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Zambia's Looming Dual Healthcare Crisis

Zambia's Looming Dual Healthcare Crisis

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Published by Zambian-Economist
Zambian Economist essay for July 2012 on Healthcare and Development
Zambian Economist essay for July 2012 on Healthcare and Development

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Published by: Zambian-Economist on Jul 31, 2012
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02/19/2013

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[NEOGNB DFHBHEGVP
G`dnv chr n odppdr [neogn
LDNIPLFN_D NB@ DFHBHEGF @DSDIHZEDBP; [NEOGN‗V IHHEGBM @TNI%LDNIPLFN_D F_GVGV
 Pld vgmlp hc n `rgsd%plrt ACF nihbm pld Anctd _hn` gv ohtb` ph od n vtrzrgvd chrnbwhbd plnp lnv bhp oddb gb [neogn chr n cd} wdnrv" [neogn gv flnbmgbm) nb`~tgfaiw) dvzdfgniiw dsg`dbfd` gb pld bd} vlhzzgbm eniiv nb` dnpdrgdv }gplgb pldtronb fdbprdv" Lh}dsdr) `dvzgpd [neogn‗v vgmbgcgfnbp dfhbhegf mrh}pl nb` pldrgvd hc n eg``id finvv) enbw zdhzid gb [neogn lnsd bhp vddb pnbmgoid vhfgh%dfhbhegf gezrhsdedbpv gb rdinpghb ph enfrh%dfhbhegf mrh}pl" Nb gbfrdnvgbmiwvprnpgcgd` vhfgdpw `dvdrsdv etfl nppdbpghb gb rdinpghb ph enbw vdfphrv) hbd hc }lgfl plnp gv hc frtfgni gezhrpnbfd gv ldniplfnrd"[neogn‗v zrgenrw fhbfdrb chr vdsdrni `dfn`dv lnv oddb fheetbgfnoid `gvdnvdv"Gb znrpgftinr) LGS(NG@V nb` eninrgn zrdvdbp nb geedbvd flniidbmd ph pld [neognbldnipl gbcrnvprtfptrd nb` nrd nvvgvpd` ow btedrhtv ihfni nb` gbpdrbnpghbni Bhb%Mhsdrbedbpni Hrmnbgvnpghbv ,BMHv'" Lh}dsdr) [neogn nv n mrh}gbm dfhbhew }gpln rgvgbm eg``id finvv bh} cnfdv pld `htoid otr`db hc ohpl fheetbgfnoid nb` bhb%fheetbgfnoid `gvdnvdv" Pldrdchrd) pld Egbgvprw hc Ldnipl‗v rdfdbp rdidnvd hc pld[neogn Bnpghbni Ldnipl Vprnpdmgf Zinb `dvdrsdv etfl mrdnpdr nppdbpghb plnb gp lnvoddb mgsdb nv [neogn gv cnfgbm n `tni%ldniplfnrd frgvgv) }gpl zhpdbpgni `dprgedbpnifhbvd~tdbfdv chr gpv dfhbhegf `dsdihzedbp"
Fheetbgfnoid nb` bhb%fheetbgfnoid `gvdnvdv
 Pldrd gv) hc fhtrvd) nb hosghtv bdd` chr pld prdnpedbp nb`) gb znrpgftinr)zrdsdbpghb hc fheetbgfnoid `gvdnvdv" Nffhr`gbm ph TBNG@V dvpgenpdv crhe ?::7)pldrd nrd 7<:)::: gb`gsg`tniv gbcdfpd` }gpl LGS gb [neogn) }gpl n zrdsnidbfd rnpdhc >6"4 zdrfdbp nehbmvp pld >4%07 nmd mrhtz" Pld otr`db hc fheetbgfnoidgiibdvvdv nivh d|pdb`v ph ptodrftihvgv) hcpdb n enbgcdvpnpghb hc NG@V) nv }dii nvhpldr vd|tniiw prnbvegppd` `gvdnvdv" Pld Dfhbhegf Fheegvvghb chr Ncrgfn‗vFheegvvghb hb LGS(NG@V nb` Mhsdrbnbfd gb Ncrgfn nrmtdv plnp pld mrdnpdvp geznfpchr n fhtbprw }gpl nb LGS(NG@V dzg`degf gv gb ltenb fnzgpni" Vzdfgcgfniiw) “NG@Vvdidfpgsdiw `dvprhwv ltenb fnzgpni) plnp gv) zdhzidv‗ nfftetinpd` igcd d|zdrgdbfdv)pldgr ltenb nb` kho vagiiv) nb` pldgr abh}id`md nb` gbvgmlpv otgip tz hsdr n zdrgh`hc wdnrv‗"Eninrgn zrdvdbpv nbhpldr frgpgfni flniidbmd chr pld [neognb ldnipl gbcrnvprtfptrd)nv `h flhidrn nb` pwzlhg`" ]lgid [neogn lnv oddb np pld fdbprd hc bd} gbgpgnpgsdvcrhe pld Tbgpd` Vpnpdv Mhsdrbedbp) pld Mnpdv Chtb`npghb) nb` pld Mihoni Ctb` phCgmlp NG@V) Ptodrftihvgv) nb` Eninrgn) pldrd nrd vpgii >:0 `dnplv zdr >::):::gb`gsg`tniv crhe eninrgn dnfl wdnr) nffhr`gbm ph ]LH" Cgmlpgbm eninrgn gvvgmbgcgfnbpiw idvv d|zdbvgsd plnb cgmlpgbm LGS(NG@V ehv~tgph bdpv nb`nbpgeninrgniv fhvp n crnfpghb hc nbpg%rdprhsgrni ed`gfnpghbv" Wdp pld dfhbhegf fhvpvnrd vpgii lgml) ohpl gb nfptni mhsdrbedbp vzdb`gbm nb` ihvp dfhbhegf zrh`tfpgsgpw"N``gbm ph igvp hc cnpni fheetbgfnoid `gvdnvdv vprngbgbm [neogn‗v ldniplfnrdvwvpde nrd flhidrn nb` pwzlhg`" Ihfni bd}vznzdrv crd~tdbpiw fnrrw vphrgdv hc htpordnav hc `gvdnvd) hcpdb gb sgiinmdv nb` rtrni nrdnv) otp vhedpgedv gb inrmdrfgpgdv vtfl nv pld rdfdbp htpordna hc pwzlhg` gb Ano}d" Pld zrdsdbpghb hc pldvdgiibdvvdv gv rdinpgsdiw vgezid % gezrhsd` vnbgpnpghb nb` }npdr prdnpedbp cnfgigpgdv %otp pld prdnpedbp fnb od d|prdediw fhvpiw" Dnfl htpordna rd~tgrdv vzdfgniprdnpedbp fdbprdv nb` pld `gvznpfl hc ldniplfnrd }hradrv) nii lnb`id` bhp ktvp owpld Egbgvprw hc Ldnipl) otp nivh ow pld @gvnvpdr Enbnmdedbp nb` Egpgmnpghb Tbgp"Ctrpldrehrd) }lgid n lgml enpdrbni ehrpnigpw rnpd gb inrmd znrp zhgbpv ph hpldr>
 
[NEOGNB DFHBHEGVP
G`dnv chr n odppdr [neogn
gvvtdv gb pld ldniplfnrd vwvpde) gp gv hbiw d|nfdronpd` ow pld lgml gbfg`dbfd hc fheetbgfnoid `gvdnvdv) }lgfl fnb lnsd vdrghtv dccdfpv hb d|zdfpnbp ehpldrv"Chr [neogn) nv }dii nv chr hpldr `dsdihzgbm bnpghbv) n``gbm ph pld vprtmmid nmngbvpfheetbgfnoid `gvdnvdv nrd pld mrh}gbm rnpdv hc bhb%fheetbgfnoid `gvdnvdv,BF@v'" BF@v) vtfl nv ldnrp `gvdnvd nb` Pwzd GG `gnodpdv) pld chftv hc plgv dvvnw)nrd `dcgbd` nv “igcdvpwid‗ giibdvvdv plnp nrd inrmdiw zrdsdbpnoid plrhtml n ldniplw`gdp) d|drfgvd) nb` hpldr igcdvpwid flhgfdv"
>
Pldvd nrd `gvdnvdv plnp }drd zrdsghtviwinrmdiw novdbp crhe pld `dsdihzgbm }hri`) otp lnsd oddb gbfrdnvgbm np nb ninregbmrnpd nv n “}dvpdrb‗ `gdp hc zrhfdvvd` chh`v odfhedv ehrd rdn`giw nsnginoid ph nmrh}gbm eg``id finvv }gpl d|zdb`noid gbfhed"Nffhr`gbm ph ]LH) “Pld geznfp hc bhb%fheetbgfnoid `gvdnvdv gbfit`gbmfnr`ghsnvftinr `gvdnvdv) `gnodpdv) fdrpngb pwzdv hc fnbfdrv nb` flrhbgf rdvzgrnphrw`gvdnvdv ‖ gv vpdn`giw mrh}gbm) nccdfpgbm ohpl `dsdihzd` nb` `dsdihzgbm fhtbprgdv)nb` zdhzid gb nii nmd mrhtzv‗" Nb` pldvd `gvdnvdv fhezhtb` }gpl fheetbgfnoidhbdv) igad LGS znpgdbpv hb N_Sv) }lh nrd np n mrdnpdr rgva hc `dsdihzgbm `gnodpdv" Pldrdchrd) nv [neogn ehsdv ph}nr`v gpv mhni hc odfhegbm n eg``id%gbfhed bnpghb)gp gv odmgbbgbm ph cnfd) nb` }gii fhbpgbtd ph cnfd np nb d|zhbdbpgni rnpd) n rgvd gvbhb%fheetbgfnoid `gvdnvdv ,BF@v'"
Bnpghbni Ldnipl Vprnpdmw Zinb) ?:>>%?:>4
Chr pld znvp p}dbpw wdnrv) [neogn lnv rdidnvd` nb` gezidedbpd` Bnpghbni LdniplVprnpdmw Zinbv" Pld ftrrdbp zinb) fhsdrgbm pld wdnrv ?:>> ph ?:>4) gv pld cgcpl gbpld vdrgdv) nb` gv hrmnbgvd` nrhtb` pld ]hri` Ldnipl Hrmnbgvnpghb‗v ldnipl vwvpdeotgi`gbm oihfav" Nffhr`gbm ph @r" Khvdzl Anvhb`d) pld Egbgvpdr hc Ldnipl) pld bd}zinb “zrdvdbpv n enkhr `dznrptrd crhe pld znvp vprnpdmgf zinbv‗) odfntvd rnpldrplnb `gvdnvd hrgdbpd` zrhmrneedv gp chftvdv hb vprdbmpldbgbm pld “dbpgrdldniplfnrd vwvpde‗" Gp nivh gv pgd` ph [neognb `dsdihzedbp nv n }lhid) chregbm nb“gbpdmrni znrp‗ hc pld Vg|pl Bnpghbni @dsdihzedbp Zinb nb` Sgvghb ?:6:) “}lgflngev np prnbvchregbm [neogn gbph n zrhvzdrhtv eg``id%gbfhed bnpghb ow ?:6:‗"Gb pld gbprh`tfpghb) pld zinb d|zingbv plnp “[neogn‗v lgml otr`db hc `gvdnvd‗ gv“engbiw flnrnfpdrgvd`‗ ow pld zrdsnidbfd hc fheetbgfnoid `gvdnvdv otp “gv nivhcnfd` }gpl n rnzg`iw rgvgbm otr`db hc bhb%fheetbgfnoid `gvdnvdv‗" Nffhr`gbmiw)hbd hc pld engb hokdfpgsdv(pnrmdpv igvpd` gv ph “_d`tfd pld zrdsnidbfd hc bhb%fheetbgfnoid `gvdnvdv nvvhfgnpd` }gpl g`dbpgcgnoid odlnsghtrv‗" Pld BF@v igvpd`gb pld zinb gbfit`d edbpni ldnipl) fnbfdrv) vgfaid fdii nbdegn) oigb`bdvv) flrhbgfrdvzgrnphrw `gvdnvd) nb` hrni ldnipl zrhoidev" Nivh igvpd` gb plgv mrhtz nrd ldnrp`gvdnvd nb` lwzdrpdbvghb nb` `gnodpdv ediigptv) nrmtnoiw p}h hc pld `gvdnvdv }gplpld mrdnpdvp fhbbdfpghb ph g`dbpgcgnoid odlnsghtrv"Gb rdvzhbvd ph pld rgvd gb BF@v) pld Bnpghbni Ldnipl Vprnpdmw n`shfnpdv chr nbteodr hc zrdsdbpnpgsd d`tfnpghb nb` vfrddbgbm zrhmrneedv ohrbd crhe pld BF@Vwezhvgte gb ?::7" Lh}dsdr) gp n`egpv plnp “pldvd gbpdrsdbpghbv nrd wdp ph odd|pdb`d` ph nii `gvprgfpv nb` gbvpgptpghbv‗" Gp nivh inwv htp g`dbpgcgd` gbpdrsdbpghbvplnp lnsd bhp oddb gezidedbpd`) gbfit`gbm `dsdihzgbm nb BF@ zhigfw) }lgfl gv nbhosghtv cgrvp vpdz ph cgmlpgbm pld ihhegbm `tni ldniplfnrd frgvgv" Pldrdchrd) }lgid
>
Bhb%fheetbgfnoid `gvdnvdv nivh gbfit`d `gvdnvdv igad fnbfdr) }lgfl }lgid vhedpgedv gv dbsgrhbedbpniiw onvd`) fnb nivh od fntvd` ow hpldr cnfphrv vtfl nv mdbdpgfv) nb` hpldr mdbdpgf `gvdnvdv) vtfl nv vgfaid%fdiinbdegn) }lgfl gv pld lgmldvp fntvd hc `dnpl chr flgi`rdb gb Ncrgfn ow nb BF@"
?
 
[NEOGNB DFHBHEGVP
G`dnv chr n odppdr [neogn
pld nfabh}id`mdedbp hc pld plrdnp hc BF@v gv nzznrdbp) pldrd gv igppid gb pld zinbph pnbmgoiw n``rdvv pld zrdsdbpghb nb` prdnpedbp hc pldvd `gvdnvdv"
Pld Tbgpd` Vpnpdv
_dmnr`gbm ldniplfnrd zhigfw chr bhb%fheetbgfnoid `gvdnvdv nb` gpv rdinpghb phdfhbhegf `dsdihzedbp) [neogn }hti` `h }dii ph idnrb n cd} plgbmv crhe pld ]dvp)nb` gb znrpgftinr) pld Tbgpd` Vpnpdv" Pld Tbgpd` Vpnpdv gv pld rgfldvp bnpghb gb pld}hri`1 wdp gp gv cnfd` }gpl ltmd nb` rgvgbm ldniplfnrd fhvpv plnp lnsd odfhed nmrdnp otr`db ph pld bnpghbni dfhbhew" Gp gv hbiw bh} plnp zhigfw enadrv nrdrdnig{gbm plnp vhedplgbm `rnvpgf etvp od `hbd ph ftro pld rgvd hc BF@v nb` pldgrdccdfpv hb pld T"V" zhztinpghb) ldniplfnrd vwvpde) nb` dfhbhew" Pldrdchrd) rnpldrplnb fhzwgbm pld d|nezid hc pld T"V") [neogn vlhti` gbvpdn` idnrb }lnp
bhp 
ph `hgb pld zrdsdbpghb hc BF@v"Fheetbgfnoid `gvdnvdv }gplgb pld Tbgpd` Vpnpdv nrd inrmdiw tb`dr fhbprhi" Np plddb` hc ?::<) TBNG@V dvpgenpd` plnp >)?::)::: zdrvhbv nmd` >4 ph 07 }drd igsgbm}gpl LGS gb pld Tbgpd` Vpnpdv) hr nzzrh|genpdiw :"3 zdrfdbp" N_Sv nrd rdn`giwnsnginoid nb` ptodrftihvgv gv rnrd" Vgeginriw) eninrgn lnv oddb fhezidpdiwdrn`gfnpd`" Lh}dsdr) ldnipl nb` ldnipl fnrd gb pld Tbgpd` Vpnpdv gv cnr crhen`egrnoid gb rdinpghb ph BF@v" Nffhr`gbm ph pld F@F) >>"< zdrfdbp hc n`tipv gbNedrgfn lnsd ldnrp `gvdnvd nb` gp gv pld bteodr hbd fntvd hc `dnpl" Vgeginriw)nffhr`gbm ph pld T"V" @dznrpedbp hc Ldnipl nb` Ltenb Vdrsgfdv) <"6 zdrfdbp hc pld zhztinpghb lnv dgpldr Pwzd G hr Pwzd GG `gnodpdv" @gnodpdv gv pld vdsdbplidn`gbm fntvd hc `dnpl gb pld T"V" nb` gp gv n enkhr fntvd hc ohpl ldnrp `gvdnvd nb`vprhadv" Flgi`rdb nrd nivh np rgva hc `dsdihzgbm Pwzd GG `gnodpdv onvd` hb n zhhr`gdp) dsdb odchrd rdnflgbm n`tiplhh`"]lw nrd pld bteodrv vh lgml gb pld Tbgpd` Vpnpdv8 Pld bteodr hbd rdnvhb vddevph od `gdp) nv }dii nv hpldr igcdvpwid flhgfdv vtfl nv phonffh tvd nb` n vd`dbpnrwrhtpgbd" Pld Cgrvp In`w hc pld Tbgpd` Vpnpdv) Egfldiid Honen) lnv vzdbp ldr chtrwdnr pdbtrd }hragbm ph cgmlp pld zrgenrw fntvd) pld Vpnb`nr` Nedrgfnb @gdp ,VN@')plrhtml ldr Idp‗v Ehsd fnezngmb" Pld VN@) chftvd` hb gb`tvprgni) zrhfdvvd` chh`vnb` fhbsdbgdbfd gpdev) lnv `rnenpgfniiw gbfrdnvd` hodvgpw rnpdv gb pld Tbgpd`Vpnpdv) gb pnb`de }gpl pld bteodr hc zdhzid }gpl ldnrp `gvdnvd nb` `gnodpdv" CgrvpIn`w Honen lnv chftvd` ldr nppnfa hb cgmlpgbm flgi`lhh` hodvgpw gb znrpgftinr1fhrrdfpiw rdnvhbgbm plnp ztoigf zrdsdbpnpgsd d`tfnpghb gv adw ph rd`tfgbm pldgbfg`dbfd hc BF@v gb pld Tbgpd` Vpnpdv" Lh}dsdr) Nedrgfnbv lnsd n ltmd ltr`id phhsdrfhed) nv hbd gb plrdd zdhzid gv bh} hsdr}dgmlp hr hodvd) nb` pldrdchrd npmrdnpdr rgva hc `dsdihzgbm BF@v"]lnp gv dsdb ehrd vprgagbm gv pld ltmd fhvp hc pldvd `gvdnvdv" @gnodpdv nihbd fhvppld Tbgpd` Vpnpdv TV$>=0 ogiighb gb ?:>:) gbfit`gbm TV$4< ogiighb gb rd`tfd`zrh`tfpgsgpw" Ldnrp `gvdnvd fhvp n vpnmmdrgbm TV$000 ogiighb) hr $> chr dsdrw $3vzdbp hb ldniplfnrd gb pld Tbgpd` Vpnpdv" Nv nrmtd` ow pld ]hri` LdniplHrmnbgvnpghb) “Pnfaigbm pldvd rgva cnfphrv inrmdiw `dzdb`v tzhb nfpghbv pnadb gb nsnrgdpw hc zhigfw `hengbv) nv }dii nv gbfrdnvd` zrdsdbpghb dcchrpv nb` nffdvv phvdrsgfdv vtfl nv plhvd chr dnriw `dpdfpghb‗"
Gbpdrvdfpghb odp}ddb ztoigf ldnipl nb` `dsdihzedbp
 Pld Bnpghbni Ldnipl Vprnpdmw rgmlpiw bhpdv plnp “n ldniplw zhztinpghb gv frgpgfni phgezrhsd` zrh`tfpghb nb` zrh`tfpgsgpw‗" Pld ]hri` Dfhbhegf Chrte fhbftrv)rdfdbpiw nrmtgbm plnp zhhr nb` eg``id gbfhed bnpghbv }gii ihvd TV$="6 ogiighb gbdfhbhegf htpztp crhe pld phz chtr BF@v ,ldnrp `gvdnvd) rdvzgrnphrw `gvdnvd)6

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