Africa, as a continent , has made progress in reducing premature mortality and prolonging life expectancy since the year 2000, adding nearly an average of 5 years in life expectancy per decade. Under-5 and maternal mortality rates have equally fallen by 54% and 41% respectively. Communicable diseases such as malaria, measles, and HIV/AIDS which long constituted the most prominent contributors to disease burden have substantially declined.
Despite the progress, equity analyses based on socio-economic status and geographical location reveal up to 14-fold difference in under-five mortality between high income and low-income countries, while access to care is also skewed against the poorest.
Under-nutrition, external and internal (household) air pollution, diarrheal diseases, lower respiratory infections, and protein-energy malnutrition continue to be the top drivers of mortality in Africa. With high levels of food insecurity, the number of undernourished people could rise. More children and young people are surviving, but far too few are thriving.
The impacts of COVID-19 have shown that the pre-conditions define the rates of severity of the impacts of COVID-19, including morbidity and mortality of patients. In the U.S, the overall COVID-19 mortality rate for Black Americans is 2.4 times higher than the rate for Whites and 2.2 times as high as the rate for Asians and Latinos.indicate that more people from the less privileged communities are more likely to die from COVID-19 than their peers in other communities. Covid-19 has therefore brought to the fore the need to address structural inequalities - Africa has an opportunity to develop a health system that is equitable and addresses the social determinants of health.
To improve life expectancy, and overall health and wellbeing, Africa needs to build a health system that looks at health from pre-conception to end of life, as well as building institutional capacity to respond to pandemics and other exogenous shocks. Human health can be shaped by broader socio-economic, psychological and environmental systems of interaction with the human genotype and phenotype. The food we eat, the water we drink, the environment we live in, our mental well-being, and our social behavior and attitudes all interact in complex ways to shape our overall health and well-being. Building resilient health systems requires a radical shift in health policy from one that focuses on medical outcomes, to the broader concept of inclusive health–the provision of quality healthcare from conception to end of life, to all people and all the time.
There is therefore need to examine health thematic systems in Africa, with a view of identifying evidence-based policy briefs that can help African countries build more resilient and inclusive health systems post- COVID-19 and shape implementation responses.
a). Policy is required to incentivize African health professionals to remain in (or return to) Africa and contribute towards building inclusive health systems. Health professionals leave the continent in droves to serve outside the continent. 70,000 skilled professionals emigrate ; Doctors and Nurses. Paradoxically, Africa spends $4 billion a year on the salaries of 100 000 foreign experts. Annually, it is estimated that Africa loses around $2 billion through brain drain n the health sector. Many of the Doctors and Nurses cite better health infrastructure and other policy incentives as pull factors. But in each of them is a palpable desire to be able to contribute to the continent of their birth and/or ancestral origins.
b).To be resilient, Africa’s health sector needs to be rooted in robust national health innovation systems. Expanding access to care through e-health technologies is rapidly evolving across the globe. In Africa, the use of mobile phone-based applications presents intriguing opportunities. Mobile operators have begun to better position themselves to facilitate health payments that are made via mobile devices. With COVID-19, the e-health technologies, including tele-medicine, are likely to become the new normal. However, Africa’s record on health innovations remains disappointingly low. Efforts geared to this cause will not only keep the continent in sync with developing trends but also alleviate the status quo.
c).Africa-led health policy institutes, universities and national research institutions should be strengthened to inform evidence-based research and policy guidance that are embedded in African realities. Our biodiversity resources contain between 40, 000 and 45,000 species of plant with a potential for development and out of which 5,000 species are used medicinally. Africa contributes nearly 25% of the world trade in biodiversity. Nonetheless, the paradox is that despite this huge potential and diversity, the African continent has only few drugs commercialized globally. The potential of medicinal plants from African biodiversity which have short to long-term potential to for future phytopharmaceuticals to treat and/or manage a panoply of infectious and chronic conditions remains untapped. By leveraging indigenous knowledge for incusive Health, we can make great strides.
d). Lastly, building health system resilience requires a sustained investment in health infrastructure and the pharmaceutical industry, as well as in other sectors that provide a healthy environment for the human experience. Few African countries south of the Sahara have come close to meeting the target of the Abuja Declaration of investing at least 15% of the government budget allocation in the health sector. Government supported programs at a nascent stage need to be supported to grow while limiting leakages in the service delivery supply chains.
Health is wealth! Our proclivity to alleviating health concerns can certainly transit to have a ripple effect on each detail of the way we live.
Derick B. Wesonga is a medical student passionate about policy.
derickb.wesonga@gmail.com