How to plug healthcare financing gap

Medicines from manufacturers go through multiple middlemen before landing in hospitals. FILE PHOTO | NMG 

By BITANGE NDEMO
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Summary

• We need political will to drive change in healthcare and make our people feel better even as they forget those who made it possible for them to have the feelings.

“I've learned that people will forget what you said, forget what you did, but will never forget how you made them feel.” - Maya Angelou

Last week in Addis Ababa, late American poet Maya Angelou’s words resonated with those of retired Ivorian footballer Didier Drogba, who through his foundation facilitates health and education access for vulnerable populations. Drogba said, “Scoring the many goals at the Champions’ League final cannot be compared to helping that one child get a better chance at life.” Many of Drogba’s beneficiaries will forget what he said, even that at one time he a football legend, but they will never forget the feelings he brought to them.

More Africans in their private capacities need to stand up and be counted in working with the public sector to plug the rising gap of Africa’s healthcare financing. Indeed, more private sector players are seeking collaboration with public sectors to find ways of dealing with the financing gap.GBCHealth, the Aliko Dangote Foundation and the UN Economic Commission for Africa (UNECA) jointly held a high-level dialogue on Africa’s Health and Financing dubbed Pathways to Economic Growth and Prosperity on the margins of the 32nd African Union Summit.

The forum attracted participation from public and private sectors with a common agenda of collaborating on health outcomes.

Findings from their report, Healthcare and Economic Growth in Africa, called for greater African private sector involvement and investment in healthcare. The report emphasised that neither government nor existing public-private partnerships (PPPs) are effective enough to deal with widening problem.

It recommends a new model, where public private partnerships focus on the most significant disease burden and broaden their scope to benefit every citizen in the continent for greater economic growth.

The link between healthcare and economic growth was emphasised by the Executive Secretary of the United Nations Economic Commission for Africa (ECA) and co-convener of the forum, Vera Songwe, who said, “A healthy Africa is a productive Africa; a productive Africa is a prosperous Africa.”

Referencing their report, she noted that health spending remains largely inadequate to meet the growing healthcare needs and Africa has a financing gap in this regard of at least $66 billion per annum.” Songwe added, “Only two countries (Algeria and Namibia) spend more than five percent of GDP on health, and out-of-pocket payments are still extremely high.

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The report shows us just how much economic impact can be made from investing in health.”In my view, the report although welcome, did not cover all aspects for reducing the burden of healthcare in Africa. Africa has commoditised patients and is trading them like beans across the world. My recent interview with employees from two referral hospitals in East Africa reveal that insurance companies, including public ones, are brazenly trading patients with some doctors, fixing pricing and making decisions on how they can make the best out of any patient.

Private hospitals are beholden to brokers who fix prices for services that cost a fraction elsewhere. A new profession, IndoAfrica Health-link healthpreneurs, is emerging and hundreds of Africans are traversing hospitals in India fixing deals on how many patients they can bring to their facilities.

Doctors too have become conduits that refer even mundane cases to India. Medicines from manufacturers go through multiple middlemen before landing in hospitals. Salesmen bribe doctors to prescribe their medicines and doctors dance to the tune prescribing useless supplements to desperate patients without an iota of empathy. There is no PPP model that will change our rotten “entrepreneurial” practices.

My appeal to Dangote’s GBCHealth Foundation and UNECA is that in the era of the Fourth Industrial Revolution, they need to facilitate technology that can minimize the corruption in healthcare and enable greater transparency and accountability. The technology to remove middlemen and truly lower the cost of treatment exists. We need political will to drive change in healthcare and make our people feel better even as they forget those who made it possible for them to have the feelings.