Africa: Promise of Health for All Hangs in the Balance – A Call to Action

Halfway to the target date for the realisation of the United Nations Sustainable Development Goals, the promise of health for all hangs in the balance, making it more important than ever that we make up for the ground lost during the Covid-19 pandemic, writes Dr Susan Nakhumicha Wafula in a guest column for AllAfrica. Dr Wafula, Kenya’s Cabinet Secretary for Health, reflects on a recent meeting of health ministers from the Commonwealth of Nations, the 56-nation association which includes 21 states from Africa.

Health For All. Three simple words which could change our world, but millions of Commonwealth citizens still live without the services to make them a reality.

It was on this subject that I had the privilege to chair the recent 35th Commonwealth Health Ministers’ Meeting, which comprised dozens of my fellow ministers and health leaders from across the growing family of nations.

Meeting in person for the first time since the Covid-19 pandemic, ours was a vital discussion on how to accelerate this noble mission; of a Commonwealth where healthcare is available to all.

Achieving this vision, and securing the resourcing for it, was called for by our Heads of State at last year’s Commonwealth Heads of Government meeting (CHOGM) in Rwanda. A priority for the Commonwealth since 2015, the need for progress was brought into stark relief by the collective experience of living through the Covid-19 pandemic.

Our meeting this year focused on practical building blocks of the vision. It focused on pandemic preparedness, mental health, digital health and investing in local manufacturing. It also gave particular attention to how we strengthen Primary Health Care (PHC).

Building a strong system of PHC is the foundation of a health coverage system that reaches everyone. For the parent with a child ill from fever, it is the frontline health worker, the closest health facility, and subsequent rapid diagnosis that can make the difference between life and death. This matters, not just to individual parents, but to all citizens of the Commonwealth and beyond.

Diagnosing and treating fever is not just about saving an individual child’s life, but about tracking and understanding whether the fever is a disease like malaria,  which we know how to treat, or an unidentified pathogen which could lead to the next pandemic and undermine our collective global health security.

At the meeting we heard about the inspirational achievements being made by countries on accelerating PHC coverage. Listening to statements from various Commonwealth members, Kenya is just one example of a country making great strides, with the Kenyan Government and our partners rolling out Primary Health Care networks on a “hub and spoke” model and community health promoters acting as pillars of Universal Health Coverage (UHC) at the household level. This innovative programme aims to accelerate primary care access and is complemented by a commitment to reach 100 percent coverage of essential health services.

Primary health care is a building block to achieving UHC and it ties closely to another issue which country leaders have prioritised for the Commonwealth. At the last two CHOGMs, our leaders committed to focus on eliminating and ending the scourge of one of our oldest and deadliest diseases, malaria. With about 90 percent of Commonwealth citizens living in countries with a risk of malaria, accounting for over half the world’s burden, we have much to gain from accelerating progress on fighting the disease.

Malaria elimination, Primary Health Care, and the vision of health for all are closely linked. Investments in malaria prevention, preventative education and case management are often delivered through, and directly provide the funding for, the work of community health promoters, the bedrock of PHC. This is done through the integrated community case management of malaria, pneumonia and diarrhoea, providing timely and effective treatment in rural areas with limited access to health facilities.

The substantial investments made in malaria programming by domestic and international actors are at the heart of strengthening PHC. Management of malaria at the community level has improved access to care in malaria-endemic areas in Kenya, and has directly led to reductions in the country’s  mortality rate. Many of these investments come through The Global Fund to Fight AIDS, Tuberculosis and Malaria, and are underpinned by parallel, coordinated, funding towards the  strengthening of wider health systems.

Halfway towards the target date for the Sustainable Development Goals (SDGs), and ahead of the UN’s High-Level Meeting on Universal Health Coverage in September, the promise of health for all hangs in the balance for many Commonwealth states. It is now more important than ever that we come together to make up for the ground lost during the Covid-19 pandemic.

As an outcome of the recent health ministers’ meeting, we have committed to working jointly with our ministers of finance to identify innovative and sustainable funding solutions. One example of innovation is the experience of many African countries in the establishment of “End Malaria” councils and funds. These have been pivotal in driving new sources of finance for disease elimination efforts from private, philanthropic and non-health spending by governments.