Life expectancy across Africa has increased by 10 years since 2000 — a result of interventions such as the implementation of the 2000-2015 Millennium and successful commitments made by national governments in the framework of the Sustainable Development Goals (SDGs) 2015-2030. Working to serve the greatest number of people in a sustainable way, having a people-centered vision, and planning for greater investment in health as part of national development programs, in conjunction with good democratic governance, stability and economic growth have also positively influenced health indicators across the continent.

“We must absolutely celebrate these positive results, however, we must be cautious and avoid complacency, because this positive news is a tree that hides the forest,” says Dr M’Pele. “One-third of clinical conditions in Africa require surgical, obstetric, and anesthetic care, and yet there is less than 1 surgical specialist per 100,000 inhabitants, so surgery is a particularly neglected component of health systems in Africa. It is a critical area where much improvement needs to be made. While much of the world is looking to the latest technologies to improve their clinical care, we are saying that in Africa, there is still a lot of work to do to increase the number of qualified, specialized, and dedicated doctors and nurses too.”

Access to quality, safe, and affordable surgical, obstetric, and anesthesia care is a luxury in most African countries, and especially for the poorest populations. The challenge of equity and the integration of surgical and anesthesia care into national health systems are prerequisites for achieving Universal Health Coverage in Africa.

Preliminary results of research conducted by Mercy Ships in 602 district hospitals in 32 sub-Saharan African countries as part of the organization’s engagement with African governments, national and international partners, and health experts revealed an alarming situation that requires action in all countries.

“The aim of this research, and the political commitment it is encouraging, is to increase investment in upgrading surgical, obstetric, and anaesthesia care systems by 2030 to achieve Universal Health Coverage. When you understand that one in four district hospitals, for example, has no water or electricity, and only one in twenty-five has an Internet connection in this century of computerization, it helps you to identify the areas where the most improvement needs to be made,” says Dr M’Pele.

This is why initiatives like the baseline assessment are so important. The survey is helping national leadership to identify gaps in areas such infrastructure, human resources, service delivery, information management, finance, impact of Covid-19 on surgery, governance, and leadership, as well as pediatric surgery. The survey’s findings confirm the need for investment in infrastructure, continued education and surgical support in Africa, and highlights the value and urgent need for the work of Mercy Ships in collaboration with African nations.

It is a topic that Dr M’Pele addressed in his recent opinion editorial entitled “Health in Africa: the tree that hides the forest” (https://bit.ly/3dNLY4r), and one he discussed with The African Union Commissioner for Education, Science, Technology and Innovation, H.E. Prof. Mohamed Belhocine, who granted him an audience on 07 September 2022 in Addis-Ababa, Ethiopia He also shared his thoughts with key stakeholders during his recent visit to Europe.

As a decisive step towards advancing policy dialogue on ways to strengthen health systems within AU Member countries, the results of the survey will be handed over to the African Union Commission at the end of the year.  

It is hoped that it will spur other member countries to join the six African states (Cameroon, Comoros, Congo, Gambia, Guinea Bissau, and Senegal) which have adopted the Dakar Declaration.

The Declaration may be ambitious, but it brings hope for filling the healthcare gap for most Africa's populations. Mercy Ship’s wish is that all African leaders, governments, and partners, will commit to the financial investment necessary to develop concrete actions for better health for the continent’s populations, especially the poorest.