Sugar-free health care

WHILE AT dinner recently at a restaurant in Nigeria’s capital, Abuja, I observed a mismatched couple. The man appeared to be at least 60, but was dressed in skinny jeans and a skin-tight sleeveless top, with a large gold chain and dark sunglasses, though it was after eight in the evening. His companion, who looked no older than 22, skipped in behind him with three friends. She tried to include him in their conversation, even leaning in to kiss him occasionally, but a weak smile could not obscure her sugar daddy’s growing discomfort. Of course, such relationships are neither new nor limited to Nigeria. Few people are shocked to see a wealthy older man take up with a younger, poorer women, promising to finance her education, travel, or shopping in exchange for her company. What is surprising is when one of these relationships develops into something deep and lasting. The relationship between Africa and the West, especially when it comes to health care, strongly resembles this sugar-daddy dynamic. For decades, health-care innovations have been copied from developed countries, perhaps with slight variations, on the assumption that father knows best. But the results have been cumbersome, expensive, and almost never sustainable. The reality is that African countries’ needs, interests, and resources differ substantially from those of their Western counterparts. For example, in most European countries, there are roughly 30 doctors for every 1,000 patients; in Nigeria, that ratio is closer to 4:100,000. Given such divergences, it is not surprising that Western medical protocols do not work in developing countries. The problem is that it has been difficult to shake the conviction that innovation flows only one way: from North to South. But developing countries can help to improve Western countries’ health-care systems, which are far from perfect (even at home). Indeed, as advanced-country populations age, health-care costs are spiraling out of control. Total health-care spending in the United States is expected to reach $4.8 trillion – nearly one-fifth of GDP – in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970. Likewise, in Europe, public expenditure on health care could rise from 8% of GDP in 2000 to 14% in 2030. Advances in medical technology also contribute considerably – 38-65%, according to the Robert Wood Johnson Foundation – to the increase in health-care spending. Such technologies expand the range of treatments available to patients, but often by replacing lower-cost options with higher-cost services. More cost-effective solutions are critical to ensure that more people can access life-saving medical technologies. That is where developing-country innovations come in. Ever-increasing global connectivity has reshaped the innovation landscape, enabling anyone with a mobile phone or an Internet connection to access the ideas and resources they need to deliver game-changing systems. Add to that a level of need that developed countries do not share, and developing countries can not only revolutionize their own health-care systems; they can also help to find solutions to the developed world’s health-care predicament. The good news is that developing countries’ innovative potential is becoming increasingly apparent. In order to leapfrog the constraints imposed by their countries’ lack of modern infrastructure, Africans are increasingly taking advantage of mobile technologies and renewable-energy sources like solar. Relationships between sugar daddies and their companions rarely last. But a partnership of equals has a fighting chance. It is time for world leaders and multilateral organizations to recognize and support Africa’s potential to innovate – for everyone’s sake. Ola Orekunrin, a medical doctor and trainee helicopter pilot, is Managing Director of Flying Doctors Nigeria, West Africa’s first indigenous air ambulance service. Copyright: Project Syndicate.