One year into the Ebola epidemic, the international community must take stock of the lessons learned and emerge stronger than before. The crisis in Liberia, Guinea and my own country, Sierra Leone, has shown us that without strong and resilient health systems, countries are left powerless in the face of disease epidemics.
The reality is that the countries most affected by Ebola are not uniquely vulnerable. According to a new report from Save the Children, 26 countries have worse access to healthcare than Sierra Leone – 16 of these are in sub-Saharan Africa.
The best way to prepare a country for health crises is to invest in the systems that protect against the more pervasive health challenges, such as diarrhoeal diseases, cancer and malaria. Ensuring that Africans receive even the most basic healthcare requires the people, institutions and technologies that together help keep communities healthy.
Commitments to build strong health systems from African governments and organisations like the African Union have led to significant progress across the continent, including a dramatic reduction in malaria deaths, a decline in HIV-Aids incidence and new efforts to get maternal health services to those in hard-to-reach areas.
Nevertheless, many countries continue to face dire health challenges and governments must continue to mobilise domestic resources for health, and strategically use international aid as a complement to these efforts. New and innovative partnerships, including those with other countries in the Global South, are rapidly becoming an important part of this landscape, particularly as traditional donor budgets come under pressure. South-South cooperation allows African countries to exchange experiences and expertise with other countries that have faced similar health challenges, and that share similar health goals. A prime example of this is Africa’s growing partnership with China.
Health cooperation between China and Africa is not new: since the early 1960s, thousands of Chinese medical personnel have served in more than 40 African countries, providing services ranging from treatment of infectious diseases to complex surgeries. These investments have proved critical during the Ebola outbreak, as Chinese doctors helped to treat numerous patients, including several hundred in Sierra Leone. In addition to providing and training health workers, China and African governments have worked together in 46 countries to build hospitals, clinics and malaria treatments centres, train health workers and distribute health equipment and drugs.
Increasingly, African and Chinese governments and pharmaceutical companies are exploring means of collaboration through joint ventures, partnerships and technology transfers. China and Africa are now paving the way for new pipelines for drugs, vaccines, diagnostics and health technologies, such as the introduction of the Chinese Sino-implant, a highly effective, low-cost contraceptive in Africa. In addition, through linkages between the private sector and governments, these kinds of partnerships are building African capacity to produce and deliver essential medical products.
As collaboration between African countries and China increases, universal access to healthcare – an issue that we are both tackling – is a growing area of focus. At the last gathering of Ministers of Health from China and Africa, leaders enshrined their commitment to “universal coverage of health systems” in the Beijing Declaration.
This commitment linked ongoing collaboration around human resources, infrastructure and medicines to a broader focus on health coverage, with the goal of reaching everyone, even the poorest, with the services they need. Universal health coverage is a priority for African countries, with new models and investments being made from Ethiopia to South Africa, and was the theme of the African Union’s Africa Health Strategy from 2007-2015.
Ebola starkly highlighted that weak, or even non-existent, health systems are a primary obstacle to progress, and is an important reminder that attention to and resources for universal coverage are urgently needed.
In our efforts to build strong health systems, China can be a valuable partner, drawing on its own recent domestic health system reform. In the last few years, China has achieved considerable progress in expanding health coverage, particularly in rural areas, using models that rely on training community health workers to respond to basic needs. China’s investments in health research and development, and its growing manufacturing industry can also be a resource to African countries looking to develop capacity in these areas. This partnership goes both ways. Innovative models used in countries across the continent, such as those utilising community health workers and mobile technology, or simplified drug-regimens like the once-a-day HIV pill, can inform Chinese domestic health efforts as well.
China and African countries are taking steps to deepen their commitment to universal health coverage and move the agenda forward. I recently had the pleasure of attending the Fifth International Roundtable on China-Africa Health Collaboration in Beijing. The Roundtable brought together more than 350 participants, including representatives from governments, the private sector and international organisations to identify new ways that China and Africa can partner on priority areas and leverage their unique experiences and resources to meet shared health goals.
At the Roundtable, we discussed different approaches and models for collaboration, as well as ways to engage new partners to build strong health systems. Meeting organisers released a set of policy recommendations for consideration at this year’s ministerial gathering, calling for strengthened dialogue between China and African countries, commitment to tailoring Chinese support to African priorities and increased Chinese and African investments in health, specifically around universal coverage and the supply of safe, high-quality health products.
At the African Union, we recognise that health is a catalyst for development and progress. As China and African countries continue to invest more in health, we need to leverage our respective experiences and resources to make universal coverage a reality. Together, we can help prepare for the next infectious disease outbreak, as well as the more common, but no less tragic health challenges that people across Africa and China face every day.
His Excellency Dr Mustapha Sidiki Kaloko is the Commissioner for Social Affairs at the African Union Commission.