Prioritising the health sector in Africa

Africa and EU in Partnership website. The Millennium Development Goals (MDGs) have two health-related objectives, child and maternal health, both of which are lagging behind in Africa. The EU adopted conclusions recently on its role in global health, which will be part of a coordinated plan to come with a unified voice to the UN MDG conference in New York in September. Coming to grips with health services in Africa will be crucial in securing the continent’s achievement of the MDGs.

With at least 20 million people dying prematurely each year (and half of those under the age of five) in developing countries due to the lack of basic healthcare, the importance of African countries stepping up their healthcare and developed countries increasing aid cannot be understated.

“Africa faces a troubled burden from communicable and non-communicable diseases. Having this burden means you have to have a response to reduce it. The main response is the strengthening of health systems in Africa,” said AU social affairs commissioner Bience Philomina Gawanas. The increasing disparity between and within countries in the coverage of basic healthcare has raised the profile of healthcare on the international agenda. It has intensified the call for a fairer distribution of health resources.

As a result of globalisation, contagious diseases have taken on a new dimension. The burden has increased as international travel has been made easier and more accessible to larger parts of the world’s population. As could be seen by the recent outbreak of the avian influenza, or H1N1, an outbreak in one corner of the world can quickly spread to other corners in days. This is why preventative measures should be taken at an early stage as those populations lacking basic health services are the most affected. In this sense, regional, continental and indeed global responses are needed to tackle global health inequalities.

“Even though we are from different continents, disease knows no borders. What impacts on Europe also impacts on Africa. We should not see Europe as a funding organisation but as a partner in our drive towards global health for all,” said Commissioner Gawanas. This point was echoed by European Commissioner for Health and Consumer Policy, John Dalli: “Working with the world’s poorest countries – for example through research partnerships – to improve access to new knowledge and to lifesaving treatments is a moral obligation and also in our own interests: communicable diseases, for example, do not stop at borders.”

The upcoming AU Summit to be held in July will have a focus on health-related issues, with African heads of state and government set to debate maternal and child health. “This will be very important in driving the African health agenda forward,” said Commissioner Gawanas.

International action

While new innovations in science and medicine have certainly spurred medical advances and helped alleviate some of the world’s most deadly diseases, without making these innovations accessible and affordable they will not tap into the places they are needed most: developing countries. “We have to prioritise the health sector,” said Commissioner Gawanas. “We need to increase access to medicine. We have to concentrate on dealing with diseases of the poor and make sure that medicine is affordable.” Therefore, innovation in medicine has to go hand in hand with accessibility and affordability in medicine. This is what one project, co-funded by the EU, is trying to do in sub-Saharan Africa.

The European Developing Countries Clinical Trials Partnership (EDCTP) is a partnership between 14 EU countries and 47 African countries which seeks to accelerate the development of new or improved drugs in sub-Saharan Africa. The focus is on vaccines against the biggest killers on the continent which contribute to poverty, namely tuberculosis, HIV/AIDS and malaria. Because it is a partnership, it enables EU countries to integrate their research and development agendas and form close bonds with their African counterparts.

The EU supports action at the global level, where the WHO’s Global Strategy and Plan of Action for Public Health, Innovation and Intellectual Property aims to increase access to healthcare in the world’s poorest regions. AU Commissioner Gawanas believes the world needs to “get a better understanding of Africa’s needs and priorities”, where it could specifically target health-related aid.

Health governance

Health aid is largely fragmented at the national level due to the multiple actors involved in the system. This is also due to the differing financial and implementing processes as well as the targeted nature of health services in different regions. However, the fragmented nature undermines the overall delivery of health services, as the ‘trustees’ of the system, the institutions who administer health, have reduced capacities and leadership.
The multiplicity of actors in the health field along with increasing resources has unfortunately not been met by accompanying structures, which has led to the fragmented nature of the system.

EU role

The EU wants to build global alliances in health to both enhance its visibility and help contribute to shaping the wider health agenda. This is what it set out to do in its Health Strategy 2008-2013, which aims to share the EU’s experiences in health to improve global health. The EU policy on global health focuses on helping developing countries strengthen their healthcare systems and provides specific sector support. In March 2010 the European Commission adopted a Communication on the EU role in Global Health which was supported by the EU Council conclusions in May 2010.

A global health forum held in Brussels on 10-11 June 2010 gathered about 300 participants from ministries of health, development and research from EU Member States, candidate and neighbourhood countries as well as partners from Africa, the Americas and Asia, from WHO and other UN organisations, the private sector, academia, industry, civil society, professional groups and other NGO’s. The conference’s aim was to present the European Commission Communication on Global Health and to discuss key challenges, goals, policy instruments and partnerships with stakeholders and global partners to see how the EU can most effectively engage with all actors to improve health at the global level. “The dialogue between Africa and the EU should be on how to make support effective,” said Commissioner Gawanas.

By making the EU’s contribution more effective, it can help underprivileged countries achieve the health-related MDGs. “The MDGs related to health, on child mortality, maternal mortality and HIV/AIDS are among those most off track. We cannot accept this,” said European Commissioner John Dalli. It is thus important for the EU to discuss all the health-related MDGs as a package, rather than separately. While African countries have adopted countless decisions and commitments related to health, Commissioner Gawanas believed it was high time that these should now be translated into actions.

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