• Six SADC countries are establishing a technical committee to explore pooled procurement of medicines and health commodities
• Zimbabwe’s US$10 million local-medicine procurement drive comes amid US$3.1 million in expired NatPharm stock identified by the Auditor-General
• Regional procurement could expand the market for Zimbabwean pharmaceutical manufacturers while exposing weaknesses in domestic medicine distribution

Harare- Zimbabwe is joining a six-country SADC initiative to explore pooled procurement of medicines and health commodities, opening a new route for the country to increase purchasing power and potentially deepen regional pharmaceutical production. The development comes while Zimbabwe's own public medicine system continues to face shortages, weak inventory controls and losses from medicines expiring before they reach patients.

Health and Child Care Minister Douglas Mombeshora convened a meeting with ministers and representatives from six SADC member states on the margins of the 76th WHO Regional Committee for Africa meeting in Addis Ababa, where the countries agreed to establish a technical committee to explore a Regional Medicines and Health Commodities Pooled Procurement Initiative. Cabinet approved the report on Zimbabwe's participation at the meeting at its latest sitting.

The initiative puts Zimbabwe into a regional procurement conversation at precisely the point when the domestic system needs greater purchasing efficiency and more reliable medicine availability. Cabinet said the WHO meeting also reinforced sustainable domestic financing, resilient health systems and stronger African capacity to produce essential medicines and health technologies.

The importance of the regional initiative becomes clearer when placed against the condition of Zimbabwe's existing supply chain. The latest Auditor-General's report on State-Owned Enterprises and Parastatals found that NatPharm wrote off approximately US$3.1 million in expired medicines during 2025, with the audit identifying weaknesses in the systems used to monitor expiry dates. The finding sits alongside wider concerns over inventory management within public health facilities.

The result is a health-financing problem that begins long before a patient reaches a hospital pharmacy. Government can allocate money to procure medicines, NatPharm can purchase and warehouse them, and hospitals can place orders, yet the expenditure does not become effective healthcare if medicines expire in storage or fail to reach facilities with demand.

This makes the latest Cabinet decision more consequential than a routine regional cooperation agreement. Zimbabwe is trying to solve a procurement problem at regional level while its audit record shows that part of the domestic problem lies in how medicines are managed after they have been purchased.

That distinction needs to shape the country's next phase of health reform. The Auditor-General's findings show that NatPharm's financial statements received an unqualified audit opinion, while operational weaknesses in inventory management were still identified. The two findings address different questions. The financial audit establishes whether the accounts fairly present the company's financial position. The operational observations examine whether systems are working effectively to protect public resources and support service delivery.

At NatPharm, the audit found that there were no documented processes for systematically identifying and monitoring expiry dates. The resulting US$3.1 million write-off represents medicine that had already consumed public resources but had lost its usable value before reaching patients.

The problem does not stop at the national warehouse. The Auditor-General also identified inventory-control weaknesses at United Bulawayo Hospitals, including inconsistent labelling and difficulties separating near-expiry stock. Prolonged vacancies in specialist positions, including the head of pharmacy, were also identified in the audit findings. These weaknesses create additional points at which medicines can be delayed, misplaced or allowed to expire.

The latest evidence on availability makes the problem harder to dismiss as an administrative issue. Medicine availability at public health facilities averaged 47% in June 2026, below Government's 50% minimum target, while Treasury mobilised US$10 million for urgent NatPharm procurement.

Zimbabwe therefore faces two related pressures. It needs more medicines entering the system, while it also needs to ensure that medicines already procured are converted into usable stock at health facilities.

That is where pooled procurement can become important. SADC has been developing a regional pooled procurement system designed to aggregate demand across participating countries. The regional body has said group contracting could strengthen bargaining power, improve medicine availability and create a larger and more predictable market for pharmaceutical manufacturers. SADC has previously estimated that collective procurement could generate savings of up to 40%, although the actual benefit to Zimbabwe will depend on the products covered, participating countries, tender outcomes and implementation.

For Zimbabwe, the potential value extends beyond obtaining medicines at lower prices. A larger SADC market could change the economics of domestic pharmaceutical production. Zimbabwean manufacturers currently operate within a relatively small national market, while pharmaceutical production requires investment in plant, quality systems, regulatory compliance, raw materials and working capital. A regional procurement mechanism can potentially give manufacturers access to larger tender volumes and more predictable demand.

That opportunity fits with a parallel domestic policy initiative. Government has committed US$10 million through NatPharm to procure medicines from local pharmaceutical manufacturers, with the stated objective of strengthening domestic production and creating a sustainable market for local companies.

The combination of domestic procurement support and regional demand could give Zimbabwean manufacturers a larger platform from which to expand. The industrial benefit, however, will depend on whether local producers can meet the quality, price, volume and regulatory requirements of regional tenders.

This is where Zimbabwe's health strategy intersects with industrial policy. The country has spent considerable foreign currency importing medicines and medical supplies, while domestic manufacturers operate with capacity that is not fully utilised across all product categories. Expanding local production can retain part of the health procurement bill within Zimbabwe, support manufacturing employment and create opportunities for exports.

But Government cannot treat local production as an end in itself. A locally manufactured medicine still has to reach the patient at the right time and at a competitive cost.

The Auditor-General's findings therefore provide an important counterweight to the industrial strategy. Increasing domestic production without fixing inventory management would enlarge the volume entering a supply chain that already has documented weaknesses. The policy needs to address production and distribution together.

The first measurable test is medicine availability. The second is wastage. If Government increases procurement while expired-stock write-offs remain high, additional expenditure will not produce a proportionate increase in treatment availability. The US$3.1 million NatPharm write-off therefore provides a baseline against which improvements in inventory management can be measured.

The third is the cost of procurement. Pooled buying should produce transparent evidence on whether Zimbabwe obtains lower prices for medicines purchased through regional mechanisms than through fragmented national procurement.

The fourth is domestic production. Government can track the value of medicines purchased from Zimbabwean manufacturers, the number of locally produced medicine lines, factory capacity utilisation and the share of public procurement supplied domestically.

These metrics would turn the health strategy into something that can be tested rather than assessed through allocations and announcements.

The latest Cabinet briefing provides the regional policy direction. The Auditor-General provides evidence of the domestic weaknesses that the policy needs to overcome.

The two developments also expose a financing issue. NatPharm's ability to maintain medicine stocks depends partly on the financial position of the institutions buying from it. Recent reporting found public hospitals and health institutions in Matabeleland owed NatPharm almost US$2.7 million, while NatPharm officials told Parliament that around US$47 million was required in 2026 for essential medicines covering areas including non-communicable diseases, maternal and child healthcare, sexually transmitted infections and surgical supplies.

That creates a circular financing problem. Hospitals need medicines to provide services, NatPharm needs cash to replenish stocks, and Government needs the health financing system to ensure that allocations ultimately reach the institutions responsible for procurement.

Pooled procurement can reduce the purchase price of medicines, but it cannot by itself solve arrears between public institutions, weak inventory management or inadequate funding.

The regional initiative therefore needs to be accompanied by stronger domestic systems. Digital inventory management would be one practical intervention. NatPharm and public hospitals need real-time visibility of quantities, consumption rates, batch numbers and expiry dates. Slow-moving products can then be redirected to facilities with higher demand before they expire, while procurement can be based more closely on actual consumption.

The Auditor-General's finding on expiry monitoring makes this particularly relevant. The problem identified is not simply that medicines expired. It is that the system lacked documented processes capable of systematically identifying and managing expiry risk.

That is a process problem with a financial consequence, and also a patient problem. A medicine sitting in a warehouse that expires is unavailable to the patient who needs it. A medicine ordered by a hospital but delayed because of unpaid invoices produces the same outcome at the point of care. The financial accounting differs, but the patient experiences a stock-out.

This is why the new regional procurement initiative should not be measured only by the price Government pays for medicines. The more important measure is the cost per medicine successfully delivered and dispensed. That calculation incorporates procurement price, freight, warehousing, wastage, financing costs and distribution. A cheaper tender that produces large stockpiles of slow-moving medicines can generate a poorer outcome than a slightly more expensive procurement system that matches supply closely to consumption.

Zimbabwe therefore has an opportunity to use the SADC initiative to redesign the supply chain rather than simply negotiate another procurement contract.

The regional system can aggregate demand. Domestic manufacturers can increase supply. NatPharm can improve inventory management. Hospitals can strengthen consumption reporting and stock controls. Government can improve payment flows. Together, these measures address different points in the same chain.

The health sector's wider transformation agenda makes this particularly important. Cabinet's latest report on the WHO meeting places universal health coverage, health financing, workforce development, health security and local manufacturing within the same regional policy discussion.

Zimbabwe's National Health Strategy 2026–2030 is operating within that broader framework. The Government has reported progress in health financing, medicine availability, infrastructure and health-worker vacancies, while specialist shortages remain an issue.

The next stage needs stronger operational measurement. Government should be able to show whether the proportion of essential medicines available at public facilities is rising, whether stock-out periods are shortening, whether expired medicines are falling and whether more procurement expenditure is reaching domestic manufacturers.

The regional procurement initiative creates an additional opportunity to measure whether Zimbabwe is obtaining better prices and more reliable supply through collective purchasing.

Those are the numbers that will determine whether the policy has changed the health system.

The significance of the latest Cabinet briefing therefore lies in the timing. Zimbabwe is attempting to enlarge its purchasing power through SADC at the same moment that domestic audit evidence is exposing weaknesses in the management of medicines already purchased.

The policy challenge is to make those two developments work together. Regional procurement can bring scale. Domestic manufacturing can bring production capacity. Better NatPharm and hospital systems can protect the value of what is purchased. The final test remains the same: whether a medicine paid for by Government reaches the patient before its clinical and financial value is lost.

That gives Zimbabwe a measurable health-transformation agenda for the next phase: lower procurement costs, higher medicine availability, fewer stock-out days, fewer expiries, stronger domestic manufacturing and a larger share of regional medicine demand supplied from within Africa.

Those outcomes would provide a far more meaningful measure of health-system reform than the size of the procurement allocation alone.

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