More investments needed in Africa’s healthcare systems

03 May, 2020 - 00:05 0 Views

The Sunday Mail

Vision 2030
Allen Choruma

As at April 28 2020, the number of Covid-19 cases in Africa had risen to 33 000.

More than 1 400 people from 52 countries had died, while 10 000 had recovered.

Egypt, South Africa, Morocco, Algeria and Cameroon had recorded the highest deaths in that order.

Only three countries — Lesotho, Comoros and Saharawi Democratic Republic — had not recorded any Covid-19 case.

Some experts believe that with more testing the numbers could be higher. As the coronavirus pandemic takes its social and economic toll across Africa, it would most likely expose the need for more investments in healthcare on the continent. Most of the continent’s inherently deep-rooted problems are already known.

These challenges are unlikely to go away any time soon unless African countries take aggressive measures to invest heavily in their healthcare systems.

Covid-19 will definitely be not the last pandemic to affect the world.

Weaknesses

The current pandemic has come at a time when some parts of Africa are still grappling with diseases such as tuberculosis, malaria, cholera and typhoid, which are all preventable.

Healthcare in Africa has remained a challenge for decades, especially for vulnerable groups such as those living in outlying rural areas, women and children and those living with disabilities. The 2001 Abuja Declaration committed African countries to invest 15 percent of their public expenditure in healthcare.

Sadly, most countries have not been able to keep this commitment.

According to the World Health Organisation (WHO)’s Global Health Expenditure database (2016), average African healthcare expenditure stood at 10 percent of national                                                budgets. By 2016, only a handful of countries — Malawi, Ethiopia, Gambia and Swaziland — were spending above 15 percent of their public expenditure on healthcare.

South Africa, Namibia, Central African Republic, Burundi, Lesotho, Carpe Verde and Tanzania were spending between 11 percent and 14 percent. Zimbabwe was among countries such as Kenya, Eritrea, Cameroon and Angola that were spending less than 5 percent.

“For every US$100 that goes into state coffers in Africa, on average US$16 is allocated to health, only US$10 is in effect spent, and less than US$4 goes to the right health services. This failure to ensure that public financial resources reach the health services that need them has undoubtedly had a negative impact on health sector results  .  . .” reads part of the WHO 2016 assessment report, “Public Financing for Health in Africa: From Abuja to SDGS”.

What is also worrying is that health budgets do not satisfactorily cover marginalised people, most of whom cannot even access primary health care. Despite its devastating impact on African people and economies, Covid-19 has forced governments across the continent to look at investing in healthcare more seriously.

There is also need to ensure that investments into healthcare reach intended beneficiaries.

Post Covid-19, we are likely to see a fundamental shift in investments in healthcare by both governments and the private sector.

WHO Warning

WHO has warned that Africa could be the next epicentre of the Covid-19 pandemic, particularly during the second half of 2020.

African countries have, however, reacted more swiftly and quicker than some developed countries like the UK, Italy, Spain and USA to threats posed by disease.

Most African countries have introduced national lockdowns to limit the movement of people and prevent public gatherings.

This also allows governments to put in place measures to better manage the pandemic at its peak. Africa needs to develop its own home-grown solutions, with a strong bias towards community healthcare. A one-size-fits-all approach will not work.

Individual countries will need to come up with models that work well for them, but obviously guided by WHO guidelines.

For example, countries like Tanzania and Madagascar did not implement total lockdowns out of fear of disrupting people’s livelihoods.

Ghana, Ivory Coast and Burkina Faso lifted their lockdowns early in April.

Countries like Burundi and Benin did not even go into lockdown, only introducing minimal restrictive measures. However, the efficacy of all these varied measures is not yet known.

Zimbabwe introduced a 21-day lockdown on March 30, which was extended further to May 17. There are strict social-distancing rules, including observance of basic sanitation such as washing hands with soap and water and the quarantine of returning residents at designated locations. Government has also increased its testing capacity to determine the extent of spread of the coronavirus.

Most health facilities are noticeably being refurbished, while the supply of personal protective equipment and drugs has been ramped up.

Business, civic society, non-governmental organisations, foreign governments, religious organisations and individuals have generously donated medical equipment, drugs, food, funds and a lot of other materials to complement Government’s efforts.

South Africa

South Africa, the most industrialised country and second-biggest economy in Africa, also went into full lockdown, which was lifted on April 30.

On April 21, the country announced a R500 billion (US$312 million) relief package — equivalent to 10 percent of the country’s Gross Domestic Product (GDP) — to mitigate the economic fallout of the pandemic on both citizens and businesses. This relief package, which is supported by domestic resources, was in addition to R300 billion (US$188m) relief measures announced by the South African Reserve Bank (SARB).

In addition to this, South Africa introduced a robust “community-based” Covid-19 screening and rapid testing programme.

By the end of April, it was conducting about 180 000 tests per day.

As Africa begins its epic fight with the Covid-19 pandemic, it requires robust and risk-based screening, isolation, testing, treating and containment measures guided by epidemiological findings.

God Bless Zimbabwe!

 

Allen Choruma can be contacted on e mail: [email protected].

 

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