National health systems – SADC’s big challenge

Lazarus Sauti

Countries in the Southern African Development Community endure a heavy burden of diseases, underpinned by malaria, HIV/AIDS and tuberculosis, which impacts families, impoverishes the large numbers of citizens and undermines socio-economic transformation on the region.

Sadly, public health systems in the region as well as other African countries are struggling to provide effective and adequate health care to nationals.

Regional and other African states, therefore, need to scale up their health systems for disease prevention and control as citizens are suffering because national health systems are in deprived shape.

The World Health Organisation, a specialised agency of the United Nations that is concerned with international public health, agrees: “People get sick and die in many cases because the systems for disease prevention and control are not in place or – if they are – they do not function properly.

“By any measure of health system function – immunisation coverage, skilled birth attendance, malnutrition, and maternal and child mortality – the region is in poor shape.”

Disease burden is further fuelled by the region’s lack of production of sufficient healthcare professionals combined with conditions under which healthcare employees work, inadequate auxiliary and community health workers, and poor conditions of services.  

In most, if not all, countries in the region, health sectors have also remained a critically neglected area in national budgets as budgetary allocations fell far short of the Abuja target of 15 per cent.

In April 2001, African Union countries meeting in Abuja, Nigeria, pledged to increase government funding for health to at least 15 per cent, and urged donor countries to scale up support.

Governments and health institutions in SADC, accordingly, need to improve health systems in the region to ensure citizens have access to quality health care systems.

Olivier Bucyana, an associate in the Political Governance Programme of the Open Society Institute for West Africa, believes: “A collective and well-coordinated response by governments as well as regional institutions is needed to make sure citizens have access to quality health care systems. One of the government’s primary roles is to ensure its citizens have access to a good health care system,” says Bucyana.

Vera Songwe, a non-resident senior fellow with the Africa Growth Initiative and lead economist at the World Bank, adds that the region needs strong leadership from governments and health services, rapid assistance from local and international partners, adequate coordination with the international community and confidence-building measures targeted at public health systems.

“Longer-term recovery should focus on strengthening health systems, establishing innovative partnerships to research and develop vaccines, planning for economic recovery, and reforming global health crisis management systems,” she says.

A unique opportunity exists for governments to produce and implement bold strategies that can have large health and economic benefits, to say the words of Dr. Delanyo Dovlo, Director of Health Systems and Services, WHO Regional Office for Africa.

But this robust and functional health system should provide health services for other routine medical conditions such as diarrhoea, malaria, pneumonia, high blood pressure and diabetes.

“To improve these, a coherent government-led strategy including legislation, regulation, protection of human rights, mobilisation of communities, and education of the public is call for,” says Dovlo, adding that “these strategies require integrating all health services from clinical care to surveillance, health promotion, disease prevention and management, and palliative care.

“All services need to be people centred in order to build trust and increase utilisation of services.”

Sharing same sentiments, Dr. Eric Buch, New Partnership for Africa’s Development Adviser on Health as well as professor of Health Policy and Management at the School of Health Systems and Public Health, University of Pretoria, says: “At the heart of what we are doing is a process of trying to support efforts to tackle not only the major burdens of diseases, including Aids, TB and Malaria, for example, but also many other diseases affecting communities like childhood deaths, caused by diarrhoea and pneumonia to sleeping sickness.”

Dr. Buch pleads with governments and development partners to invest in improving health systems but strongly advices nations to invest own resources into the health sectors.

“I feel very strongly that a country cannot say the health of its nation is a priority unless it is increasing its own investment in the health sector,” he says.  

A healthy population is a pre-requisite for the sustainable human development and increased productivity in a country.

SADC recognises that close co-operation in the area of health is essential for the effective control of communicable and non-communicable diseases for addressing common concerns within the region.

Forthrightly, health needs to be placed higher on the political and economic agendas of countries throughout the SADC region.