What $24bn can do for Africa’s health

What you need to know:

  • Continent now faces the triple burden of non-communicable diseases and re-emerging epidemics including Ebola.
  • Most countries are unable to provide their growing population with access to affordable and quality health care services.
  • Ticad highlighted the Japanese government’s support to track universal health coverage progress in Africa through an annual report.

One of the key announcements made during the Tokyo International Conference on Africa’s Development (Ticad) is on expanding universal health coverage in Africa.

The World Bank Group, the Global Fund, and other partners announced a commitment of $24 billion to accelerate this.

Many African governments continue to demonstrate goodwill towards health and have achieved significant improvements.

However, a lot more remains to be done.

For instance, according to World Bank data, whereas maternal mortality has improved drastically, from 980 maternal deaths per 100,000 live births to 560, it still pales in comparison to the Organisation for Economic Cooperation and Development countries, where it stands at 15.

In addition, while Africa continues to grapple with infectious diseases such as HIV/Aids and malaria, the continent now faces the triple burden of non-communicable diseases and (re)emerging epidemics including Ebola.

To further compound Africa’s challenges, most countries are unable to provide their growing population with access to affordable and quality health care services.

Additionally health systems in most African countries are inadequately financed.

ACCESS TO BASIC HEALTH

The $24 billion commitment could mean a chance to achieve universal health coverage in five years.

A key component of attaining universal health coverage is providing people with access to basic health care.

This implies that citizens are assured of pre-paid access to qualified health care providers and quality essential medicines without the need for out-of-pocket payments.

One of the feasible ways is by ensuring that national health insurance schemes are pro-poor and inclusive through government subsidies.

This would be a substantial step to moving away from out-of-pocket payment by patients, which perpetuates poverty, to pre-paid health care.

Universal health coverage could prosper from an increasingly digitising continent by harnessing technology such as mobile money to provide home grown solutions to health care.

IMPORTANCE OF PARTNERSHIPS

While there is general consensus on the important role of the private sector and public-private partnerships in universal health coverage, private sector participation in Kenya and Africa can and should improve.

Private sector participation in health can be enhanced by facilitating more strategic alignment of projects to government priorities that sustainably support and lift the poorest out of poverty, improving the business environment to make investments in health care attractive to the private sector, and improving policies and regulatory frameworks.

Further, the commitment to universal health coverage should consider the role of the private sector, especially those targeting the poor — a market that is innately risky for businesses in health.

It can offer solutions to challenges faced by the private sector by de-risking the process of providing health care, especially to the poor, through supporting initiatives that improve the regulatory and business environment and providing a pool of funds for accessible and affordable credit and other appropriate lending mechanisms.

Perhaps one of the best ways of complementing universal health coverage is to ensure that the investments and targeted health outcomes are systematically monitored and on track.

Proper monitoring and evaluation of universal health coverage’s implementation should enable us to build on the progress and ensure that we leave no one behind.

Ticad highlighted the Japanese government’s support to track universal health coverage progress in Africa through an annual report.

My suggestion would be to localise the monitoring of these targets so that they are not too abstract for the immediate context and are directly relatable to health care stakeholders.

There is the risk, as in most international conferences, to make huge announcements without concrete frameworks and steps towards implementation.

Ticad participants have made salient calls to strengthen and deepen partnerships between the private  and public sectors and non-governmental organisations in the health space.

It is only in strong and innovative partnerships that the disease burden in Africa can be tackled to ensure that it does not cripple our economies and provides everyone with the opportunity to live a healthy and productive life.

Dr Rono is health systems expert and partner at E&K Consulting. [email protected]. Twitter: @Dr_Josea_Rono