Malawi is making significant strides in prioritising health within its national agenda. The 2024/25 fiscal year marks a historic shift as the government allocates a substantial portion of its budget to health, surpassing allocations for agriculture and education for the first time. This move highlights Malawi’s commitment to achieving Universal Health Coverage (UHC) and Sustainable Development Goal (SDG) 3.

Increased Health Budget Allocation

The health sector’s budget has seen a notable increase from 8.8% in 2023/24 to roughly 12% in 2024/25, amounting to MK723 billion (approx. $417,254,145), including allocations for Water, Sanitation, and Hygiene (WASH). Excluding WASH, the health budget stands at MK554 billion (approx. $319,721,710) reflecting a 44% rise from the previous year. This increase signifies a growing prioritisation of healthcare in Malawi’s national budget.

Primary Healthcare (PHC) Investments

Investments in PHC have increased, with budget allocation rising from 36.2% in 2022/23 to 41.4% in 2024/25 as a percentage of the district budget. This aligns with Malawi’s disease burden and the recognition that key health determinants are largely influenced by the performance of its PHC system. However, it’s important to note that these allocations heavily benefited from donor support, highlighting the need for increased domestic funding.

Challenges and Recommendations

Despite the positive trends, challenges remain. The human resources budget has remained unchanged despite high vacancy rates, posing challenges to staffing levels in the healthcare sector. Additionally, the significant budget increase is partly due to donor contributions, with domestic health budget experiencing only a 10% increase after removing donor-funded supports.

To optimise the impact of budget allocations, Malawi could:

• Address inefficiencies and wastage within the healthcare system.
• Increase domestic funding for PHC.
• Diversify domestic revenue sources to reduce reliance on donor funding.
• Invest in critical gaps, including health infrastructure and workforce capacity.
• Investigate debt swop options with global creditors.

Conclusion

Malawi’s increased health budget allocation is a positive step towards prioritising the health and well-being of its citizens. Sustained efforts, including collective advocacy, political will and stakeholder engagement are essential to address existing challenges and achieve equitable and sustainable improvements in health outcomes.

Additional Resources