimbabwe could position health as both a human right and an economic growth driver, joining nations like Rwanda and Ghana that have demonstrated the multiplier effects of universal coverage.

The Crossroads Moment

Standing before journalists at the Zimbabwe Medical Association Congress, Dr. Mombeshora summed up the government’s challenge in a single phrase:

“We must ensure no Zimbabwean is denied care because they are poor.”

The simplicity of that statement hides a monumental complexity, building a system that is affordable, trusted, and efficient.

To achieve this, the state will need partners, private innovators, civil society, and communities themselves. It will need transparency that rebuilds confidence and accountability that endures beyond administrations.

As the clock ticks toward June 2026, Zimbabwe’s NHI is not just a health story. It is an economic reform, a social justice project, and a moral test of what it means to govern in solidarity with one’s people.

Conclusion: A National Test of Faith and Foresight

The story of Zimbabwe’s National Health Insurance is ultimately one of belief, that a nation can rebuild its health system through shared responsibility and vision. If the reform succeeds, it will heal more than the bodies of its people; it will restore trust in public institutions and rekindle confidence in the promise of universal care.

And perhaps one day soon, a mother in Mberengwa or a worker in Epworth will walk into a clinic, present an NHI card, and receive treatment without first being asked to pay. That quiet moment, when access replaces anxiety, will mark the true transformation of Zimbabwe’s healthcare system.

Equity Axis News