Tuesday, October 20, 2009

Africa needs effective health service delivery systems and research

By Ochieng’ Ogodo

One of the desirable key drivers of Africa’s social and economic development, which can be best realised through the vehicle of regional integration, is the reduction of the burden of disease.
But Africa still faces huge challenges in her efforts to provide affordable, quality and accessible health care to the people.
It is for this reason that Juma Mwapachu, Secretary General of the East African Community (EAC), says putting effective health service delivery systems and health research is at the heart of regional cooperation and integration.
“It is generally recognised that one of the key drivers of Africa’s social and economic development, which is indeed best realised through the vehicle of regional integration, is the reduction of the burden of disease,” he told the Fifth European and Developing Countries Clinical Trials Partnership (EDCTP) Forum in Arusha, Tanzania 12TH – 14TH October 2009.
He said that amongst the four basic types of investment required to enable the poor world escape from poverty, is health, “including control of the main killers-infection, nutritional deficiencies, and unsafe child birth through the provision of preventative and curative health services”
“In its Africa Health Strategy 2007-2015,” he said, “policy document adopted by the African Ministers of health in Johannesburg in April, 2007, the African Union equally recognises this linkage. Whilst Africa’s population is 10 percent of the world population, Africa bears 25 percent of the global disease burden. Yet Africa has only 3 percent of the global health workforce.”
Africa’s health care provision, Mwapachu said, has been wanting and whereas commitments have been made in the past, such proclamations have not been accompanied by practical follow ups at policy levels.
“It is difficult to doubt or question this state of affairs when many Sub-Saharan African countries remain stuck in dependency syndromes with at least 40 percent of their recurrent budgets, on average, being paid for by development partners,” he said.
The funding deficit for better health care for all, he said, troubles many right thinking people in Africa due to the new wave of a disease burden emerging. Mwapachu also observed the serious issue of counterfeit drugs that has hit East Africa hard.
“It estimated that in the East African Community region as much as 70 percent of the generic drugs sold in the drug stores and pharmacies are counterfeit,” he told the gathering.
On health research or research for health, he said, the picture in so far as Africa’s commitment to health research is concerned is not any different from that of health care generally.
He said there is no African-wide health research as such and the African Union has merely called for multi-country collaboration in health research which is to be undertaken through the Regional Economic Communities (RECs) such as the EAC.
But most of the RECs, except the EAC one and a few others have no policy framework for promoting such collaboration and their policy focus and priorities differ.
The EAC, he said, has mainstreamed Annual Health Scientific Conferences which brings together policy makers and top researchers focusing on selected key health research projects in its calendar of activities.
“At the EAC, we have seen the importance of developing an institutional health research framework and capacity.”
With multilateral support mainly from Canadian and Swedish Governments, the EAC is now at an advanced stage of enacting a law, through the EAC Legislative Assembly, for constitution of a fully fledged EAC Health Research Commission.
Explaining further, Mwapachu said the AU is engaged in advancing the translation of health research into policy and action and has evidence informed policy network (EVIPNet-Africa) that will, among others, form a strong basis for health research collaboration and exchange of health research outputs.
But the challenge is on how the programme would be funded given that Africa is yet to reflect serious commitment to allocating adequate resources to fund health and other scientific research.
“The African Union has set a benchmark of 2 percent of national recurrent budget expenditure and 5 percent of health development budget for health research at national levels,” he pointed out.
Only few African countries, he said, have been able to fulfil such benchmark with Tanzania that recently scaled up state investment in research and development from 0.3 percent to 1.0 percent of Gross Domestic Product.
“Africa’s commitment to health and research would be of little meaning if research is not translated to productive use. Africa faces a huge challenge in so far as its infrastructure is concerned for commercialisation of health research findings,” he summed up.
**Ochieng’ Ogodo is a Nairobi journalist whose works have been published in various parts of the world including Africa, the US and Europe. He is the English-speaking Africa and Middle East region winner for the 2008 Reuters-IUCN Media Awards for Excellence in Environmental Reporting. He can be reached at ochiengogodo@yahoo.com or ogodo16@hotmail.com.