Liberia's health sector is facing a demanding performance test as the country approaches 2030, with health leaders warning that progress will depend on the government's ability to strengthen financing, retain health workers, reduce inequalities and build a system capable of withstanding future emergencies.
The warning came on Thursday during the 10th Annual General Scientific Meeting (AGSM) and Convocation of the Liberia College of Physicians and Surgeons (LCPS), where health professionals, policymakers, educators, researchers, and trainees gathered to examine the country's preparedness to meet its health sector goals by 2030.
Held under the theme, "Resilient, Equitable, and Sustainable Health System for Liberia 2030," the meeting brought together physicians, nurses, allied health professionals and other stakeholders for plenary sessions, scientific presentations, panel and group discussions, leadership dialogue and poster presentations.
The scientific program centered on three major areas: "Health System Strengthening and Financing"; "Health Workforce, Education and Digital Health"; and "Emergency Preparedness, Climate Change and One Health."
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Delivering the keynote address, Partners In Health Liberia Country Director Dr. Maxo Luma congratulated LCPS for reaching the 10-year milestone, describing the AGSM as a forum for scientific knowledge and dialogue.
"For 10 years, this gathering has served as an important forum for advancing scientific knowledge, professional dialogue, and critical reflection on the future of healthcare in Liberia," Dr. Luma said.
"That future will require more than resources alone. It will require leadership, partnership, and innovation," he said.
He urged Liberians to move beyond repeatedly recovering from crises and instead build a health system capable of absorbing and adapting to future shocks.
Luma said Liberia's performance by 2030 would depend on whether the country can move beyond repeatedly rebuilding its health system after crises and establish structures capable of absorbing and adapting to future shocks.
"My reflection today focuses on a journey that Liberia knows very well--the journey from recovery to resilience, and ultimately from resilience to sustainability," Luma said.
"Recovery cannot be our sole destination. The real challenge is whether we are building a health system capable of withstanding future shocks without repeatedly starting over."
According to Luma, Liberia's history of civil conflict, Ebola and COVID-19 has demonstrated the consequences of entering emergencies with underlying weaknesses already present in the health system.
"The emergency may be unpredictable. That's why it's called an emergency. But the vulnerability is not unpredictable," he said.
He pointed to the 2014 Ebola outbreak as a major example, saying the epidemic struck a health system weakened by years of civil conflict and limited resources.
"When Partners in Health arrived in Liberia in 2014, there were approximately 45 doctors in the public health system serving close to 4.5 million people," Luma said.
"Ebola was the spark, but a weakened and under-resourced health system served as fuel."
Luma said the post-Ebola period created opportunities for Liberia to strengthen community health programs, develop its health workforce and reinforce public health institutions, including the National Public Health Institute of Liberia.
But he cautioned that recovery from one crisis does not necessarily mean the health system is prepared for the next.
He explained that while recovery focuses on rebuilding after an emergency, resilience requires systems to absorb shocks, adapt, learn and continue delivering essential services.
"Recovery is about what happens after a crisis. Resilience is about what exists before the crisis begins," Luma said.
For Liberia, he said, community health workers represent an important component of that resilience because they can identify threats early, connect communities to healthcare and reduce pressure on hospitals.
"This means the first line of defense is no longer your level two, level three hospital. The first line of defense now is pretty much the community itself," he said.
However, financing remains one of the major questions confronting Liberia's 2030 health ambitions.
Luma expressed concern over reductions in international health financing and challenged policymakers to consider whether a health system heavily dependent on external assistance can be sustainable.
"Can a health system be truly resilient if it depends strongly on international or foreign aid?" he asked.
He called for increased domestic investment in healthcare, stronger training and retention of Liberian health professionals, equitable deployment of health workers and greater investment in primary healthcare.
"The future of Liberia's healthcare system must be designed, led, and sustained by Liberians," Luma declared.
He also urged Liberia to use digital health, data systems and other innovations to improve service delivery, access and accountability.
"Innovation is not really simply about technology. It's about finding better ways to solve persistent challenges and improve the health of the people we serve," Luma said.
Another major test, he noted, is equity.
Luma warned that improvements concentrated in urban areas would not amount to a resilient national health system if rural and underserved communities remain excluded from quality care.
"A resilient health system, for some, is not a resilient health system," he said.
He called for reducing urban-rural disparities, improving the distribution of health workers, strengthening referral systems and ensuring reliable access to medicines and supplies.
Speaking on behalf of Health Minister Dr. Louise Marpleh Kpoto, Assistant Minister of Health for Curative Services Dr. Tayah S. Moore praised LCPS for expanding specialized medical training in Liberia.
"I remember years back, if you want to specialize in Liberia, you have to fly out of the country," Dr. Moore said.
He acknowledged continuing weaknesses in Liberia's health indicators, citing high maternal and newborn mortality and the need for better health data.
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"The statistics we have as a country, they are not encouraging," he said.
Dr. Moore said the 2019-2020 Liberia Demographic and Health Survey is outdated and expressed hope for a new survey by 2027 to provide a clearer picture of progress toward SDG 3 on health and well-being.
He highlighted the health workforce shortage across Africa, saying retention remains a major challenge.
"One of the discussions on the continent now is the retention of health workforce, because the continent Africa of 1.4 billion only has 46% of its required health workforce," he said.
He added that Africa is estimated to need an additional 30 million health workers by 2030, making workforce retention and capacity-building critical priorities.
LCPS Secretary General Dr. Philderald Pratt described the 10th AGSM as a milestone.
"The purpose of the scientific meeting, of course, is to bring together doctors, researchers and the like to share ideas, to share knowledge on important scientific topics, on issues that are emerging within our society," Dr. Pratt said.
He recalled that the first AGSM was held at Monrovia City Hall, where then-Vice President Joseph Nyuma Boakai served as keynote speaker, while the college installed its first executive members and inducted its Foundation Fellows.
"Before the year 2012, such an event was unheard of," Dr. Pratt said. "Except we traveled to other countries to participate in other conferences. We were not opportune to have this kind of forum."
