When what starts as a simple cough turns into pneumonia, a seven-day course of antibiotics could be the cure.
But in Kenya, that treatment could cost almost a month’s wages for many. What good are healthy lungs if the price you pay for them leaves you with little to eat?
In many sub-Saharan African countries, medicines account for up to two-thirds of all health costs, which patients pay out of their own pockets. And that’s for the medicines that are available.
Drugs used to treat non-communicable diseases like asthma or heart disease are often unavailable. Insulin, for treating diabetes, is only available in a half of the health facilities in 15 African nations, according to a survey by the World Health Organisation (WHO) this year.
Complicating matters further, half of all reports of substandard and falsified medicines come from Sub-Saharan Africa. These drugs play a role in the deaths of 100,000 people in Africa every year, and also contribute to the rise of drug-resistant diseases that make potent medicines useless despite their high prices.
There are 54 regulatory authorities for medical products in Africa, but not all have the same capabilities. Many lack the resources to efficiently register and approve medical products.
Over the past five years, however, 15 countries in the region have revamped how their populations access the right medicines and get treated properly.
The work, managed by WHO through a 10 million Euro grant from the European Union, started with updates to each country’s essential medicines list, the “shopping list” of current approved medicines for healthcare.
Many of these updates included the new child-friendly medicines for HIV, TB and malaria that recently came on the market.
In Ethiopia, the Ministry of Health used the resources from this project to define which medicines would be covered by the national insurance scheme, the first step towards universal health coverage.
The ministry also assessed the drug and therapeutics committees in 111 public hospitals, dramatically improving their performance in stocking and distributing medicines for treatment.
Ethiopia also joined Mozambique in improving how they screen for substandard and falsified medicines at ports of entry.
Mozambique’s work in monitoring medical treatment increased the number of adverse drug reactions tracked by authorities from 118 in 2012 to 936 in 2014, helping medical staff respond more quickly to systemic problems. Mozambique also joined Kenya and four other countries in improving the registration and inspection of medicines, revamping quality control, the tracking of adverse reactions, and the authorisation of pharmaceutical distributors.
The partnership behind all this work trained a total of 3,600 health workers — including pharmacists, regulators, and supply and distribution technicians — in the 15 countries over the last five years. Many of the countries surveyed how antibiotics were used, a first step in the effort to limit drug-resistant infections.
This is the type of work that will not create front-page news, and it would be difficult to generate an accurate account of just how many lives have been improved. And yet, this partnership has established some of the essential building blocks that will improve healthcare delivery in Sub-Saharan Africa.
This work needs to continue, and we need to find additional resources to extend the partnership to all of sub-Saharan Africa. A cough should never lead to more serious problems—especially the heartache of not having enough money to feed one’s family—when a simple course of medicine is all that is needed.