Methods: Data came from three sources: a literature review, including a search for grey literature, review of government documents from the Zimbabwe National AIDS Council (NAC), and key informant interviews with representatives of the Zimbabwean government, civil society and international organizations.
Lastly, key informant interviews were conducted with three groups of stakeholders: representatives of Zimbabwean government, representatives of Zimbabwean civil society and representatives of international organizations. Key informants were selected purposively for their specialized knowledge or perspective on the AIDS Levy and represented a spectrum of viewpoints. Subsequent key informants were interviewed based on recommendations of initial key informants during their interviews. Key informant interviews took place from November 2012 to January 2013 in Zimbabwe.
How did the existence of the AIDS Levy impact the overall response to HIV and AIDS in Zimbabwe? While other low- and middle-income countries have committed increasing resources to the HIV and AIDS response, the Zimbabwe AIDS Levy is notable for having been established in the late 1990s, relatively early in comparison to the responses and funding from other low-income countries (Ávila et al. 2013). Zimbabwe is also notable for having a substantial decline in HIV incidence in the late 1990s and decline in adult HIV prevalence from 26% in the late 1990s to 15% in the early 2010s (Global AIDS Response Country Progress Report, Zimbabwe 2014). While the decline may not be attributed directly to the AIDS Levy, both are indicative of a vigorous national response to the epidemic. The AIDS Levy stands out as a well-established, highly visible commitment on the part of government as well as citizens. Most formal-sector employees have an itemized deduction for the AIDS Levy listed on each pay stub. As envisioned at inception of the AIDS Levy, substantial other donor support for the HIV and AIDS response has been successfully attracted to Zimbabwe, including currently each year over US$100 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria and nearly US$100 million from the US President's Emergency Plan for AIDS Relief (UNAIDS and Kaiser Family Foundation 2014). Statements from the Global Fund indicate that the AIDS Levy was factor in the decision to increase funding for Zimbabwe (Zimbabwe Ministry of Health and Child Welfare 2013). The relative, direct public health impact of the AIDS Levy also needs to be considered together with other government spending. For example, US$38.6 million was raised by the AIDS Levy in 2014 while the overall MOHCC budget for 2014 was US$301 million, most of which funds the labor costs of health care workers who implement HIV and AIDS medical care and treatment. So, while the AIDS Levy is a very substantive commitment to the national response to HIV and AIDS, and it has funded some key non-health activities, it is a fraction of the overall national spending on health. Further policy considerations in this area should weigh the relative merits of the AIDS Levy versus the alternative of funding the response to HIV and AIDS from within the national budget derived from general revenue streams, taking into account the positive visibility of the AIDS Levy balanced against the administrative costs for a relatively small proportion of the overall response.
This part of the OBS measures public access to information on how the central government raises and spends public resources. It assesses the online availability, timeliness, and comprehensiveness of eight key budget documents using 109 equally weighted indicators and scores each country on a scale of 0 to 100. A transparency score of 61 or above indicates a country is likely publishing enough material to support informed public debate on the budget.
The OBS examines the role that legislatures and supreme audit institutions (SAIs) play in the budget process and the extent to which they provide oversight; each country is scored on a scale from 0 to 100 based on 18 equally weighted indicators. In addition, the survey collects supplementary information on independent fiscal institutions (see Box).
Zimbabwe is on a path to strengthening transparency in how it manages public finances and delivers results for citizens. The southern African nation, home to about 15 million people, has shifted to a program-based budgeting (PBB) approach, a budgeting reform approach that promotes sound public financial management (PFM). Despite its benefits, adopting and implementing PBB can be difficult and requires a long-term commitment.
Going forward, transparency and accountability can be further enhanced through the inclusion of program budgeting reporting provisions in either the PFM Act or PFM regulations. In addition, the strengthening of institutional capacity and enhancing the ownership of PBB will need the continued buy-in and engagement of key stakeholders. Steps have already been taken to sensitize Parliament and the Audit Office on the rationale of PBB and their respective institutional roles and responsibilities:
While there has been notable progress in creating appropriate and policy-relevant performance information and measures, there is room to improve their quality and relevance. Concurrent to the development of program structures, initial efforts have focused on developing and refining performance data and measures. According to the performance information and measures in both the 2020 and 2021 estimates of expenditure books, key challenges relate to the use of: (i) activity and input indicators that inherently focus on internal processes; (ii) indicators that are difficult or expensive to measure and monitor; and (iii) performance information with limited relevancy for budgetary decision-making.
Notable progress achieved to date needs to be sustained and deepened by addressing institutional, human resource, and technical constraints to PBB implementation. That means ensuring implementation reports are produced and made publicly available. It also means that the authorities should consider adopting enabling legislative amendments to anchor the PBB reform and nurture a performance culture within the public service. Such measures would strengthen the dedicated reform unit in MOFED; the strategic phase of the budget cycle; and enhance parliamentary oversight.
Through the ZIMREF Results Based Technical Assistance program, the Ministry of Finance and Economic Development has developed a budget that will ensure that national resources are more effectively used in support of national development goals.
In the 2016 National Budget submission, the pilot ministries presented two budgets, one in the customary format and one in the new results-based format. To help parliamentarians understand the new budgets, a workshop was held with the key committees to familiarize them with program budgeting and how it will help to strengthen their oversight of national spending.
The ZIMREF Results-based Budgeting Technical Assistance Program ($0.7 million) is supporting the rollout of program budgeting to all the line ministries by 2018, as well as policy and expenditure analysis in the Ministries of Health and Child Care, and of Primary and Secondary Education. Six additional ministries are receiving training and technical assistance for the next budget cycle, and the program will continue to provide support to Parliament and civil society organizations that monitor public spending
Results-based budgeting forms part of broader effort by the Government of Zimbabwe to introduce results-based management across the public services and to improve public financial management in general. The Zimbabwe Reconstruction Fund, under its window of Systems Reconstruction and Development, is also supporting the Office of the President and Cabinet to improve monitoring and evaluation with ZIMREF-funded technical assistance ($0.5 million), the Ministry of Finance and Economic Development to improved state-owned enterprise governance and public investment planning ($4.2 million), the reform of public procurement ($4.0 million), and the strengthening of the public financial management ($20 million).
According to recent estimates, the richest 10% of the population consume close to 40% of national resources. This skewed distribution of resources and economic opportu- nities is detrimental to national cohesion and the achievement of national objectives outlined in the National Development Strategy 1 (NDS1) framework. Inclusive and re- sponsive allocation of national resources is vital to reduce poverty and inequality. In this regard, the 2022 budget fails the poverty and inequality test by increasing the tax burden on the poor, without doing enough to level the playing field for the 70% majority subsisting in the informal economy or boosting household incomes through meaning- ful resource transfers.
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