We've all heard the usual social mantras throughout our lives from 'we're all in this together' to 'no man is an island'. Couple that with healthcare's own mantras like 'health is wealth' and the question now becomes 'how does society affect my ability to live a healthy life, if it does at all?' For most people reading this blogpost, the reality of the intersection between our health and the environment in which we live may not be as stark as for the most disadvantaged, vulnerable and poor in our society. However, we will soon come to see the strong feedback loops that exist.
Sub-Saharan Africa (SSA) comprises a myriad of types of people, of different cultures, socio-economic status and backgrounds. However, when looked at on the whole, the statistics on healthcare depict quite a frightening image. The region accounts for 11% of the world's population and yet bears up to a quarter of the global disease burden. It gets more 'real': only LESS THAN 1% of global expenditure on healthcare comes from SSA, and one can find only 3% of the world's health workers in the region. Both you and I may know of relatives and friends who may have found their way out of the region and 'abroad' after medical school, if not having pursued medical school outside of the region in the first place. There's nothing inherently wrong with that except for the fact that it is one of the key markers of the significant gaps in the health systems of SSA: their ability to offer the environment whereby every student who wants to can learn the trade with full access to the quality of tools, equipment and technologies that are relevant in today's world, and can then carry this forward into a conducive working environment in which these learnings can be applied and appropriate compensation received.
Why is this important? It's important because the gaps in SSA health systems eventually render EVERYONE vulnerable, whether rich or poor, visitor or resident. This situation inevitably prevents individuals from being able to react appropriately in the instance of a healthcare crisis. The Covid-19 pandemic has been an all-too-dire example. From the provider to the seeker of medical care, individuals have been faced with less than ideal choices and options in the wake of an event that has tested the very fibre of our systems. There have been too many sad and unfortunate cases, of people having a sudden onset of severe symptoms and not being able to find an ICU bed, and of health workers, struggling to cope, both physically and psychologically, because they are having to put their lives even more at risk everyday in places especially strapped for PPE.
All of these stories make us realize the large amount of work there is to be done. And it all begins and ends with you and me. Healthcare is an essential service, and we need to start keeping our nations and ourselves accountable for that. Whereas several SSA countries signed a 2001 declaration in Abuja to spend at least 15% of GDP on healthcare, not one country has met that target, with Ghana standing at 3.3%, Nigeria at 3.8% and South Africa at 8%, for example. If we don't start re-prioritizing our expenditures as they should be, we ultimately reduce our chances of receiving the quality of healthcare we need, when we most need it. There is a little bit of advocacy we can all perform in our little corners. We can support, encourage and donate to healthcare facilities in need of essential supplies, as well as facilities that practice good business with sound values that we may consider as market leaders; in this region, we have yet to scratch the surface of the positive impact that promising organizations can have on the wider population if enabled to scale up.
It would also be useful for our mindsets to shift regarding our perceptions of the inherent good or evil of the various players in the field. If we could consider the private sector, government, civil society and multilateral organizations as all partners in this great vision, we would be able to move the needle a little further along in our quest for better health infrastructural outcomes in SSA....all whilst holding each player accountable. At the end of the day, it defeats our own purposes to hold on to a mantra that states 'each man for himself and God for us all' versus one more so to the tune of 'injustice anywhere is a threat to justice everywhere'. Ultimately, we do ourselves, and generations behind us, a gross injustice by not fighting for better healthcare all around us.