NGO sees debt burden threat to HIV fight

Rising public debt burden coupled with dwindling donor support threaten to reverse gains in HIV treatment and prevention in the country, a non-governmental organisation (NGO) has warned.

Aids Healthcare Foundation (AHF) Malawi country programme manager Davies Mwachumu told a media breakfast briefing in Lilongwe yesterday that debt servicing was limiting the Malawi Government’s ability to fund essential health services, including HIV and Aids interventions.

“When it comes to national debt, Malawi is spending a substantial share of the national budget on debt service. Due to this, social services are suffering when it comes to allocation of resources,” he said.

Mwachumu said inadequate funding was compounding shortages of healthcare workers, medicines and other essential supplies.

In theK10.9 trillion 2026/27 National Budget, public debt interest is projected to reach K2.7 trillion, up by 22.9 percent from K2.2 trillion in the previous fiscal year, according to Treasury data.

The projected interest bill is equivalent to 25 percent of the national budget, compared with K1.02 trillion allocated to the health sector, representing 9.3 percent of total expenditure.

Mwachumu said the debt burden was undermining Malawi’s capacity to increase domestic HIV financing as external support declined.

He urged Parliament to strengthen scrutiny of public borrowing and enact a debt management law to ensure loans are contracted through transparent procedures.

AHF is also advocating for a Borrowers’ Forum through which developing countries could negotiate collectively with lenders for fairer debt terms. It wants automatic pauses in debt servicing during health emergencies and climate disasters, as well as a one percent levy on revenues of major artificial intelligence companies to finance debt relief, health, education and social protection.

Mwachumu said poorer countries faced disproportionately high borrowing costs, making it harder to finance essential services.

“Poor countries are the ones paying debt at higher interest than rich countries. This is as a result of the policies that are there, and it also emanates from our colonial era,” he said.

AHF says poorer countries pay interest rates three to 12 times higher than richer nations, while African countries spend more on debt interest than on the health of their populations.

In his contribution, National Debt Coalition member Precious Mwafunga said mounting debt obligations were limiting the government’s ability to fill health financing gaps left by withdrawing donors.

“Most donors are pulling out. It means, as a country, we have to finance the health sector on our own, yet there are several financing gaps. At the same time, government has to service debt,” he said.

Mwafunga called for debt cancellation, arguing that the resources freed up could be redirected to health services.

But Parliamentary Committee on Health chairperson Anthony Masamba said in an interview that proposals for a debt management law and suspending debt payments during emergencies required careful legal, policy and fiscal assessment.

He said the committee supported stronger scrutiny of borrowing and debt sustainability but maintained that fiscal pressures should not compromise access to essential healthcare.

“Our position is that fiscal challenges should not undermine access to essential healthcare services for Malawians,” said Masamba.

In a separate interview, Ministry of Finance, Economic Planning and Decentralisation spokesperson Williams Banda said government was pursuing fiscal consolidation through macroeconomic and fiscal reforms to manage debt pressures. He did not specify how the reforms would protect health and HIV allocations.

The concerns come as Malawi faces the challenge of sustaining HIV services amid heavy reliance on external financing.

Kamuzu University of Health Sciences professor of epidemiology and public health Victor Mwapasa last week urged government to increase domestic HIV funding to prevent severe disruption of life-saving services.

“The government had no other way of doing it but to increase domestic funding, just to prevent severe disruption of life-saving HIV services,” he said.

Mwapasa, who also has expertise in HIV and malaria research spanning over 15 years, warned that reduced donor support could force government to prioritise treatment over prevention, including condom provision, if resources remained constrained.

Reports show development partners finance 77 percent of Malawi’s HIV expenditure, while domestic resources account for 23 percent.

National Aids Commission (NAC) figures show that 990 871 people were living with HIV in Malawi in 2024, of whom 896 035 were receiving antiretroviral therapy (ART) by December that year. The country recorded 11 757 new HIV infections in 2024.

NAC also reports that 13 694 people died from Aids-related illnesses in 2024, bringing cumulative Aids-related deaths since 1985 to 1 518 643.

The World Health Organisation says there is currently no cure for HIV, but effective prevention, diagnosis, treatment and care enable people living with the virus to manage the condition and live long, healthy lives. ART suppresses the virus and prevents sexual transmission when viral suppression is achieved.

AHF Malawi says it supports 27 health facilities in five districts, providing HIV testing and treatment, cervical cancer screening, tuberculosis testing, sexually transmitted infection treatment, psychosocial support and nutrition services.

The post NGO sees debt burden threat to HIV fight appeared first on Nation Online.