• Cumulative collections exceeding US$60 million have directly funded a US$30 million contract for four radiotherapy linear accelerators, with the first two machines delivered
• Major players such as Delta Corporation (US$31.2 million remitted in 2024 + US$20.3 million in 2025) and Dairibord have faced profitability pressure
• Zimbabwe records 7,000–17,000 new cancer cases annually driven partly by lifestyle factors including rising sugary beverage consumption; the tax has modestly reduced SSB intake

Harare- Zimbabwe has delivered two cancer treatment machines at its main referral hospitals, marking a significant advancement in public oncology services.

According to the Ministry of Health and Child Care (MoHCC), the first consignment of four high-tech radiotherapy machines, specifically linear accelerators, has partially arrived, with two units now in the country. One machine has been allocated to Mpilo Central Hospital in Bulawayo, while the other is designated for Parirenyatwa Group of Hospitals in Harare, the nation's premier tertiary referral centres.

This development represents a key milestone in the government's efforts to provide affordable, accessible, and world-class radiotherapy to citizens facing rising cancer burdens. The arrival comes after prolonged advocacy and criticism over delays in procuring essential oncology equipment, despite substantial revenues generated from the sugar tax since its introduction.

The newly arrived machines, linear accelerators for radiotherapy, have been allocated to Mpilo Central Hospital in Bulawayo and Parirenyatwa Group of Hospitals in Harare, the nation's primary referral centres. Each unit is valued at approximately US$5 million, bringing the total procurement cost for the four machines to around US$20-30 million, depending on ancillary equipment and installation fees.

The US$30 million contract cost set at that level is a fraction of the sugar tax remittances collected up to early 2026, which amounted to over US$60 million cumulatively, transforming a targeted health levy into concrete life-saving infrastructure.

Zimbabwe faces a mounting cancer epidemic, with over 7,000 new cases annually since 2014, projected to double in the next two decades amid urbanisation and lifestyle shifts.

According to the Zimbabwe National Cancer Registry (ZNCR), 7,841 new diagnoses were recorded in 2018 (latest detailed data), with over 3,000 deaths, while GLOBOCAN estimates escalated to 16,083 cases and 10,676 deaths by 2020. By 2022, incidences reached 17,725, with mortality at 11,739, yielding a high age-standardized mortality rate of 144 per 100,000 among the world's highest, ranking Zimbabwe in the top five globally for rates above 130.

Around 60% are HIV-associated, but NCD-linked cases are surging due to risk factors like obesity, diabetes, and poor diet exacerbated by rising ultra-processed food and SSB consumption, which grew 39% from 2021-2024 to US$623 million in sales. 

Sugar's role is indirect. Excessive intake contributes to obesity (a risk for 13% of cancers globally), type 2 diabetes, and GI malignancies, with Africa projecting a 30% rise in cancer deaths by 2030 if unchecked. Zimbabwe's 20% lifetime cancer risk before age 75 reflects the urgency, far exceeding neighbours like Zambia (16.2%).

Zimbabwe maintains a network of over 200 hospitals, including 120 government-run facilities under the Ministry of Health and Child Care, encompassing six central hospitals, eight provincial hospitals, and numerous district and rural units.

However, specialized cancer treatment, particularly radiotherapy has historically been severely limited and centralized. Prior to this procurement, public radiotherapy services were available only at two main centres: Parirenyatwa Group of Hospitals in Harare and Mpilo Central Hospital in Bulawayo.

These facilities have long suffered from outdated or non-functional equipment, Mpilo's radiotherapy unit has been largely inactive since around 2017-2022 due to breakdowns, forcing many patients to endure long waiting lists, seek costly private care, or travel abroad.

The country lacks sufficient decentralized oncology infrastructure, with chemotherapy and supportive care also concentrated in these urban hubs, exacerbating access challenges for rural and provincial populations amid an estimated 7,000 new cancer cases annually.

Health Minister Douglas Mombeshora has confirmed that renovations to radiation bunkers at Parirenyatwa and Mpilo are at an advanced stage to accommodate the new technology safely.

As the modern units are commissioned, older functional machines from these sites will be decommissioned and redeployed to provincial facilities, such as Gweru Provincial Hospital, to establish a third radiotherapy centre and begin decentralizing services.

This aligns with the National Cancer Control Plan (2025-2030), which aims to improve infrastructure, human resources (including radiation oncologists and medical physicists), and overall cancer outcomes. 

The plan highlights shortages in supporting personnel, including radiation oncologists (one per 200-250 patients ideally) and medical physicists (at least three per machine), showing the need for concurrent investments in human resources.

With cancer treatment costs in the private sector ranging from US$100-1,000 per chemotherapy dose and US$5,000-10,000 for radiotherapy courses, public sector enhancements promise to alleviate financial burdens on patients. As Minister Mombeshora stated, "This is not just about machines; it's about saving lives and building a resilient health system."

While the arrival of the first two machines signals progress toward enhanced cancer care, stakeholders including health advocacy groups continue to call for greater transparency, legislative ring-fencing of sugar tax revenues to prevent potential diversion, and accelerated installation timelines for the remaining units.

The initiative reflects the Second Republic's focus on strengthening public health resilience, though sustained investments in staffing, maintenance, and broader NCD prevention will be essential to maximize its benefits for Zimbabweans. 

Zimbabwe's sugar tax was designed with a dual purpose, to curb excessive sugar consumption linked to non-communicable diseases (NCDs) like obesity, diabetes, and certain cancers, while generating earmarked revenue for cancer treatment infrastructure.

Initially set at US$0.002 per gram of added sugar, the levy was halved to US$0.001 per gram following intense lobbying from the beverage industry, which cited potential economic fallout including reduced demand and job losses.

By the end of 2024, authorities reported collecting over US$30 million, with cumulative figures rising further in 2025, enabling the funding of the US$30 million contract for the four machines. An initial deposit of US$5.3 million (approximately 20% of the total) was paid in 2025, facilitating manufacturing and delivery.

By early 2026, the tax has amassed significant revenues, exceeding US$60 million cumulatively, yet it has sparked debates over its impact on corporate viability, consumer behaviour, and public health outcomes.

Health advocacy groups like the Community Working Group on Health (CWGH) and the Zimbabwe Association of Doctors for Human Rights (ZADHR) have called for legislative ring-fencing of funds to prevent misallocation, citing delays in equipment delivery despite early collections exceeding US$30 million by late 2024.

Parliamentary scrutiny intensified in early 2026, with MPs questioning the pace of disbursements and potential diversions, prompting Deputy Finance Minister Kudakwashe Mnangagwa to reiterate the levy's dedicated purpose for "lifestyle diseases such as cancer."

Looking ahead, the government envisions further decentralization, with plans to equip additional sites like Masvingo and potentially establishing up to five machines per province in the long term.

However, the sugar tax has undeniably imposed substantial financial pressures on Zimbabwe's beverage sector. Delta's overall tax remittances surged 24.7% to US$315 million in 2025, encompassing various heads including excise duties, VAT, and the sugar levy, highlighting its substantial role in bolstering the fiscus.

In response to the tax's cost pressures, Zimbabwean beverage firms have accelerated product reformulations, increasingly incorporating artificial or non-nutritive sweeteners to lower sugar content and evade higher levies. Delta is scaling up its low- and zero-sugar product lines, including variants of popular brands, as a direct counter to the tax's impact on traditional sugary offerings.

Industry experts report widespread reformulations, with manufacturers substituting sweeteners to mitigate price increases of 30-40% on categories like cordials, which saw a 20% sales decline in 2024.

 Starafricacorporation highlighted clients' pivot to non-nutritive alternatives, reducing sugar intake across the value chain. This shift aligns with global trends where sugar taxes incentivize innovation, such as in the UK, where a 2018 levy prompted a 28% average sugar reduction in taxed beverages.

 In Zimbabwe, however, it raises concerns: artificial sweeteners like aspartame or sucralose, while tax-efficient, face scrutiny over long-term health effects, including potential links to metabolic disruptions or cancer risks, though evidence remains inconclusive.

This adaptation may undermine the tax's health goals if consumers simply switch to equally unhealthy reformulated products, while boosting illicit trade in untaxed sugary imports. Nonetheless, it has fostered market innovation, with emerging low-sugar dairy blends and natural-flavoured options targeting health-conscious segments.

Equity Axis News