• 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 public health facilities have  averaged 47% in June 2026, below the Government’s minimum stock target of 50%, according to figures given to Parliament by Health and Child Care Permanent Secretary Dr Aspect Maunganidze. Treasury has mobilised US$10 million for urgent NatPharm procurement contracts intended to lift availability above 55%.

The 2025 Auditor-General Report on State-Owned Enterprises and Parastatals gives the shortage a wider explanation than procurement alone. NatPharm wrote off approximately US$3 million in expired stock during 2025, while internal assessments found nearly 80% of those expiries were preventable through better systems and planning. NatPharm’s performance under the vital, essential and non-essential medicine classification stood at approximately 65%, below the 70% minimum.

The figures expose both ends of the same supply chain failure. One measures medicine patients cannot find inside public facilities. The other records medicine whose economic and clinical value was lost before it could be used. Together, they make supply chain efficiency part of the health financing problem itself.

For patients, the failure shows 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 the medical situation, described how the shortage moves from a hospital balance sheet into a household budget.

“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 household then decides how much of the doctor’s treatment plan it can afford to follow.

“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 on continuous treatment, delayed or incomplete prescriptions can weaken adherence and increase the risk of complications requiring more expensive care later.

Dr Dickson Chapendana, a medical doctor at Sally Mugabe Central Hospital, connected medicine continuity directly to two measurable outcomes. “Reliable supply of essential medicines in public facilities would reduce the financial burden on households and improve treatment adherence,” Chapendana said.

The Auditor-General’s report gives one of the clearest examples of how the medicine problem develops inside a hospital. The audit of Sally Mugabe Central Hospital found the institution reported ZWL875.6 million in inventory at the end of 2023, while auditors were unable to satisfy themselves that the balance was accurate and complete. Supporting invoices were missing for some inventory purchases, physical quantities did not agree with stock sheets, some items existed physically but carried nil values in the records, and donated medicines and equipment were recorded at nil values.

The wider 2025 report found ineffective stock control systems, weak forecasting and no real-time inventory tracking in public hospitals. At Sally Mugabe, those weaknesses were associated with repeated stockouts of essential medicines and equipment while some inventory expired before use.

The problem extends beyond accounting accuracy. A hospital needs to know what medicine it holds, where it is stored, how quickly patients are consuming it and how long remains before expiry. That information determines when the next order is placed and whether a slow-moving batch approaching expiry can be moved to another facility where consumption is higher.

Without real-time visibility, a hospital can order medicine it already holds somewhere in its system, discover shortages only after shelves are empty or leave stock unused until it expires. Each failure converts scarce health funding into less treatment.

NatPharm is Zimbabwe’s central medical stores company, procuring, storing and distributing medicines and medical supplies to public health facilities across the country and serving more than 1,800 institutions. Its board and management appeared before Parliament’s Portfolio Committee on Health and Child Care in May 2026 to answer questions on procurement, medicine distribution, financial performance and weaknesses across the national supply chain.

Equity Axis attempted to reach NatPharm by telephone for comment on the US$3 million expired stock, the reported preventability of those losses and the weaknesses identified across the medicine supply chain. The calls went unanswered by the time of publication.

The US$3 million expiry figure also shows why the supply chain cannot be assessed from stock entering NatPharm warehouses alone. Medicine becomes healthcare only after it reaches the facility where a patient needs it. A box in Harare or Bulawayo has been procured, but national availability ultimately depends on whether that medicine reaches patients in Chiredzi, Gokwe, Binga, Mutare and other centres before it expires.

The Auditor-General’s report also carries findings from United Bulawayo Hospitals that connect medicine availability to human resources. The hospital experienced persistent shortages of medical supplies during 2024, while auditors found inadequate inventory controls, inconsistent medicine labelling, difficulty separating stock approaching expiry and weak controls at inventory exit points. Replenishment was also delayed by prolonged vacancies in critical positions including the head of pharmacy and laboratory scientists.

A hospital pharmacy needs trained people to forecast demand, rotate stock, monitor expiry, dispense medicines and reconcile physical inventory against records. Laboratories need specialists who can plan reagents and diagnostic supplies. Digital systems also depend on people entering reliable information and acting when stock moves outside required levels.

Zimbabwe’s hospital rehabilitation programme is encountering the same staffing constraint from another direction. Buildings are being renovated and equipment installed while the workforce required to sustain continuous service remains under pressure. A health worker at Parirenyatwa Group of Hospitals, speaking on condition of anonymity, said competitive salaries comparable to those in the region are essential to retain skilled staff and reduce the risk of service disruptions.

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

The US$3 million written off through expired NatPharm stock changes the funding equation. Treasury, donors or another funding source had already mobilised the money, procurement had converted it into medicine and the stock had entered the public health system. The value was lost before the medicine became treatment.

Preventing avoidable expiry therefore preserves more of the health funding Zimbabwe has already mobilised and increases the share of medicine spending that reaches patients.

The Auditor-General called for improved inventory systems through digitalisation, better staff capabilities and stronger internal controls after identifying the weaknesses affecting hospital medicines.

A working national system should give managers visibility from NatPharm to the facility pharmacy. Every batch should carry its location, quantity, consumption rate and expiry date. Stock approaching expiry should trigger an alert early enough for redistribution, hospital consumption should feed into future procurement, and facilities should be able to identify medicine held elsewhere before emergency purchases are authorised.

The system should also distinguish whether a shortage comes from insufficient national stock, delayed delivery, inaccurate facility records, abnormal consumption or weak redistribution because each problem requires a different response.

The report’s own reporting lag raises a further accountability concern. The Sally Mugabe audit contained in the 2025 State-Owned Enterprises and Parastatals report relates to 2023. The United Bulawayo Hospitals audit relates to 2024. Medicine can expire within months, meaning a control failure identified two or three years after stock moved through a hospital delivers accountability after the economic loss has already occurred.

Hospital management needs operating information that moves much faster than the statutory audit cycle. An auditor can establish whether controls worked, but hospital managers need to know today which medicines are approaching expiry and which are likely to run out next week.

Zimbabwe’s next medicine intervention needs a patient-facing scorecard alongside the national 47% availability rate. It should track facility-level medicine availability, NatPharm delivery completion rates, expired stock as a share of medicine received, emergency procurement volumes, pharmacy and laboratory vacancies, and the share of hospital prescriptions filled completely.

Treasury releases funding, NatPharm procures, warehouses receive stock, transport moves it, hospitals record it, pharmacies dispense it and patients take it. The Auditor-General has established that value is being lost between those stages, while the patient at Parirenyatwa describes the consequence at the other end of the chain.

Zimbabwe can raise the health budget and procure more medicines. It also needs medicines already financed to stop disappearing into weak records, delayed distribution and expiry before they reach the people they were bought for.

With availability at 47% and approximately US$3 million of stock already written off, progress can be measured at the point that matters most: a larger share of every dollar spent on medicines finishing its journey in a patient’s hands.

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