June 30, 2026 - Lusaka, Zambia
Healthcare should never be determined by a person's wealth, political influence, or ability to travel abroad. Yet for many Zambians, this is the reality. While those with financial means can seek specialised treatment outside the country, the vast majority must rely on a public health system that continues to struggle with inadequate financing, governance failures, infrastructure challenges, and unequal access to specialised care.
The paper, The Erosion of Dignity: Addressing Systemic Inequities in Zambia's Health Sector for the Common Citizen, examines these structural inequalities through the lenses of Economic and Social Rights (ESR) and Catholic Social Teaching (CST). It argues that improving healthcare is not merely a policy objective—it is a moral obligation rooted in the dignity of every human person.
Two Health Systems Within One Country
Zambia has made commendable progress in several areas of healthcare over the past decade. Maternal and child health indicators have improved significantly, skilled birth attendance has increased, and under-five mortality has declined.
However, these achievements mask a deeper reality.
For ordinary citizens, accessing quality healthcare remains an enormous challenge. Long waiting times, medicine shortages, inadequate specialist services, under-resourced facilities, and costly referrals often determine whether someone receives treatment in time. Meanwhile, those with sufficient financial resources continue to access treatment abroad whenever local systems fail.
This creates a two-tier healthcare system — one for the privileged and another for everyone else.
Health Financing Still Falls Short
Although government spending on health continues to increase in nominal terms, the sector's share of the national budget has declined.
The paper notes that despite allocations rising to K26.2 billion in 2026, health now receives only 10.3% of the national budget—well below Zambia's Medium-Term Budget Plan target of 12% and the Abuja Declaration benchmark of 15%.
This matters because percentages determine priorities.
Lower relative investment places enormous pressure on essential medicines, cancer treatment, disease surveillance, rural health services, emergency response systems, and preventive healthcare.
Encouraging investments, such as digitising 400 health facilities through the Solar for Health initiative, demonstrate progress. However, these improvements must be matched with sustained financing that strengthens the entire health system rather than isolated interventions.
Governance Matters as Much as Funding
Funding alone cannot solve systemic problems if governance remains weak.
The report highlights procurement irregularities, theft of medicines, and persistent weaknesses within the health supply chain. These failures have had serious consequences, including reduced donor confidence and cuts to external medical supply support.
When medicines disappear before reaching patients, it is not simply a financial loss—it becomes a direct threat to human life.
The paper therefore calls for stronger accountability mechanisms, including independent audits, transparent procurement systems, stronger whistleblower protections, and complete implementation of electronic logistics management systems.
Public trust depends upon knowing that healthcare resources reach the people they were intended to serve.
Geography Should Not Determine Survival
Healthcare inequality is particularly severe between urban and rural Zambia.
Although thousands of new health workers have been recruited in recent years, many continue to concentrate in urban areas. Rural communities still experience severe shortages of doctors, nurses, specialists, diagnostic equipment, and emergency referral services.
Women in rural communities continue facing significant barriers to cancer screening, maternal healthcare, and specialised treatment.
Without deliberate incentives—including housing, hardship allowances, transport support, and professional development opportunities—staff shortages in rural Zambia will continue widening existing inequalities.
Cancer Care Exposes the System's Biggest Weakness
Perhaps no issue better illustrates Zambia's healthcare inequality than the breakdown of radiotherapy services.
When radiotherapy equipment becomes unavailable, patients requiring life-saving cancer treatment face impossible choices.
Those with sufficient resources travel abroad.
Those without financial means often have nowhere to turn.
The paper argues that cancer treatment should never depend upon personal wealth. It recommends building redundancy into oncology services through multiple radiotherapy machines, guaranteed maintenance schedules, transparent referral systems, and financial assistance for low-income patients who require treatment away from home.
Healthcare should offer hope — not impossible decisions.
Infrastructure Remains a Silent Crisis
Quality healthcare depends on more than hospitals and medical staff.
Many health facilities continue operating without reliable water, sanitation, electricity, or maintenance systems.
Some facilities still lack basic water services entirely, making infection prevention extremely difficult. Electricity interruptions disrupt surgeries, vaccine storage, emergency care, sterilisation, and digital health systems.
These weaknesses become especially dangerous during disease outbreaks such as cholera, where clean water and sanitation become essential components of disease control.
The report argues that resilient healthcare infrastructure must include reliable WASH facilities, renewable energy investments, and protection of critical health facilities from prolonged power disruptions.
Zambia Faces Both Old and New Health Challenges
The country continues making important progress against malaria and HIV.
Malaria cases and deaths have declined significantly due to expanded community health programmes, mosquito net distribution, vaccination, and preventive interventions. Likewise, HIV infections and mother-to-child transmission have fallen substantially over the past two decades.
Yet new challenges are emerging.
Recent increases in malaria cases, continued cholera outbreaks driven by inadequate sanitation, funding uncertainties for HIV programmes, and persistent inequalities in prevention demonstrate that progress remains fragile.
At the same time, Zambia is experiencing a growing burden of chronic diseases such as hypertension and diabetes.
Many patients remain undiagnosed or receive inconsistent treatment, increasing the long-term costs of healthcare while reducing quality of life.
Mental Health Can No Longer Be Ignored
Mental health has become one of Zambia's fastest-growing public health concerns.
Rising substance abuse, increasing suicide rates, and growing numbers of children requiring psychiatric care highlight the urgent need for expanded mental health services.
Although government and development partners have launched important initiatives targeting young people, the country continues facing severe shortages of mental health professionals.
Integrating mental healthcare into primary healthcare, expanding community-based services, training additional professionals, and reducing stigma will be critical in the years ahead.
A Roadmap Towards Equity
The paper concludes with practical recommendations that could significantly strengthen Zambia's health system:
Healthcare Is Ultimately About Human Dignity
At its core, this paper is not simply about budgets, infrastructure, or policy reforms.
It is about people.
It is about whether a mother's access to cancer treatment depends upon her bank account.
It is about whether a child in a rural district receives the same quality of care as one living in a city.
It is about whether healthcare remains a constitutional right or gradually becomes a privilege.
A nation's health system reflects its values. If Zambia is committed to justice, equity, and human dignity, then strengthening healthcare for the common citizen must remain a national priority.
Improving the health sector is not only an investment in better health outcomes—it is an investment in equality, dignity, and the future of every Zambian.
"A just Zambian society guided by faith, where everyone enjoys the fullness of life".