Zimbabwe Health system Diaries: Circular Economy-the answer

By Rumbidzai Mashavave

In response to the dire situation in the government hospitals in Harare, Zimbabwe. The Save our Hospitals Initiative was born in Zimbabwe and thus far is made up of a co group of volunteers affiliated with the health sector in Zimbabwe. This group of volunteers will be joined by one senior doctor (consultant) from every one of the referral hospitals in Zimbabwe. The initiative will seek to assist these hospitals by mobilizing resources both at home and abroad. It will step in where government would have failed to supply the much needed medical consumables and or equipment, this will be done with the consent of the Ministry of Health.

The Core Group will also be the custodian of the process from start to finish between the hospitals and the citizenry and corporates to ensure accountability, trust and long term planning. The responsibilities that has brought to my attention are:

“The chairperson of each trust will have a seat on the Core Group so each hospital will know what will be happening at the other hospitals.”

  • Facilitates a shared economy – a circular principle (equipment sharing)

“He is also the one who will assist in getting government to issue customs rebate certificates for any equipment bought outside the country by citizens and corporates.”

  • Circular benefit: (cost reduction in purchasing equipment)

Presents an opportunity for the health sector to participate in the transition to the circular economy. Savings in the health care sector can be realized in transitioning to the circular economy.

The World Health Organization (WHO) through relevant academic studies, suggest 2 ways in which the health system and public health can have direct and indirect positive health impacts. It is also creates business opportunities within the health sector.

  1. Performance models encourage sustainable revenue streams, maximize resource use, and drive efficiency of use. A supplier of magnetic resonance imaging (MRI) scanner, for example, can lease rather than sell the equipment to Harare Hospital for example. The Save our Hospitals Initiative could lease out the equipment to 2 hospitals per equipment. Another alternative is to collaborate with private hospitals with the required equipment on a leasing agreement which achieves the same purpose of minimizing the costs of purchasing.

This helps to minimize total costs, since ownership may involve upfront investment costs, risks (repair, maintenance or obsolescence) and end-of-use treatment costs, while performance models can reduce purchasing and maintenance costs and maximize performance”  

WHO 2018

The Ellen MacArthur Foundation adds that the supplier can secure This model may also give incentives to manufacturers to design products that are easier to maintain, repair and refurbish or remanufacture. The range of products that could be procured in performance models  includes magnetic resonance imaging (MRI) scanners, radiation treatment equipment, laboratory instruments and (semi)durable goods such as scalpels and surgical apparel.

  1. 2.Recycling and waste reduction is not a new concept but needs to be emphasized for hospitals to take a leading role. Using circular principles could reduce the considerable waste generated in the health care sector, with associated cost reductions, including virtualization such as  technology-driven diagnosis A Case study is the  University Hospital in Freiburg, Germany, the introduction of waste minimization measures resulted in total annual savings of about €321 000 according to the Health Care Without Harm Europe.

Though promising short as well as long term benefits to the health system, what is lacking is research to suit the Zimbabwean context.  Uplifting the health system does require a different approach, a sustainable approach and the circular economy gives just that. What is lacking in the African context and particularly Zimbabwe to assist in the transition to a circular economy.  The responsibility does not fall on the Save our Hospitals Initiative per se, but a call to the academia to participate in research as well as disseminate the information to relevant bodies. This includes the general public who are part of the economy as the consumers.

A common remark in Zimbabwe is that we know how to make and just as well, do have the best policies in place, but no implementation. Therefore instead of advocating for policy to be our first point of call, before we act, we need to utilize, civil society, private sector, consumers and the academia to make transition to the circular economy towards positive health implications. What is important is starting.

When we do raise our flag as our Zimbabwean national anthem demands…, let it be with pride, that we use our own resources (e.g. land, labour, minerals, wide array of skills)  making the best out of residue streams, increasing resource efficiency, all of what transition to the circular economy demands.

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