The Angolan authorities' disinvest in the health system
MSF Report<BR> Angola: Pretence of normality
9 November 2000
Supplies of drugs and medical materials from the Ministry of Health to the provincial hospitals come in a trickle, when they come at all. Some deliveries do not arrive at the right destination, those which do arrive, frequently do not correspond to the needs and thus health structures are left without the most essential drugs or those necessary to treat infectious diseases. MSF is substituting for the Ministry of Health, without which, the population would have no access to care.
MSF has calculated that only 1.2% of the needs of Kuito hospital are covered by the Angolan Ministry of Health
In Kaala MSF provides nearly all the drugs and medical materials for the city hospital and 3 health centres
In Menongue, one of only three annual government deliveries was three months late, and 60% of the stock was missing.
In Matala, medical supplies delivered in the health structures were insufficient.
In the province of Zaire, the Angolan medical authorities declared to MSF that there was neither paracetamol nor aspirin available in the provincial hospital, but only in the district hospital supplied by MSF.
In September 2000, 21 cases of meningitis were declared at the provincial hospital of Malange. The only effective treatment for this disease (oily chloramphenicol) was provided by MSF.
The salaries of health personnel are insufficient, are often only paid after months of delay, and suffer badly from the inflation that affects the Angolan currency.
At the end of September 2000, the MSF teams in Menongue noted that the Ministry of Health had not paid wages for four months. In face of threats of strike action by health staff, two months wages have been paid to fill these arrears.
Generally, the authorities' involvement in the health sector continues to be particularly weak:
The budget for health accounts for only 2.8% of the total State budget in 1999 .
In some of the provinces there are very few doctors, against several hundred in the capital of Luanda. In the provinces where MSF works, the medical presence is low, sometimes non-existent. There is no Angolan doctor in the provincial hospital of M'Banza Congo; one Angolan doctor in the whole province of Moxico; two Angolan doctors in the whole province of Cuando Cubango (one of whom is occupied only with administrative tasks).
These figures are representative of a poor developing country. But Angola is not a poor country. There are immense oil and diamond resources - the United States already imports more oil from Angola than from Kuwait. Oil production in the country is estimated at 800,000 barrels per day, but the absence of a drop of diesel makes it impossible for certain hospitals to function. Clearly the Angolan population is not profiting from the enormous State riches.