A vision with legs

The theme of the forum, ‘The future of healthcare today: Re-envisioning Africa’s healthcare system’, encompasses the many facets that must be addressed for Africa to reach its full potential and the challenges that health leaders face in leading one of the most challenging regions of the world.

Hon D Chitalu Chilufya, Minister of Health in Zambia, opened his address by pointing out the direct linkage between healthy societies and productivity and stressed the need for investment in health, not just from a social sector point of view, but as a key investment into the economic growth of a country. “The current mechanisms to fund healthcare were not yielding dividends and that new innovative funding models were required. It is imperative that leadership in health take cognisance of this, saying that “political will is indispensable to good health systems.”

Hon Chilufya added that the core to strengthening health systems is the provision of services and therefore financing interventions across the continuum of care is imperative. Infrastructure and equipment are pillars of healthcare as is therobust training of professionals and an adequate and equitable spread of health services. To fund these, said Hon Chilufya, “we must part ranks with traditional methods and look at ways for bringing about adequate health resources”.

He said that to achieve universal healthcare and strengthened health systems, investment into governance structures and leadership is required and that to achieve strong public health, security systems in Africa would require partnerships with leaders from the private sector. “We have a common agenda to expand infrastructure for health. Private and public sectors have the same audience and should share responsibilities in research, training and building capacity.”

Hon Chilufya said that Zambia has made universal healthcare a priority and introduced the NHI Act of 2018. He added that Zambia’s transformational health policy, which introduced targets such as the malaria elimination target, would require elevated efforts to attaining these, and that strong leadership and a multisectoral approach would be required.

Speaking on the keynote panel on ‘2020 and beyond’, Clyde Lewis, Chief Commercial Officer for GE Healthcare in Africa, said that Africa’s transformation is based on accessibility, which meant increasing access, reducing costs and improving quality. He added that GE’s strong presence in Africa meant that strong partnerships with both government and communities have been forged. “In the quest to decrease Africa’s unacceptably high levels of peri- and neonatal mortality, GE has developed a portable ultrasound which resulted in the training of over 1,500 healthcare professionals, including nurses and midwives, to use the device. This resulted in 96% of women who had never had an ultrasound before, now having access to this technology and a reduction in mortality.”

Lewis added that connecting primary, secondary and referral systems was an important component of healthcare provision and cited the new Nelson Mandela Hospital as an example of new technology which allowed for the centralising of images that could be viewed by all the health professionals treating a particular patient. “While more point of care technology was needed, Africa could take advantage of the AI and other technology that was already available in other parts of the world.”

Quality, and especially human resource quality, is an essential component of a robust health system. To address this in Ethiopia, Dr Dawit Moges, CEO of Sr Aklesia Memorial Hospital in Addis Ababa, said that while Ethiopia is planning to produce 3,000 physicians a year, there is a need to ensure that these health professionals have access to practical training before they practice. He added that the Ethiopian government has started a more patient-orientated service where the patient is at the centre of the care they receive.

Panel facilitator and Chairman of the Africa Healthcare Federation in Kenya, believes that partnerships in healthcare should be extended from Public-Private Partnerships (PPPs) to include Public, Private, Philanthropic, People Partnerships. Dr Ola Orekunrin, MD of Flying Doctors in Nigeria agreed and said that the importance of partnerships had been recognised by SDG 17. Dr Orekunrin believes that health engagement should extend beyond just doctors and politicians and should include others, such as technology experts, so that they are able to design the products that are needed.

She added that financial constraints in Africa means that, “we have to do more with less”. To make her point Dr Orekunrin said that she brought helicopter ambulances to Nigeria to save lives but each trip was $20,000 and Nigeria just couldn’t afford it. “So we started speaking to commercial airlines and put an ambulance hub in aircraft which reduced the cost from $20,000 to $1,000.”

Dr Thacker raised the issue of affordability in Africa, making a point that people often avoid getting treatment because of lack of finances or fear or financial ruin.

Dr Mohamed El-Sahili, CEO of Medland Health Services in Zambia believes that affordability starts with discussion and that a holistic approach involving many stakeholders is required. Dr El-Sahili continued, saying that the scarcity of skills could be alleviated by attracting these resources back into the country. “Educating the population on prevention, the development of technology in Africa; pharma production and investing in research were all ways in which greater affordability could be attained in the region.”

Dr Orekunrin believes that there are learnings from other countries such as India where procedures like a coronary bypass are performed at a fraction of the cost of the USA, with better outcomes.

Dr Thacker concluded by reminding delegates that health for all in Africa is a partnership between the public and the private sectors and the African Union. He added that the Africa Healthcare Federation, a partner of Africa Health, engages with each government and  county and called on delegates to participate in the movement. “If you are concerned about healthcare in Africa, you can be part of the movement. We believe that if we are positive and committed, we will see action and achieve a ‘vision with legs’,” he concluded.

Highlights video:
https://youtu.be/z_suKHZ8Q6Q