Over the last twenty years, Africa’s population has increased by 2.5% per year and by 2050, the population is expected to rise to about 2.4 billion, with some of the countries doubling or even tripling their numbers; making Africa the region with the largest population growth. This places the continent in a favourable position with a large proportion of the population being a young workforce that is capable of contributing to the economy. This evolving demographic and a high demand of medical services presents itself with a challenging opportunity with an immense potential for economic development and growth.
According to a report by the African Development Bank, Africa’s private sector accounts for over four-fifths of the total production, two-thirds of total investment, and three-fourths of total credit to the economy, and employs 90% of the employed working age population. Given the increasing population and growing middle class that is willing to pay for healthcare services, there are significant and financially viable investment opportunities in the African healthcare space. However, optimum effectiveness and output cannot be achieved through investments and the private sector alone or by the public sector alone. A successful investment is not defined solely by financial input, but also by additional critical factors such as collaborations, robust frameworks and policies, scalable economies, targeted opportunities for development, and effective resources, that would bring it to fruition. Public, private and development partner cooperation is required for solutions surpassing borders, that will drive the investments into sustainable health outcomes, maximise the returns on those investments, and in turn create a stronger African health sector.
As we have repeatedly learned over the recent years, working together, the public, private and development sectors can effectively minimise the risks each of them undertake through their investments, and increase their chances of maximising the returns. These multi-dimensional partnerships would not only benefit each of the entities involved, but also cater to the needs of the population through decreased healthcare costs, and greater accessibility to quality healthcare. The public sector can take advantage of the private sector technical expertise and skill set, and instil healthy competition that can harness innovation. Investing in innovative technology would also leapfrog development that took several years for the developed world to achieve. For example, internet connectivity in the developed world evolved from dial-up connections going through DSL, ADSL and finally now fibre connections and wireless connectivity, whereas, a fair number of African countries leapfrogged straight from dial-up services to fibre connections. Hence, it is not always beneficial to follow the road map of developed countries, but collaboration between African countries provides on-the-ground partnerships focusing on resource-appropriate solutions for regional problems, giving Africa a resilient healthcare ecosystem.
As much as the competence of the private sector is reputed and valued, the support of the public sector is often underestimated. Government support and cooperation can generate sustainability and bridge the path towards integrating the overall health system across the countries and well as the entire continent. This would create vigorous health capacities and in turn better health outcomes, bringing us closer to achieving the Sustainable Development Goals (SDGs) sooner.
What is good, doesn’t come easy. PPP’s can be challenging and they are often easier said than done, hence it is important to be mindful of the enormity of the task ahead. It is also vital to recognise that it is because of the very challenges of emerging economies that such tremendous investment and development opportunities exist in the African economy which is favourably positioned to accommodate for disruptive innovations and alternate models, which may be more complex to alter in a developed economy. According to The Lancet Commission’s Report on “The Future of Health in Sub-Saharan Africa”, these are historic and not to be missed opportunities to improve several health outcomes within the next decade, seizing the momentum generated by the Millennium Development Goals by bringing traditional challenges under control and preventing others from taking hold. Richard Horton, Editor-in-chief, Lancet Commission further states that, “This is the best opportunity that Africa has ever had to close the health gap within a single generation. There is no earthly reason why Africa needs to have worse health systems than anywhere else in the world.”
Successful and timely attainment of the sustainable development goals (SDGs) will depend on the effectiveness of strategic partnerships, which will require the articulation of practical, on-the-ground approaches to facilitate. The 2030 Agenda for Sustainable Development is marked by solidarity, participation and universality, with a fundamental shift expected in the development finance architecture. Improving the effectiveness, quality and impact of development co-operation in this context will require inclusive partnerships, innovative approaches and the application of lessons at country level. In a shifting landscape, it is increasingly critical to break down the silos that have traditionally governed development financing and implementation. This will require a set of shared principles that encourage and facilitate meaningful and impactful partnerships at all levels across sectors, especially leveraging the capacities of the private sector.
At the second Africa Health Business Symposium (AHBSII), which will take place on 6-7 November 2017 in Dakar- Senegal, a platform to jointly engage the African Union (AU), representing the African public healthcare space, the Africa Healthcare Federation (AHF), representing the African private healthcare space, Ministers of Health across the five different regions of Africa and development partners on high-level sessions will explore how all these different sectors can collaborate in optimising their individual roles towards achieving the SDGs, and how to create an enabling environment and platform for the AU and AHF to collaborate in accelerating access to affordable quality healthcare across Africa.
AHBS II will play a catalytic role in creating a wholesome approach on the path forward, because increasing healthcare spending alone is not sufficient. A recent study by the World Economic Forum (WEF) states that Norway, Switzerland and the United States - the countries that are the highest healthcare spenders in the world are not necessarily getting the best value for money, whereas other countries’ health systems are managing to get similar or better results for far less. This is possible by creating a strong, patient-centric primary care system, using technological innovations to contain costs, and efficient allocation of resources. We need to make healthcare cost-effective rather than cost-additive. In light of this, Africa Health Business Symposium has identified 5 factors that are critical in improving healthcare delivery across the continent:
Human Resources for health:
Supply chain management;
Cutting across these five key areas, lies the critical aspect of Policy and Regulation: Regional Harmonisation of synergies which have a substantial impact on the game changers. An all-inclusive focus on these game changers will facilitate transformations in the African healthcare industry.
Digital technology innovations through connectivity have paved the way for disruptive models of functionality in every industry. Harvard Business School professors Marco Iansiti and Karim R. Lakhani through their interviews with hundreds of executives in an effort to understand how traditional modes of innovation and operational execution are changing, have rightly stated that “this paradigm is not displacement and replacement, but connectivity and recombination”.
The case for revolutionising healthcare through sustainable health systems isn’t simply a moral case of providing healthcare to all, but more importantly, it is a fundamentally economic case. Investing in improving health outcomes, would lead to a healthier and competent workforce, resulting in a healthy economy that can drive economic growth. In a few years’ time, Africa will have the added advantage of a major part of its workforce constituting of a vibrant, and young population. The question we need to consider is, do we need wealth for health, or health for wealth?