Friday, July 1 2022

Jhe coronavirus pandemic has left African governments scrambling to catch up as their historic neglect of public health systems is laid bare.

Dysfunctional hospitals with limited facilities are being hastily prepared for a possible influx of seriously ill and infectious patients. As a tsunami of cases hit developed markets, whose far more sophisticated healthcare systems were beginning to strain under the immense pressure, African government officials were forced to act to address the severe challenges of their own systems.

Government ministers raced to find the resources and political will to bring service delivery to long-neglected communities. In South Africa, towns and villages that have not had water for years have quickly been provided with reservoirs to enable communities to wash their hands to mitigate infection.

Abandoned hospital facilities received a quick facelift. The Wilkins Infectious Diseases Hospital in Harare, Zimbabwe, has been hastily revamped by China. Publicity following the Covid-19 death of a local media personality at the facility had revealed appalling conditions. Yet these quick fixes stick band-aids over a gaping wound.

In too many countries, the health sector remains on the back burner of government priorities, often seen by policy makers as a cost rather than an investment to improve the sustainability and transformation of their economies. The absence of a properly functioning health sector undermines the notion of qualitative or inclusive economic growth – especially in times of global pandemic.

According to the 2019 UNECA report Health care and economic growth in Africa, Africa accounts for less than 2% of global health expenditure, but 26% of the population and 36% of the global disease burden. Meanwhile, only a few countries have met the African Union’s 2001 guidelines to allocate 15% of their budgets to health. Average expenses are between 5 and 6%.

Poor facilities in the country have led to the outsourcing of scarce foreign exchange resources by wealthier Africans who travel to access quality medical care elsewhere. Speaking at the launch of the UNECA report, an Ethiopian official said up to 90,000 citizens of the country travel abroad for medical treatment each year – a loss of income of around 500 million dollars per year.

A crisis that affects everyone

With many favorite medical destinations in lockdown and internal borders closed, policymakers are reliant on the flawed healthcare systems they have created. A Nigerian commentator said: “This is the first time that a problem in Nigeria has affected everyone here. There is nowhere to run. You can’t throw money at it. Your other passports are not helping you! The only cure is a functioning health system!

The picture is not encouraging. Public hospitals across the continent are struggling with water and electricity shortages, drug shortages and a shortage of doctors and nurses, many of whom are being lured abroad for better salaries and working conditions. job. The average density of doctors in sub-Saharan Africa is 0.2 doctors per thousand inhabitants, according to the world Bank.

According to the ECA report, 20 African countries are severely or seriously affected by health, which means an above-average burden of disease, low official health expenditure, high out-of-pocket expenditure, low density of health professionals health and low GDP growth rates. Out-of-pocket expenditure borne directly by patients now accounts for 36% of health expenditure in Africa.

An opportunity for new thinking

Governments continue to dominate the healthcare space, although they generally provide substandard services. There are examples of successful public-private partnerships in health, but distrust of business prevents further engagement. Officials are still developing national health plans without considering or including the participation of the private sector.

There have been incremental improvements in some areas, including increased life expectancy, and the political will to address the issue is growing through a shift in continental strategy and the introduction of new initiatives.

But the current pandemic offers a golden opportunity for more critical reflection on the quality and effectiveness of interventions in the health sector in Africa, now that policy makers are compelled to pay attention.

This message was hammered home by Babatunde Omilola, Head of the Public Health, Security and Nutrition Division of the African Development Bank (AfDB), who called for the scaling up of medical technologies, increased investment in basic health and digital health tools. , and the establishment of targeted funding programs with development partners.

As he said in a blog for the AfDB April 17, 2020: “There is no time to waste: while it can be daunting to find ways to fight the current pandemic, it also presents an opportunity to focus on strengthening African health systems by adopting a global and integrated approach based on the situation of each country. Individual needs. Let’s not go back to business as usual after this pandemic. »

This article originally appeared in the May 2020 edition of African Business magazine.


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