The Ministry of Health (MoH) has admitted that the suspension of aid by the United States (US) government has put the health sector in a difficult position as some critical services have been closed, compromising public healthcare service delivery.

MoH Chief of Health Services Matias Joshua said this in Lilongwe Thursday.

He was speaking at the launch of Pen-Plus initiative by the World Health Organisation (WHO).

The initiative is premised on scaling up non-communicable diseases (NCDs) services and decentralising critical treatment to small clinics.

He said, for example, that all US-funded laboratories were non-functional because they were being operated by US-recruited technicians that have been put on administrative leave.

He said this closure comes following the delayed integration of the laboratories and other donor-funded services into the government system, stressing that crucial reforms to reduce dependence on foreign aid were a must now, regardless of the pain that would inevitably come.

Some reforms, according to Joshua, include scaling up paid-for services in public hospitals to reduce resource gaps and limit the effects of funding shocks.

“[The] time of relying on donor support is now elapsing. We need to strategise on how we move forward with our health services,” he said.

According to the National Health Financing Strategy, which covers the period from 2023 to 2030, the health system is heavily under-resourced, with per capita total health expenditure at an estimated $39.9, compared to the recommended public sources expenditure of $86 for low-income countries.

Much of the sector’s financing is highly donor-dependent, with 54.5 percent of all resources coming from donors.

“Of all [the] resources, 40.3 percent are pooled under the government scheme. However, the percentage of resources managed by the government is slightly less, at 39.4 percent, indicating that the government has less control than donors in making direct expenditure decisions,” the strategic plan reads.

With the US—a major donor—suspending aid to all countries, including Malawi, and its possible pulling out of WHO and other United Nations agencies, the country braces for a tough time.

WHO representative to Malawi, Neema Rusibamayila Kimambo, declined to comment on the situation when asked about the impact of the aid freeze on foreign interventions in the country’s health delivery systems.

This comes at a time NCDs are on rampage, claiming 32 percent of deaths in the country.

In Machinga District, for example, a presentation at the event showed that NCDs were claiming 65 percent of patients, out of the recorded cases under Pen-Plus initiative.

Meanwhile, with WHO support, Pen-Plus initiative has been scaled up to Ntcheu, Machinga and Mchinji as it aims to reach all the distr