Health expenditure implications of SACU’s revenue volatility in BLNS countries

Southern African Customs Union (SACU) revenue is on the decline and a likely effect of which is that critical areas such as health, education and agriculture may be scaled down. This is an issue of major concern given that SACU countries carry the world’s worst HIV/AIDS epidemic, therefore, any scaling down of prevention, care and treatment programs will decelerate current initiatives and, in some cases, reverse advances made in combating the scourge. Six policy proposals are presented, including: lobbying for increased aid to offset the declining SACU revenue; fiscal restraint aimed at realigning declining revenue with public expenditures; increasing the fiscal deficit to avoid disrupting public projects amid declining government revenue; restructuring the fiscal framework to move away from relying on SACU revenue, especially for recurrent expenditures; developing a long-term expenditure plan anchored on domestic revenue; and finally, efficient and effective use of public resources.
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