Universal health care in Africa received a boost last week, when the World Bank and the Global Fund to Fight AIDS, Tuberculosis, and Malaria committed to invest $24 billion in the continent over the next three to five years.
The move is an important step to establish health as a fundamental right for everyone.
The announcement was made on August 26th, ahead of the Sixth Tokyo International Conference on African Development held in Nairobi, Kenya.
“Africans can become globally competitive if they ensure that everyone, everywhere has the opportunity to live a healthy and productive life,” said Jim Yong Kim, president of the World Bank Group.
His statements echo the health framework launched that day by the World Bank and the World Health Organization (WHO), the government of Japan, Japan International Cooperation Agency, the Global Fund, and the African Development Bank.
Titled “UHC in Africa: A Framework for Action,” the report claims that the prevention of malnutrition and ill health leads to improved health, which in turn boosts productivity, higher earnings, and averts health costs for beneficiaries.
This framework further provides key areas that will be critical to achieving better health outcomes, such as financing, service delivery, targeting vulnerable populations, mobilizing critical sectors, and political leadership.
The World Bank Group expects to contribute $15 billion in the next five years to investments that are critical to universal health coverage, including early childhood development, pandemic preparedness, the poor, crisis preparedness, and the private sector. The commitment assumes successful funding from the World Bank’s lending arm, International Development Association.
The Global Fund’s $9 billion commitment for 2017 through 2019 includes $6 billion of investments in programs that treat and prevent key diseases, such as HIV, TB, and malaria. The funding also includes $3 billion of investments in health systems, such as strengthened procurement systems and supply chains, improved data quality and data management systems, and human resources for health.
The commitment also assumes a $13 billion Global Fund replenishment, which launches in September. The World Bank and Global Fund’s funding is important as it recognizes that Africans lag behind the world when it comes to health care. According to the 2014 KPMG Healthcare Sector Report, poverty is the reason why health treatment is inaccessible to many.
Only a few Africans can afford privatized health care and insurance, which puts the majority at risk. Furthermore, the HIV/AIDS pandemic is the main reason why there is still a huge health gap between sub-Saharan Africa and the rest of the world.
Battling Infectious Diseases
The WHO estimates that sub-Saharan Africa accounts for almost 70 percent of the global total of new HIV infections. By the end of 2014, there were 25.8 million people living with HIV in the region. Southern Africa is the area that has been hardest hit by the HIV/AIDS pandemic, and research has shown that countries affected by the HIV/AIDS pandemic are likely to suffer from infectious diseases, such as tuberculosis (TB).
According to the KPMG report, after HIV has transitioned to AIDS, TB infection often leads to death. Though there have been successful efforts to reduce TB, the infection requires more effort by affected countries to eradicate it.
This is the same case for malaria, which is a leading cause of infant mortality in most African countries. There have been successful efforts to eradicate it through insecticide-treated nets; however, in other African countries, mosquitoes have developed a resistance to the insecticide.
It is against this backdrop that the third goal of the 2015 United Nation’s Sustainable Development Goal (SDG) advocates for healthy lives and the promotion of well-being for all. Thus, more must be done beyond reducing and preventing HIV, TB, and malaria by 2030.
“In order to accelerate universal health coverage and all of the health SDGs, we also are actively investing to build resilient and sustainable systems for health,” said Mark Dybul, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Universal Health Care
Achieving universal health coverage requires funding.
In 2014, African countries spent about $126 billion of domestic funding for health. According to Margaret Chan, director-general of WHO, the organisation promises an additional $65 to $115 billion in domestic funding to be mobilized annually over the next 10 years.
WHO further cites Rwanda, Ghana, and Ethiopia as African case studies for universal health coverage. While Rwanda has been able to lower its mortality rates between 2010 and 2000, in Ghana, the National Health Insurance Scheme gives citizens equitable access and free financial coverage for medical care. On the other hand, a 2003 Health Extension Program in Ethiopia, trained and deployed medical staff to rural areas, ensuring that locals had access to primary health care.
Ultimately, collaboration among governments, the private sector, and external donors is necessary to address the health needs of African countries. Thus, the $24 billion funding by the World Bank and Global Fund in collaboration with African governments for universal health coverage should be effective.