A healthcare expert tells us the benefits of Universal Health Coverage and how to make it widely accepted in Africa

Africa Health 2019 is convened by Amref Health Africa, the Rwanda Ministry of Health, and numerous other partners. Dr Githinji Gitahi is the Group Chief Executive Officer of Amref Health Africa, an organisation reaching more than 9 million people each year through 150 health-focused projects across 35 countries.

In this interview with Business Insider Sub-Saharan Africa, Dr Gitahi tells us about Africa’s road to universal health coverage and what to expect at Africa Health 2019, the largest African-led health conference on the continent.

The World Health Organisation defines Universal Health Coverage as ensuring that all people have access to needed quality health services while ensuring that the use of these services does not expose them to financial hardship.

Definition of Universal Health Coverage PAI

Business Insider Sub-Saharan Africa (BI SSA): You're a firm believer in Universal Health Coverage (UHC). Why do you think it is feasible in Africa, especially with the many fragile health systems and weak government infrastructure?

Dr Githinji Gitahi (DGG): The consensus among experts, including more than 360 economists from 53 countries, is that UHC is a smart investment and an achievable goal that enables people to fulfil their potential and contribute to the development of their countries.

It’s true that there are many challenges when it comes to realizing UHC in Africa – too many people across the continent lack access to safe, affordable and quality health care and advanced technologies, and as a result, many lives are lost to preventable diseases and treatable illnesses. Epidemics and other public health emergencies, like the Ebola crisis in West Africa a few years back, are a stark reminder of the urgent need to strengthen health systems.

But this is only one side of the story. Political momentum for UHC is growing, and many countries across Africa are making impressive strides in expanding health coverage. Rwanda now has a near-universal health care system that covers about 90% of the population, and the country has significantly expanded Primary Health Care, which is the most cost-effective way to increase access to care for vulnerable populations.

Kenya recently launched its UHC pilot programme, which aims to reach 3.2 million people from four counties with free health services, before scaling up nationwide, Ghana has been at it for several years and so is Senegal and Ethiopia is driving forward with its UHC plan. With strong political will, UHC can become a reality for any African country.

BI SSA: What would you say are the biggest benefits of UHC?

DGG: UHC is a triple win: it improves people’s health, reduces poverty and fuels economic growth. Aside from the obvious benefits of having a healthier population, UHC improves how health care is delivered and financed so that it is more accessible, more equitable and more effective. When health care becomes accessible and affordable, families will be able to educate their children, start a business and save for emergencies – contributing to both social and economic growth within the nation. We need to view UHC not as a cost, but as an investment for the future.

BI SSA: How do you communicate these benefits to the common man?

DGG: Almost every person I’ve talked to knows someone who has faced a serious setback in life due to extremely high health expenses. People intuitively understand the importance of access to care when you need it most, as well as the need for financial protection

A frequently cited statistic is that 11 million Africans are pushed into poverty every year due to high out-of-pocket payments on health – for what you call the “common man,” this is not a statistic; it is a very real personal story of a family member or a friend.

BI SSA: Why should governments care and what are you doing to ensure they are committed to UHC?

DGG: The benefits of a healthy population extend far beyond the individual – health transforms communities and economies. Every $1 that a developing country invests in health today can produce up to $4 in benefits annually.

What’s more, UHC policies create resilient health systems with two major benefits: in times of distress, they mitigate shocks to people’s lives and livelihoods; in times of calm, they improve a community’s economic productivity and ability to work together. The path to “health for all” is the same path to economic growth and prosperity – these goals are inextricably linked.

Amref Health Africa (Global) and the Amref Health Africa office in Spain receiving the Princess of Austria’s Award for International Cooperation in Oviedo, Spain in 2018 that was officiated by the King of Spain Filipe VI. Amref

Amref Health Africa is working with governments to create community-responsive financing mechanisms that are tailored to the needs of communities in our own countries, instead of replicating the systems used in other parts of the world. In addition, we are working with partners worldwide to advocate for recognition and remuneration of Community Health Workers (CHWs) throughout Africa, to optimise their contribution to Primary Health Care and UHC.

CHWs are the backbone of many health systems in Africa, filling critical gaps in the delivery of essential health services. Amref Health Africa is also convening the Africa Health 2019 conference which focuses on multi-sector collaboration to achieve UHC in Africa by 2030 and will serve as a platform for governments and other stakeholders to re-affirm their commitment to UHC ahead of the UHC High-Level Meeting scheduled at the UN General Assembly in September 2019.

BI SSA: Tell us more about Africa Health 2019 and what the objectives are?

DGG: Africa Health 2019 is geared to be one of the largest health convenings in Africa, with over 1,500 participants expected. Amid growing global enthusiasm for UHC, there are urgent unanswered questions about UHC implementation at the country level. The conference will help African health leaders, practitioners and advocates exchange country examples and best practices on delivering UHC, including disruptive technologies now being deployed on the continent and models for successful public-private collaboration. It will also be a platform for leaders to reaffirm political support for health for all.

Many African countries have already made commitments to achieving UHC – this conference will be a place to map the pathway from a commitment to action.

BI SSA: What can people expect to gain from attending this conference?

DGG: Africa faces unique health challenges – our socio-cultural context, disease profiles and health infrastructure are different from that of Europe, for example. We can learn from Europe and North America as we can learn from Asia, however, we cannot model Africa’s health solutions the same way. There is no “one-size-fits-all” approach to UHC, and African countries must design their own unique pathways toward health for all. Africa Health 2019 will contextualize discussions on UHC in Africa, understanding that priorities will differ from one country to another, depending on local circumstances and national dialogues. Critically, the conference will be a platform for conversations on health to happen on African soil and led by African voices.