The burden of an incompetent healthcare system on Africa

We’ve heard stories of patients who died in hospitals due to poor medical infrastructures. We’ve heard stories of people who died from ingesting fake or expired drugs. We’ve also heard of people who died because they couldn’t afford medicine.

It’s almost like a curse in Africa.

The average African does not have access to an affordable, reliable, effective and efficient healthcare system. The wealthy ones travel outside to receive medical care, including their presidents; they don’t trust their own healthcare system. The poor ones resort to herbal medicine because they cannot access or afford medical care.

Most public health centres are ill-equipped both in infrastructure and professional competence to cater to the medical needs of the people. For instance, hospitals give painkillers as a treat-all drug in some parts of Zimbabwe because there are no drugs in the facility. The situation is worse in government hospitals. While some private hospitals offer better care and have better facilities, they are usually very expensive, located in big cities and only patronised by the high-brows in the society.

Despite that, Africa bears one-quarter of the global disease burden, yet it only has 2% of the world’s doctors. The situation is worsened by the brain drain of homegrown doctors migrating abroad to seek better pay and a better standard of living. The ones left are always complaining about low wages and often engage in union strikes to make their grievances known to the government. During such times, patients are left without medical care and treatment, which either complicates their health or causes premature death.

Africa cannot even produce its drugs. Less than 2% of the drugs consumed in Africa are locally produced; they prefer to import drugs for even the simplest sickness. Except for countries like South Africa, Morocco and a few others, Africa lack the necessary infrastructure, research and resources to manufacture drugs. For a continent immersed in poverty, that is not cost-effective at all.

During epidemics and pandemics, Africa is usually unprepared to handle such situations. The continent relies heavily on support from tier-one countries and INGOs for medical help, supplies and relief. They cannot even make a viable contribution because they do not have a good structure to collate medical data that will aid in pharmaceutical research and development. That is how messed up the African healthcare system is.

To add salt to the injury, Africa’s inept, corrupt and bureaucratic public sector supply system is often plagued by poor procurement practices that make drugs very costly or unavailable. Often more than not, medical staff in public health care institutions tend to sell free drugs and theft for personal use illegally or resell them through the black market. In addition, these public officers receive bribes to approve drugs for registration or pass drug-quality inspections, which inadvertently results in fake drugs “legitimately” entering markets.

The over-arching burden of incompetence in the African healthcare system is the incessant loss of lives. According to the World Bank, around 80% of Africans rely on public health services, primarily those in the middle and lower-income brackets. Many patients die of easily treatable ailments due to persistent drug shortages in public health institutions.

There is the case of disability. Many persons with disability were victims of an incompetent healthcare system. It is either they were not vaccinated, as is the case with Polio patients, or they were not attended to on time, or they were given sub-standard or wrong medications, or their medical personnel was not competent enough to handle their case, or there was poor infrastructure to facilitate their care. The list is endless.

And of course, the economic burden of an incompetent healthcare system is reflected in the country’s GDP, as dead people cannot work and the money we lose when wealthy citizens fly abroad for their medical checkups and the increasing population of persons with disability that are poor and frustrated.

At present, the healthcare system in Africa demands innovative and multi-faceted solutions to tackle these issues. It has become the need of the hour to look at each challenge and design solutions that ensure a healthy and happy life for its citizens.

Poor people in impoverished communities cannot afford health insurance and obviously cannot pay medical bills out of pocket, as such state government should have state support to pay a proportion of the medical bills accrued in state and community health centres.

Health insurance should be made affordable to middle-income and low-income earners. Also, employers should provide health insurance as part of the pay package of their employees.

Technology can assist African countries in restructuring some of the more traditional and costly methods of delivering care while lowering the cost of care. Such medic-tech solutions include Flying medical aid by the South African National Blood Service employing drones to transport blood to tackle the high mortality rate among women during childbirth across the continent; Hello Doctor, a South African app, provides essential healthcare information, access to advice and a call back from a doctor for 55 rands ($3) a month; Omomi helps pregnant women and mothers in Nigeria monitor their children’s health and chat with doctors on a pay-as-you-go or subscription basis;  Pelebox, a smart locker system that dispenses medicine to patients with chronic illnesses; Ugandan mTRAC is a mobile health system to report on pharmaceutical stocks across the country.

Faced with difficulties accessing modern medicines, many Africans resort to ritual and herbal remedies. Instead of ruling herbal remedies out, the government should rebrand and standardise traditional medicine practices. This could improve access to affordable medicine, stimulate local production, and develop and retain its medical talents.

The most well-known is medical tourism. Many people believe that African healthcare would naturally improve if we could prohibit people from travelling abroad for medical care. Nigeria is one of Africa’s richer countries. According to available data, medical tourism costs us $1 billion each year, which could have been invested in improving the healthcare system.

If we want our medical professionals to stay, we must offer them better salaries, benefits, and career opportunities. We can retain our best brains in medicine while providing incentives for their continuous growth and improvement.

It is a pity that despite the burden of the poor healthcare system in Africa, our leaders are more concerned with borrowing money to equip our military armoury. Not that it’s wrong, but have you checked the national budget? African governments spend between 3% to 6% of their GDP on health. That shows where our priorities are, definitely not in the life and health of her people.

Africans in the diaspora, especially engaged in the health sector, need to be engaged in healthcare initiatives in Africa for both investment and expertise. Governments should collaborate with INGOs like WHO, USAID, UNESCO etc., to form people-friendly policies that are more responsive and result-driven and drive sustainable medical initiatives, especially in rural communities. Public-private partnerships can also help proffer innovative ways to improve and accelerate healthcare services in the continent; for example, the partnership between Nortiva, IBM and Vodafone in South Africa to make healthcare more accessible to remote people.

African governments must invest heavily into the healthcare system by creating research and development centres where disease research, data analysis, drug testing and analysis can be carried out. It is also paramount that African countries have drug manufacturing companies to reduce the cost of drugs in Africa.

Finally, people need to be informed on health issues to reduce the burden of sicknesses. Take personal responsibility by organising awareness campaigns in your communities or carrying our advocacy campaigns online.

Finally, people need to be informed on health issues to reduce the burden of sicknesses. Take personal responsibility by organising awareness campaigns in your communities or carrying our advocacy campaigns online.

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Your health is your first wealth. Put it first.