By Issy Spaven-Donn, Communications Manager at Amref UK
We need new ways of thinking and implementing ideas to combat Africa’s triple burden in health, said panellists at an engaging discussion hosted by Amref Health Africa UK and Wolfson College
The greatest healthcare challenge for Africa over the next 50 years? Population
opened Dr Githinji Gitahi, Group CEO Amref Health Africa, at Healthcare in Africa: Fit for the Future? – an event co-hosted by Amref and longtime supporter Wolfson College, University of Oxford. Faced with increasingly prominent and interconnected challenges to health systems in Africa—pandemics, non-communicable diseases and climate change—we need solutions that focus on equity, innovation and partnerships to futureproof the health rights and access of people across the continent.
Africa Rising and the Triple Burden
The pervasive optimism of ‘Africa Rising’ popularised in the Western media over the past few decades rightly shifted the narrative about the potential of the African continent for innovation and opportunity from its paternalistic, colonial overtones. But, it was a concept focussed solely on capital that forgot the people: “Africa is the only continent where in the majority of countries, the majority of people still do not have access to basic health services,” said Dr Gitahi (WHO global service coverage database, 2021).
Fuelled by rapid population growth and urbanisation, the African continent is facing an increasing burden of endemic diseases, rising incidence of non-communicable diseases (NCDs) and re-emerging and emerging diseases. Coupled with the financial constraints placed on people, particularly those living in poverty, there are worsening barriers to access to basic health services. This is the Triple Burden.
"We need new ways of thinking and action based on equity, innovation and promotion/prevention to respond to the Triple Burden"
with Dr Githinji emphasising the vital importance of equity. Governments must be focussed on serving the most vulnerable and the furthest behind first, through Universal Health Coverage. Innovation—particularly in systems models and service delivery, which in the last few quarters alone has seen US$3bn raised in investment from African start-ups, noted panellist Dr Anne Makena from the Africa Oxford Institute—provides alternative solutions top close access gaps. And prevention and promotion programmes provide avenues to reach people to help keep them healthy in the life course.
86 percent of deaths due to NCDs are in low and middle-income countries (WHO) — but there are incomplete and unreliable data in Africa. This lack of data contributes to the cycle of the poverty trap; increasing incidence levels of NCDs, the high cost of NCD management to governments and providers, cost barriers to access health services, and associated societal effects.
This means healthcare in Africa must move from the hospital-centred to people/community centred. We need community-centred education, research contextualised to local needs, innovation and funding for new healthcare models,
Unprecedented climate changes need smart partnership solutions
The overwhelmingly negative impact of climate change on human systems has already been observed, from water and food production, cities and infrastructure to health and wellbeing, presented Tilly Alcayna, senior technical advisor at the Red Cross Climate Centre.
Data projections for the African continent show that these impacts are only going to worsen, with more hotter days, higher humidity, droughts and other extreme weather events.
Creating lasting health change in Africa means facing the emerging, and interconnected, threats of climate impacts and the challenges of the Triple Burden. In a healthcare system that is severely stretched under pressures of low financial and human resources, we need an approach that is based on equity, that prioritises innovation, builds strong partnerships and takes collaborative action.
An approach that centres communities and builds resilience through innovations and partnerships is vital to ensure not only access to health services and information, but also which safeguards people’s right to quality health.
Such partnerships are being developed through modelling of extreme climatic triggers of endemic disease, including cholera and dengue, to develop systems for anticipatory action, and using recent innovations in digital technology for collaborative action—using data intelligence to forecast and plan for health challenges worsened by climate impacts.