Health Equity in Africa – a stitch in time…

The African Union and member states should consolidate on the gains achieved during this trying period. Now is the time for Africans to experience transformational leadership on all fronts and government should be held accountable for the lives of citizens. As they say, a stitch in time saves nine.

COVID-19 has exposed the inadequacies in the public health infrastructure of many countries. From the lack of preparedness for a pandemic to the welfare of health workers who sacrifice their lives for us all. The story has been similar from New York to Nairobi. Countries who have not prioritised the provision of health care at all levels and invested in the health system have suffered the most.

There has been a palpable fear in Africa about the spread of corona virus. This fear is not unfounded, as the region’s health systems is fragile, the population are malnourished with underlying health conditions, multiple barriers to testing, and low doctor to patient ratio (1:5000). Unlike Ebola which was contained quickly within West Africa, corona virus was a global phenomenon.

Fourteen years ago, I was part of an organisation that developed and implemented the ‘15% Now! Campaign’, the first articulated global campaign on sustainable health financing in Africa. The advocacy was towards realising 15% allocation of national budgets to the health sector as pledged by the African Union member States in 2001. With 35 organisations in 14 countries, we organised key advocacy events at the World Social Forum (WSF), African Union, World Health Assembly, G8 summits and other forums. At the 2007 WSF event in Nairobi, Nobel Laureates Archbishop Desmond Tutu and late Wangari Maathai spoke and signed a petition addressed to African Head of States appealing for more resource allocation to health. We engaged the African Health Ministers in 2007 to draft the African Health plan to ensure the continent meets the UN Millennium Development Goals by 2015. The campaign led to a significant increase in budgetary allocation to health in Rwanda, Botswana, Niger, Malawi and Zambia.

Since 2012, AFRIDAC have been part of a growing global campaign for a proposed Framework Convention on Global Health (FCGH) – a global treaty based in human rights and aimed at national and global health equity. The framework is focused on all people, wherever they live to enable easy access to comprehensive universal health coverage in a health system that does not discriminate. There has been a sustained global campaign in achieving the FCGH and a side event was organised at the 2016 World Health Assembly in Geneva.

Africa has been lucky, according to WHO, Africa is the least affected region globally, with 1·5% of the world’s reported COVID-19 cases and 0·1% of the world’s deaths. This has been attributed partly to the continent’s young population, hot temperature and experience with dealing with infectious disease outbreaks. But this is not a time for complacency.

Post COVID-19, African governments should significantly increase the investment in health. Access to free and/or affordable healthcare should be a human right and not a privilege. Beyond provision of comprehensive universal health coverage to all Africans, the quality of health services should be at parity with those accessible in developed countries. The era of health tourism abroad by wealthy Africans should end.   Africa should use this opportunity to stem the disproportionate migration of health workers to richer climes due to poor remuneration and health facilities.