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Zambia beckons SA healthcare investors

But the economic and political climate might not be ripe yet.

Zambia is reportedly open to private South African healthcare companies and investors – and the demand and need is dire. 

Senior medical superintendent and representative of Zambia’s minister of health Dr Alex Makupe said that of a population of 17 million people, Zambia has just 86 to 90 general surgeons. This he says is a common situation in other sub-Saharan African countries, apart from Kenya and SA. The number of obstetricians and anaesthetists is even more dire.

Makupe was speaking at the Healthcare Management Conference in Midrand. 

In February, Zambia’s health minister Chitalu Chilufya said the government wants to rejuvenate health provision. “With the rising middle class, as well as the increasing prevalence of non-communicable diseases and disabilities, the ministry is increasingly focusing on preventing diseases,” states the BMI.

Its sites are set on primary healthcare. “We want to make essential surgery part and parcel of primary care. Essential obstetrics should also come into the community, together with essential anaesthesia. These three things are key to saving mothers who are dying from [as a result of birth-related causes],” said Makupe, who is also general surgeon at Ndola Central Hospital.

“The health sector’s never been touched – it’s a raw area. Government runs 90% of public healthcare.”

Talking to Moneyweb on the sidelines of the conference, he reckons Zambia would be very open to private SA healthcare companies. “It’s been spoken about many, many times.” Apart from a few small clinics, there doesn’t seem to be a significant South African influence in the sector yet.

“What we would like to see is a Mediclinic kind of investment.”

A few South African companies have tried to enter via medical insurance – but up until now it wasn’t established. This is about to change.

Social health insurance is now becoming policy, with a bill currently before parliament.

More healthcare opportunities

There may be more posts for doctors and nurses than there are in SA currently. “In the beginning of 2017 government employed about 1 000 health workers. They’re doing everything to improve the level of service for our hospitals … the working environment is better than before,” says Makupe.

The overall standard of medical care in Zambia is well below international standards, especially in the government (public) facilities. “Private medical facilities in major cities may provide reasonable care, although the scope of medical specialities offered is very limited and healthcare may not be of an international standard. Basic medical care outside of major cities is extremely limited,” according to International SOS.

“The facilities in Zambia are only suitable for treatment of simple medical conditions or for stabilisation of patients prior to medical evacuation. Complex medical conditions should not be treated locally…. Generally, no specialist care is available outside of Lusaka.”

Makupe admits people go to Johannesburg and India for surgery rather than Lusaka. 

Pharmaceuticals would also be starting from a very low base. The April BMI Research Zambia Pharmaceuticals & Healthcare Report said the country’s local pharma industry is largely underdeveloped and almost completely reliant on importing medicine supply.

“South Africa and India are traditionally among the country’s biggest medicine import partners. Local manufacturing of antiretroviral drugs will be positive for the domestic industry, and we do not expect import reliance to drop significantly over the period (to 2020).”

Inflation rose to 18% last year, but is seen dropping to 13% in 2017 and 10% in 2018. BMI sees the Bank of Zambia continuing to cut its key policy rate over 2017, after reducing rates for the first time in five years in February. “Inflation will remain in single digits over the year, and this will enable the central bank to take a more dovish monetary policy stance.”

The downside

As was recently publicised with DA leader Mmusi Maimane’s deportation from Zambia, President Edgar Lungu has been making headlines for the wrong reasons, and the country’s no stranger to social unrest.

“Social unrest will continue to occur over 2017 as unemployment remains elevated compared to the pre-2014 copper price slump. While a recovery in mining activity will ease unemployment over 2017, structurally lower output will not enable the sector to create sufficient jobs, leading to protests and strikes,” says BMI.

GDP growth is sketchy, dropping from 5% in 2014 to 3.2% in 2015 and 3% in 2016. This year it’s projected to rise to 4% and on to 5% in 2018 and 2019, according to S&P.

Zambia’s over-reliance on copper has limited the economy’s growth prospects. The exchange rate adjustment’s been particularly severe in Egypt, Mozambique, Nigeria, Ghana, Zambia and Angola,
where the depreciation against the dollar between the start of 2014 and the end of 2016 exceeded 40%, states Deloitte’s ‘African trends going into 2017’ report.

In August 2016 Standard & Poor’s affirmed Zambia’s sovereign rating at ‘B/B’ and kept its outlook at negative. In its sub-Saharan Africa Soverign Ratings trends report 2017 it says: “The negative outlook reflects downside risks to our economic growth outlook, concerns that the government’s financing options could remain constrained into 2017, and the possibility that monetary policy effectiveness could be permanently reduced if high levels of dollarisation in the economy are not reversed in the short term.”

However, it expects that Zambia will sign an IMF programme in 2017, providing liquidity and helping to anchor policy.

Zambia also tanked in ease of doing business rankings.

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So Zambia sees the benefit of private healthcare and is embracing it whereas in SA the government is looking to nationalise the healthcare sector through its national health plans. No comments from Helen please about healthcare and colonialism!

End of comments.





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