There are many misconceptions surrounding health care in Africa, a continent of 54 sovereign countries and a population exceeding 1.2 billion souls which is growing at the fastest rate in the world. Enormous diversity has direct impact on the notion, practices, and availability of health care on the continent. There are no satisfactory generalizations about the state of health and the strength of health care systems for the continent as a whole. Indeed, differences between neighboring countries are enormous, as well as among population groups within countries. There is a significant mix of public, private, and faith-based health care providers. In most African countries, 60 percent of health providers fall into the latter two categories (IFC, 2008). Moreover, movements towards national and private risk pooling for payment of health care are underway in only a few countries, but virtually all modern African constitutions declare health care as a human right and aspire to some form of Universal Health Coverage (UHC). Despite these principles, Africans endure a dual burden of communicable and non-communicable disease. In the face of these challenges, Africans are confronted with out-of-pocket payment for health services – when it is available at all – and challenging logistics for accessing and maintaining consistency of care. The patient journey for Africans is a winding path, often exacerbated by an additional reliance on the importation of talent, pharmaceuticals and vaccines, medical and diagnostic tools, and digital support of the health systems. The health care value chain in Africa is incomplete. Each of Providers, Payers and Producers need further development. When any of these is weak or missing, there cannot be a sustainable health system. The issue, therefore, is not scientific or clinical competence; it is capacity and the necessity to promote a comprehensive and integrated health care ecosystem – including the Producer segment. To address the Producer link, more direct engagement by the global biopharmaceutical industry in assisting and investing in the advancement of indigenous laboratory and clinical development, product production and distribution, and the advancement of human capital necessary to achieve health care sovereignty for the continent is necessary. There is all the more reason to do so as humanity enters the age of genomic and precision medicine. There is a pathway for African health care to leapfrog as it has done in telecommunications.
Aligning Payment and Policies With Health Care Value and Equity
