If there is an overriding lesson Africa can learn from the COVID pandemic, it is self-sufficiency. Though Africa was not the originator of the pandemic, it has suffered disproportionately from it. The strains on our healthcare systems were vast and remain raw, especially among the most vulnerable. Following the pandemic, it is important to look to the future – to assess what we can do to prepare ourselves for future pandemics or health crises.
Self-sustaining healthcare systems are at the core of Africa's developmental success. Our leaders have been working to improve our healthcare systems over the years. We have seen progress since the Abuja Declaration of 2001 – but there are still some gaps that need urgent attention to match our healthcare spending with our fast-growing population, and the rising disease burden that we face. Low healthcare spending means that Africans would continue to confront diseases – like TB and malaria – which have been eliminated elsewhere. And our high disease burden means that some of the most vulnerable people in our societies are still suffering ill-health, and paying for their healthcare out-of-pocket, pushing 11 million more people into poverty every year.
In February 2019, the African Union convened global and regional health leaders and heads of state for the African Leadership Meeting (ALM) - Investing in Health. The outcome was the ALM Declaration, an initiative aimed at boosting domestic resources for health and reorienting health delivery systems. Through the ALM, African leaders committed to a structured reform pathway, which aims to address the way health systems are financed across multiple dimensions - not only on the volume of domestic resources required to meet healthcare needs but also how these resources are used efficiently and equitably.
This was a timely intervention, laying down a roadmap for change. Now is the time to follow that map – taking Africa on a journey towards sustained health financing and stronger and more resilient healthcare systems. How does this look like in practice?
The first step is for Governments to re-assess their current commitments for adequacy and progress The ALM Declaration is just one piece of the puzzle – as we have already seen many African nations commit to the Universal Health Coverage (UHC) in the past years. In Rwanda, for example, a national community-based health insurance programme is subsidizing health insurance for the least well-off citizens, using funds pooled from the more affluent. In Namibia, the government plans to introduce UHC next year, building on our medical aid offering.
This kind of commitment can be supported by raising additional capital and redirecting funds within our domestic treasuries. But Governments can also shore up financing for UHC, by supporting the current Global Fund's replenishment drive. The Fund's replenishment conference in September is a key opportunity for both donor and recipient countries to renew their commitments to financing, and to ramp up support for the fight against AIDS, malaria, and TB. Doing so will not only reduce the global mortality rate from HIV, TB, and malaria – by up to 60 percent by 2026, and save 20 million African lives, it will also provide a foundation upon which we can entrench sustainable and resilient healthcare systems in Africa.
The second step in our journey is tapping into the connections, relationships, and opportunities we already have and channeling them into one united goal: building better healthcare systems across the continent. By working together, we can help to prevent thousands of deaths and protect our economies from the adverse effects of healthcare emergencies and ensure healthy and productive generations for the future.
There are opportunities globally to secure knowledge, resources, and other forms of needed assistance. Other Governments can provide guidance to ensure a smooth path through the crises we face, and global corporations can be a source of funding, research, and technical know-how. Over the last few years, we have used Public Private Partnerships (PPPs) to tackle capital-intensive challenges that face our countries and promote better healthcare across our continent. These mutually beneficial partnerships are one of the key drivers of development – and will help set us up to manage these challenges in the future.
We can also leverage the recent leaps in innovation, including the development of pharmaceuticals within the continent, and the drive towards local manufacturing. During the pandemic, we saw local manufacturers pivot towards the production of bridge ventilators. And in 2019, the African Union Assembly adopted a treaty to establish the African Medicines Agency offering access to safe, high-quality medicines across the continent.
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Any of these partnerships will need careful nurturing – and part of this is demonstrating progress and accountability for the funds and support we're receiving. That is where initiatives like the African Union's Health Financing Tracker can help. This kind of tool could help our governments to maintain oversight on the funds and resources they receive, guide much-needed reforms and assist them to adhere to their spending commitments.
As our healthcare goals grow even more ambitious, these kinds of innovative approaches are key to our progress. Our Governments need to continually engage with citizens, working diligently on pandemic recovery, and forging public-private partnerships to deliver more efficient and effective health outcomes.
By working within these pathways in a collaborative and committed way, we can transform our continent and deliver the change that Africa deserves. Health is the bedrock for sustainable African development – we need to take the future of our continent in our hands.
Madame Monica Geingos is the First Lady of the Republic of Namibia
