Accra, Ghana Lenias is passionate about improving access to quality affordable treatments.
Lack of access to medicines is not just an African problem. It is a problem that affects health systems all over the world. All around the world, countries have only so much money. They are increasingly forced to decide what to spend it on. In this respect, African countries face the same budgetary problems as the rest of the world. What is different is that we have a higher burden of disease. Our infrastructure is inadequately prepared to meet current health care needs let alone serve the needs of our burgeoning youthful population. We need to find a viable path towards sustainable health development in countries.
In this respect, the challenges that we face in African countries are greater. That is why we need to invest in developing national infrastructure needed to serve the growing health care needs of a young population with their entire lives ahead of them. Only then can we be prepared to face the challenges facing our countries in the coming decades from changing disease patterns from the dominance of infectious diseases to the dominance of NCDs.
The resilient infrastructure that we need to strengthen African health systems in any meaningful and sustainable way will take time to develop. It is an enormous task, overwhelming to contemplate. We should take comfort in the knowledge that others have walked this path before, with success, but that success is not a given. We must roll our sleeves and get to work. Just because our problems are hard, does not mean we should not attempt to solve them.
Toronto, Canada Peter Evans is the former Chief of Procurement at WHO and UNFPA and Chief of Medical Procurement at UNICEF
Why Medicines for Africa and why now?
Because Medicines for Africa represents a sustainable approach in the long term, building on what is in place, leading to the best comprehensive health care that the countries can afford, with the least dependence on donors.
“Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.” Currently, the “teaching” is often limited to learning how to advance each Agency’s objective and the provided “fish” are dumped in ways that cause long term collateral harm.
Donors more and more insist on almost immediate confirmation of success and choose target disease reduction, as a validation of success. The effectiveness, of investments in health systems, is difficult to measure and therefore difficult to fund. Over the past few decades, the transfer away from financial and technical support for health infrastructure, towards targeted support limited to specific diseases, has been significant. Indicators of success usually concentrate on dollars spent in a given time period, how many health units provided, then how many health units used and finally how much health was achieved. However, as far as I have seen, no one measures how much other health care was displaced.
The health gains from attention to the targeted diseases are significant and to be applauded but while all major international health programmes pay lip service to providing support to the basic health infrastructure of each country, the reality is that support is mostly given to the elements that require the vertical programme (disease-specific) to achieve success and not to the horizontal support (population-specific) required for all other health improvements.