Africa: How We Invest In - and Achieve - Health for Africa

Toyin Saraki speaking at the London School of Hygiene and Tropical Medicine special event hosted by the WOMAN Trial and the Centre for Maternal, Adolescent, Reproductive & Child Health, spotlighting a drug that can save mothers hemorrhaging during childbirth.
31 October 2018
guest column

Abuja — Now is the time for African women to stand up for ourselves and nurture leadership among others. We have been fantastic in many areas essential to progress at the family and community level. Now it is time for us to be role models and to show that we can contribute our quota in every area of social and economic development and to make our voices count on the global stage.

Women can transform the lives of Africa's people. We are beginning to insist that our countries have policies that deliver the demographic dividend of a large youth population, rather than pay the inevitable price for allowing the majority of our people to remain undereducated, jobless and desperate.

Last month at the United Nations General Assembly, I joined others to press the urgency of investment in our collective future and to warn of the dangers of delay.

Health is a requisite foundation for sustainable development. Yet only two countries in Africa – Rwanda and South Africa – have met the Abuja Declaration, in which governments pledged 15 per cent of their budgets to health.

Meanwhile, tuberculosis kills more than 4,000 people every single day, non-communicable diseases kill over 41 million people every year, and 80% of deaths in childbirth could be avoided with techniques that should be available across the globe. There has also been a distinct lack of progress in delivering upon the World Health Assembly 2017 Sepsis Resolution, designed to control deadly, systemic infections, or in improving water, sanitation and hygiene in healthcare facilities, schools and communities.

What Is to Be Done?

There are five key interventions that must be a priority if we are to see real advances in health. Unless significant progress is made – and soon – the Sustainable Development Goals will not be met by the global community.

First, invest in family, community and primary healthcare – and in hospitals, where needed – to bolster healthcare wherever people need it; in rural areas and urban, cities and villages.

Second, protect frontline health workers, who often deliver life-saving care amid danger to themselves. The recent murders of two young midwives working among the victims of conflict in northeast Nigeria, as well as attacks on health professionals working to contain Ebola in eastern Congo (DRC), must spur governments and global institutions to strengthen security provisions for health workers.

Here I would like to do a big shout out for midwives and midwifery. Midwives' hands are the first to hold a newborn and the first eyes to see them – and often midwives are forgotten. So many people don't remember the name of their midwife. It is time for us to remember them. In addition, it is time to regulate and register the members of the profession, as well as to remunerate them properly. Through this, we will win a huge increase in human capital value for these skilled birth attendants, most of whom are women and all of whom do an essential job for society.

The Wellbeing Foundation Africa's Emergency Obstetric and Newborn Care programme, operated with its global partners Johnson & Johnson and the Liverpool School of Tropical Medicine, can serve as a benchmark for health worker training. We have shown that qualified midwives can and do lead the way with quality care.

Third, we need fact-based information about the health sector. Civil registrations and systems to record vital statistics must be implemented and strengthened. Otherwise, governments cannot allocate investment where it is needed the most and are unable to prepare for epidemics.

According to the World Bank's latest figures, 1.8 billion people have no government identification. Consequently, their health needs are highly unlikely to be met. Individuals and countries and regions will be vulnerable to disease outbreaks, including potential pandemics.

Fourth, governments must be held accountable for investing in universal health care. Promoting health insurance systems is an important step toward achieving universal coverage. In my country, Nigeria, and elsewhere, too many people are pushed into poverty by health emergencies that they or their families experience. We will never defeat scourges of malaria or high rates of infant and maternal mortality unless our people have access to medical care.

Fifth, we must recognize the acute threat of non-communicable diseases that kill over 41 million people every year. The Director-General of the World Health Organization, Dr. Tedros, has rightly highlighted the NCD crisis, and public officials must make it a core focus of all government programmes.

Whilst progress has been made in many areas, I feel compelled to speak out, as too many women, children and communities are being left behind. We have the opportunity to change the course of history, but it is a chance that is slipping away. Urgency is the order of the day.

Toyin Saraki is Founder-President of the Wellbeing Foundation Africa, Global Goodwill Ambassador for the International Confederation of Midwives, Special Adviser to the World Health Organization regional office for Africa and wife of the Senate President of the Federal Republic of Nigeria.

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