• Medicine availability at public health facilities averaged just 47% in June 2026, below the Government’s 50% minimum target, prompting Treasury to mobilise US$10 million for urgent NatPharm procurement
• NatPharm wrote off approximately US$3 million in expired medicines during 2025, with internal assessments finding nearly 80% of those losses were preventable through better planning and systems
• Auditor-General findings across public hospitals revealed weak stock control, inaccurate inventory records, poor forecasting, delayed replenishment and critical pharmacy/laboratory vacancies that turn scarce health funding into stockouts and expiries

Harare- Medicine availability at Zimbabwe's public health facilities has averaged just 47% in June 2026, falling below Government's minimum stock target of 50%, according to figures presented to Parliament by Health and Child Care Permanent Secretary Aspect Maunganidze. Treasury has since mobilised US$10 million for urgent National Pharmaceutical Company (NatPharm) procurement contracts intended to raise availability above 55%, placing renewed attention on the efficiency of the supply chain responsible for delivering medicines to patients.

The 2025 Auditor-General's Report on State-Owned Enterprises and Parastatals exposes weaknesses extending beyond insufficient procurement funding. NatPharm wrote off approximately US$3 million in expired medicines during 2025, with internal assessments attributing nearly 80% of the expiries to preventable failures in systems and planning. Its performance under the vital, essential and non-essential medicines classification stood at approximately 65%, below the minimum benchmark of 70%. These findings raise questions about how effectively public health resources are managed after procurement.

The figures expose failures at both ends of the medicine supply chain. The national availability rate measures the proportion of required medicines accessible at public facilities, while the expired stock represents medical supplies whose economic and clinical value was lost before treatment could be administered. Together, they establish that improving healthcare access requires stronger control over the medicines Government has already financed.

For patients, the consequences become immediate at the pharmacy counter. A patient receiving treatment for a chronic condition at Parirenyatwa Group of Hospitals, who requested anonymity because of the sensitivity of their medical circumstances, described how medicine shortages transfer treatment costs from public facilities to households.

"The doctor attended to me at the hospital, but some of the medicines were not available," the patient said. "I had to go outside and buy from a private pharmacy, and that is where the cost becomes difficult."

The resulting financial pressure can force households to purchase only part of a prescribed course of treatment, leaving patients to make decisions based on affordability rather than medical need.

"Sometimes you do not buy everything at once because you do not have enough money," the patient said. "You buy what you can afford first and hope to get the rest later."

For patients requiring continuous medication, interrupted or incomplete treatment can undermine adherence and increase the risk of complications, potentially creating greater healthcare costs through avoidable deterioration and subsequent hospital visits.

Doctor Dickson Chapendana, a medical doctor at Sally Mugabe Central Hospital, linked reliable medicine supply directly to household expenditure and treatment continuity. "Reliable supply of essential medicines in public facilities would reduce the financial burden on households and improve treatment adherence," Chapendana told Equity Axis.

The Auditor-General's report identifies deficiencies within hospital inventory systems that help explain how medicine shortages can persist despite procurement expenditure. At Sally Mugabe Central Hospital, the institution reported ZWL875.6 million in inventory at the end of 2023, but auditors could not obtain sufficient evidence to confirm the balance's accuracy and completeness. Some inventory purchases lacked supporting invoices, physical quantities differed from stock records, certain items existed physically but carried nil values in the accounts, and donated medicines and equipment were similarly recorded without assigned values.

The wider audit identified ineffective stock controls, inadequate demand forecasting and the absence of real-time inventory tracking in public hospitals. At Sally Mugabe, these weaknesses were associated with recurring shortages of essential medicines and equipment alongside stock that expired before being administered. The findings expose deficiencies in the information needed to match procurement decisions with actual patient demand.

Effective medicine management depends on accurate records of stock quantities, storage locations, consumption rates and expiry dates. Hospitals require this information to determine when replenishment is necessary and whether supplies approaching expiry should be redistributed to facilities with higher demand. Without reliable inventory visibility, managers face difficulty distinguishing genuine shortages from stock that is available elsewhere within the health system.

Weak information systems can consequently result in unnecessary procurement, delayed replenishment and medicine remaining unused until its expiry date. Each outcome reduces the treatment value obtained from available funding, while placing additional pressure on already constrained hospital budgets.

NatPharm serves as Zimbabwe's central medical stores company, responsible for procuring, storing and distributing medicines and medical supplies to more than 1,800 public health institutions. Its board and management appeared before Parliament's Portfolio Committee on Health and Child Care in May 2026 to address procurement, distribution, financial performance and weaknesses affecting the national medicine supply chain.

Equity Axis attempted to contact NatPharm by telephone for comment on the US$3 million in expired stock, the reported preventability of those losses and deficiencies identified in medicine distribution. The calls went unanswered before publication, leaving the company's explanation of the findings and subsequent corrective measures unavailable.

The expiry losses demonstrate why medicine procurement cannot be measured solely by quantities delivered to NatPharm warehouses. Supplies must reach facilities where patients need them while remaining clinically usable. Medicine stored at a central depot contributes little to treatment availability in Chiredzi, Gokwe, Binga or Mutare if distribution delays prevent it from reaching those facilities before expiry. National procurement performance must therefore be assessed against the quantity of usable stock ultimately delivered and dispensed.

Findings from United Bulawayo Hospitals expose another source of weakness within the distribution system. During 2024, the institution experienced persistent shortages of medical supplies, while auditors identified inadequate inventory controls, inconsistent medicine labelling, difficulties separating stock approaching expiry and weaknesses at inventory exit points. Replenishment was further affected by prolonged vacancies in critical positions, including the head of pharmacy and laboratory scientists.

These vacancies carry operational consequences because medicine availability depends on specialised staff who forecast demand, monitor expiry dates, rotate stock, dispense prescriptions and reconcile physical inventories. Laboratories also require personnel capable of managing reagents and diagnostic supplies. Digital tracking systems can improve oversight, but their effectiveness depends on trained employees maintaining accurate records and responding promptly to emerging shortages.

The staffing challenge extends into Zimbabwe's broader hospital rehabilitation programme, where renovated infrastructure and new medical equipment require sufficient skilled personnel to operate effectively. A healthcare worker at Parirenyatwa Group of Hospitals, who requested anonymity, said regional wage competitiveness was important for retaining experienced staff and maintaining uninterrupted services.

"Competitive salaries, comparable to those in the region, are essential to retain skilled staff and reduce the risk of strikes that disrupt services," the healthcare worker said.

NatPharm's US$3 million expiry write-off has direct implications for healthcare financing. Resources had already been committed to acquiring medicines, but the stock lost its usable value before reaching patients. The reported preventability of nearly 80% of the expiries makes inventory management a material financial-control issue, with avoidable wastage reducing the effective purchasing power of public health expenditure.

Reducing preventable expiry would allow a greater proportion of available funding to translate into medical treatment. It would also improve the return on Government and donor-financed procurement by limiting the need to replace medicines already purchased but never dispensed.

The Auditor-General recommended stronger inventory controls, digitalisation and improved staff capacity after identifying weaknesses in hospital stock management. These measures address the operational failures responsible for inaccurate records, delayed replenishment and inadequate monitoring of medicine approaching expiry.

An effective national inventory system should connect NatPharm's central warehouses with individual hospital pharmacies, allowing managers to track each batch's quantity, location, consumption rate and expiry date. Early warnings should enable redistribution before stock becomes unusable, while facility-level consumption records should guide future procurement decisions. Access to reliable information would also help prevent unnecessary emergency purchases when suitable supplies are available elsewhere.

The system must distinguish between shortages caused by insufficient national procurement, delayed distribution, inaccurate facility records, unexpectedly high consumption and ineffective redistribution. Identifying the underlying cause is necessary to determine whether the appropriate response is additional funding, improved logistics, corrected inventory records or changes in procurement planning.

The Auditor-General's reporting cycle introduces another accountability challenge. The Sally Mugabe Central Hospital findings contained in the 2025 report relate to inventory recorded in 2023, while those concerning United Bulawayo Hospitals relate to 2024. Given that medicines can expire within months, weaknesses identified through delayed audit reporting may only become publicly visible after opportunities to prevent the associated losses have passed.

Hospital administrators consequently require more immediate operational information than annual statutory audits can provide. Auditors can establish whether inventory controls functioned effectively during a reporting period, but decisions about replenishment, stock redistribution and expiry prevention must be taken while the medicines remain usable. Continuous monitoring is therefore necessary to prevent losses before they materialise.

Zimbabwe's next medicine procurement intervention should be accompanied by a patient-facing performance framework. Alongside national medicine availability, authorities should publish facility-level stock availability, NatPharm delivery completion rates, expired stock as a proportion of medicines received, emergency procurement volumes, pharmacy and laboratory vacancies, and the percentage of prescriptions filled completely. These indicators would allow Parliament and the public to assess whether additional financing is improving treatment access.

The medicine supply chain connects Treasury funding, procurement decisions, central warehousing, transportation, hospital inventory management and pharmacy dispensing. Weaknesses at any stage can prevent available resources from producing the intended clinical benefit. The Auditor-General's findings establish deficiencies within that system, while the patient's experience at Parirenyatwa demonstrates how medicine shortages can shift costs directly onto households.

Increasing healthcare expenditure and purchasing additional medicines remain important, particularly where national stock is insufficient. However, the value of that expenditure depends on whether existing supplies are accurately recorded, distributed according to demand and administered before expiry. The US$10 million procurement intervention will therefore require effective inventory and distribution controls to produce sustained improvements in availability.

With medicine availability at 47% and approximately US$3 million in stock written off, the most consequential measure of progress is how much publicly financed medicine reaches patients while it remains usable. Zimbabwe's healthcare financing challenge extends to protecting the value of medicines already purchased, ensuring that scarce resources fulfil their intended purpose: delivering treatment to the people who need it.

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