• 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 averaged 47% in June 2026, below the government's minimum stock target of 50%, on figures given to Parliament by Health and Child Care Permanent Secretary Dr Aspect Maunganidze, with Treasury mobilising USD 10 million for urgent NatPharm procurement contracts 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 USD 3 million in expired stock during 2025, and internal assessments found nearly 80% of those expiries were preventable through better systems and planning, while NatPharm's performance under the vital, essential, and non-essential medicine classification stood at approximately 65%, below the 70% minimum.

The two figures sit alongside each other in a way that reframes the medicine debate. One measures the medicine patients can find inside the system. 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, not a separate administrative concern.

 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 is followed.

"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." The consequences build quietly for patients on continuous treatment, a hypertension patient misses a dose, a diabetic patient stretches a prescription, an asthma patient postpones a new inhaler, with the immediate saving carrying the risk of a larger clinical event later requiring hospitalisation or emergency care.

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 ZWL 875.6 million in inventory at the end of 2023, with auditors 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 and carried nil values in the records, and donated medicines and equipment were recorded at nil values.

The wider 2025 report went on to find ineffective stock control systems, weak forecasting, and no real-time inventory tracking in public hospitals, using Sally Mugabe to show the effect on service delivery, with those weaknesses producing repeated stockouts of essential medicines and equipment alongside inventory that expired before use where disposal schedules were poorly maintained.

The problem runs past accounting accuracy. A hospital needs to know what medicine it holds, where it is stored, how fast patients are consuming it, and how long remains before expiry, because that information sets when the next order is placed and lets managers move a slow-moving batch near expiry to another facility where consumption is higher. Without real-time visibility, a hospital can order medicine it already holds somewhere in its system, find shortages after the shelf is empty, and leave a batch near expiry stationary until its therapeutic value reaches zero, each outcome turning 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.

That scrutiny produced the USD 3 million expiry figure and showed that the shortage cannot be read from stock entering NatPharm warehouses alone. Medicine becomes healthcare only after the last delivery is completed. A box in Harare or Bulawayo has been procured. It has not treated a patient in Chiredzi, Gokwe, Binga, or Mutare, and that distinction matters most when national availability is measured, because Zimbabwe needs the availability figure at the facility where the patient presents, not only the medicine held nationally.

 The Auditor-General's report carries findings from United Bulawayo Hospitals that tie medicine availability directly to human resources. The hospital ran persistent shortages of medical supplies during 2024, with the Auditor-General citing funding constraints among pressures severe enough to raise uncertainty over continued operations. Inventory controls were inadequate, auditors found inconsistent medicine labelling, difficulty separating stock approaching expiry, and limited controls at inventory exit points, with replenishment 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, while a laboratory needs specialists who can plan reagents and diagnostic supplies. Digital systems need people who enter reliable data and act when it shows stock moving outside required levels. Infrastructure spending cannot perform those functions.

Zimbabwe's hospital rehabilitation programme is entering the same constraint from another direction: buildings are being renovated and equipment installed while the workforce that turns those investments into 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 strikes that disrupt services, with the staffing issue mattering most in pharmacies, laboratories, theatres, and specialist units where one prolonged vacancy can constrain an entire service line.

 "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 USD 3 million written off through expired NatPharm stock changes the funding equation in a specific way. Each dollar lost to expiry has already cleared the hardest first stage of health financing. Treasury, donors, or another source mobilised it, procurement turned it into medicine, and the medicine entered the system. The loss came at the last step, before the medicine became treatment. Recovering that leakage carries an economic benefit close to finding new procurement money, because it raises the share of existing health spending that reaches patients and makes medicine expiry a financing measure as much as a warehouse one.

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 carrying its location, quantity, consumption rate, and expiry date, a batch near expiry raising an alert early enough for redistribution, hospital consumption feeding automatically into future procurement, and facilities able to find medicine held elsewhere before emergency purchases are authorised. The objective is for Zimbabwe to know whether a shortage comes from insufficient national stock, a delayed delivery, inaccurate facility records, abnormal consumption, or poor redistribution, because those causes call for different decisions.

 The report's own reporting lag adds a further accountability concern. The Sally Mugabe audit in the 2025 State-Owned Enterprises and Parastatals report relates to 2023. The United Bulawayo Hospitals audit relates to 2024. That gap matters in medicine management, where stock can expire in months, and a control failure found two or three years after the affected inventory moved through the hospital delivers accountability after the economic loss has already occurred. Hospital management needs operating information that works far faster than the statutory audit cycle. An auditor should verify in time whether the system worked, but hospital management should already know today which medicines are likely to run out next week.

Zimbabwe's next medicine intervention needs a patient-facing scorecard that sits alongside the 47% availability rate, facility-level 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 report has established that value is being lost between those stages and the anonymous patient 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, distribution delays, and expiry before they reach the people they were bought for.

With availability at 47% and millions of dollars of stock already written off, the next measure of progress is straightforward, more of every dollar Zimbabwe spends on medicines has to finish its journey in a patient's hands.

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