Why Medicines for Africa, and why now?

 Peter Evans, Brussels Belgium. Peter is the former Chief of Procurement at WHO and UNFPA and Chief of Medical Procurement at UNICEF

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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.
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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.