Malawi’s 1948 Public Health Act faces overhaul amid push for accountability and modern health reforms
By Edwin Mauluka
Malawi’s civil society organisations (CSOs) are pushing for a new Public Health Act that they say is better equipped to address the country’s modern healthcare challenges, ranging from mental health and digital health systems to public health emergencies and the protection of healthcare workers.
The call emerged during discussions between the Parliamentary Committee on Health, civil society groups and health sector stakeholders on proposed reforms to the Public Health Act, with a focus on strengthening accountability and improving service delivery.
The engagement brought together representatives from the Malawi Health Equity Network (MHEN), the Malawi Network of People Living with HIV (MANET+), the Malawi Human Rights Resource Centre (MHRRC) and the Centre for Social Accountability and Transparency (CSAT).
MHEN executive director George Jobe said the current Public Health Act, enacted in 1948, is outdated and no longer reflects the realities facing Malawi’s health sector.
“As a nation, we are currently faced with a number of challenges such as mental health issues, digital health systems, the management of public health emergencies and the protection of health workers. These require a new Public Health Act that responds effectively to these issues,” said Jobe.
He argued that a reformed law should place citizens and patients at the centre of health governance by promoting dignity, equity, access to healthcare, transparency and accountability.
Jobe also called for stronger domestic financing for healthcare, including ring-fenced funding aligned with the Abuja Declaration, which urges African governments to allocate at least 15% of national budgets to the health sector.
He further proposed expanding optional paying services across public health facilities to generate additional resources while maintaining access to free healthcare.
“District hospitals have opened optional paying services, but we need a system that ensures every public health facility, including health centres, has a paying option for those covered by medical schemes,” he said.
Jobe also urged authorities to introduce digital medicine-tracking systems and identification markings on government-supplied drugs to curb theft and improve accountability. He said stronger sanctions were needed against officials found guilty of negligence, corruption or abuse of public health resources.
According to Jobe, civil society organisations continue to play a critical role in shaping reforms, particularly around non-communicable diseases, public health legislation, transparency and accountability in health programmes.
Law Commissioner Rosemary Kanyuka said consultations conducted during the review process had similarly highlighted the need to modernise the law, including provisions for optional paying wings in public health facilities.
“It is a nominal fee. It’s like a contribution to the facility because many health centres, particularly in rural areas, often run out of basic supplies such as gloves,” Kanyuka said.
She added that stakeholders had also identified the need for stronger accountability mechanisms, increased citizen participation and improved protection of public health resources.
Parliamentary Committee on Health chairperson Anthony Masamba said lawmakers would work towards ensuring the proposed legislation reaches Parliament.
“We will continue engaging various stakeholders, including the Minister of Health and the Ministry of Justice. We are hopeful that these consultations will produce a strong report that can be presented to the National Assembly and support the passage of the law,” said Masamba.
Beyond legislative reform, discussions also focused on strengthening collaboration between Parliament and civil society organisations to address persistent public health challenges and improve healthcare delivery across Malawi.
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