Knowledge Event 2: “Building Africa’s Healthcare Defense System”
The objective of this knowledge event is to examine key vulnerabilities in Africa’s healthcare system that have been dramatically exposed as a result of the COVID pandemic, so as to discuss how to rebuild Africa’s healthcare systems more boldly for greater healthcare security and resilience to future outbreaks. In other word, this event will discuss how to build Africa’s Healthcare Defense System.
Investment in Africa’s healthcare systems is key to inclusive and sustainable growth. Pre-COVID-19 pandemic, Africa’s healthcare system was said to be the worst in the world, especially sub-Saharan Africa. Health expenditure as a percentage of GDP averaged 5.1% in sub-Saharan Africa in 2018, the lowest globally. The myriad of issues in the African healthcare systems spans the entire ecosystem including: dire expert health worker shortages exacerbated by the brain drain phenomenon, need for better medical education, poor associated healthcare infrastructure, counterfeit drugs, poor governance and weak governments’ budget allocations, inadequate data systems and poor use of technology, lack of R&D centers even for the disease burdens peculiar to Africa, need for better collaboration with the WHO and UN healthcare agencies, and generally poor collaboration between public and private sector in healthcare for optimal quality, affordability and coverage, amongst others. The extremely low level of ICU beds, MRI and other diagnostic equipment per 10,000 people is unprecedented. With 26% of the global disease burden, and 16% of the world’s population, sub-Saharan Africa commands less than 2% of the world health expenditure. A pre-pandemic report from UNECA, indicated that there was an annual funding gap of circa US$66 billion, notwithstanding the increase in government budget allocation which still falls far short of the Abuja declaration where African governments made a historic pledge to allocate at least 15% of their annual budgets to the healthcare sector. This will be a larger problem today where governments fiscal abilities are limited amidst mounting debt burdens.
Today, because of the pandemic and the ensuing global health crisis, vulnerabilities in the global pharmaceutical supply chain (including vaccines), as well as the healthcare infrastructure system have been seriously exposed, particularly in Africa. We have witnessed the revival of protectionist behaviors, with countries keeping critical health products (PPEs, drugs, vaccines, etc.) for their own needs and banning exports. The global competition for medical supplies and vaccines has brought into focus Africa’s weak production base and over-reliance on imported pharmaceutical and medical supplies: up to 70% of the pharmaceutical products and almost all its vaccines are imported. Although Africa’s pharmaceutical industry is currently unable to produce the basic lifesaving therapeutics or vaccines locally, this crisis is a real opportunity to revitalize the African pharmaceutical industry to guarantee minimum security of supply and increase the continent’s health sovereignty, and hence healthcare defense system. A key example of the healthcare infrastructure deficiency exposed by the COVID-19 pandemic –relates to the fact that in January 2020, there were only two (2) referral laboratories on the continent, responsible for testing COVID samples from other Africa countries. As a result of urgent action taken, now preventive, diagnostic, and treatment measures have been improved, and all African countries can now diagnose COVID-19, with 14 countries performing over 100 tests per 10,000 people.
African leaders are seizing this opportunity to unlock the potential of African pharmaceutical manufacturing, including vaccine manufacturing as evidenced by the well-participated and attended African Vaccine Manufacturing Summit on 12-13 April 2021, sponsored by the African Union and the Africa CDC. Acquisition and greenfield activities have accelerated over the past 5 years in the African pharmaceutical industry, demonstrating its viability. Despite its current small size, the African vaccines market is expected to continue to grow steadily, thanks to strong fundamentals such as a growing population (25% of world’s population by 2050), increased access to vaccines and expected new product introductions, such as the malaria vaccine.1 The size of this market is expected to reach almost 5 billion dollars by 2030, from a current size of 1.3 billion dollars.
This knowledge event will provide opportunities for stakeholders (political leaders, private sector, regulators, DFIs, researchers and innovators, etc.) to examine the healthcare system vulnerabilities exposed by developments during this pandemic. Questions for discussion could include:
- How are African leaders and other stakeholders prioritizing investments in their health systems to rebuild back better and with greater resilience?
- Which key reforms should be prioritized to facilitate access to quality healthcare, including institutional reforms on a pan-African basis e.g. expedited ratification of the African Medicines Agency?
- What steps should African Governments take to develop and retain a skilled workforce to support a stronger and more inclusive healthcare system?
- Can Africa afford to establish R&D centers, especially those geared towards disease burdens peculiar to Africa?
- How can Africa leverage the Fourth Industrial Revolution to improve coverage and quality of healthcare?
- How can the external Pharmaceutical Manufacturing Plan for Africa be implemented in line with the AU Agenda 2063?
- How can the principle of leveraging regional hubs e.g. for manufacturing pharmaceutical products including vaccines, be accepted politically and financially supported by African countries?
- How could the continent achieve such an aspiration of an African Healthcare Defense System? What should be the role of various stakeholders (governments, private sector, DFIs, researchers, etc.)? And what kind of partnerships will be required?
- What are the best strategies for attracting more funds in the health and pharmaceutical sectors?
- Which opportunities are well suited to public-private partnerships?
- How can the current global vaccine supply architecture be restructured to serve Africa better?
- What would it take to prepare Africa to deal with future health pandemics?
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