While distinct and distant, Africa and Asia today are on similar journeys – their economies are undergoing impressive transformations, communities are evolving, and the growth is drawing global attention, as new ideas and strategies aim to improve health and advance development equitably.
Globally, Universal Health Coverage (UHC) – the goal that all individuals and communities receive the health services they need without suffering financial hardship – is gaining momentum, as governments, development partners, civil society and the private sector acknowledge both the moral and economic imperative of providing health for all.
If UHC is to become a reality – if health is to be truly universal – African and Asian countries must not only be a part of this narrative, but a driving force. Across both continents, millions of families do not have access to essential health services, medicines and advanced technologies. As a result, many lives continue to be lost to preventable diseases and treatable illnesses. For those who do have access, health care is too often unaffordable: together, Africa and Asia account for an astounding 97% of the world’s population impoverished by out-of-pocket health spending.
With varying social and economic realities among countries, the challenge of providing access to quality, affordable health services for entire populations has led to a renewed focus on the importance of home-grown approaches, tailored strategies and community-led innovations to deliver UHC. But that doesn’t mean that every country needs to start from scratch.
Many countries in Africa and Asia face challenges such as domestic resource mobilization, high burdens of both infectious and non-communicable diseases, hard-to-reach populations, and weak primary health care systems – to name just a few.
Many countries are implementing innovative strategies to address these challenges, and where similar challenges abound, similar solutions are also possible. There is much that countries in Africa and Asia can learn from each other, and platforms to share learnings and best practices have great potential to advance UHC.
For instance, the Governments of Thailand and Kenya have partnered to accelerate progress towards Kenya’s UHC goals. In 2002, Thailand instituted a tax-financed model to provide free health care to 70% of its population, regardless of their ability to pay.
Today, coverage has expanded to 99% of the population. Now, Thailand is serving as an advisory and technical partner to Kenya, as the latter seeks to roll out and scale up UHC nationwide by 2022.
As countries of all income levels embrace the goal of UHC, we now need to shift our attention to how to implement UHC. Yet, there are major gaps in the information and guidance available to countries in the Global South seeking to do so – partnerships like the agreement between the governments of Kenya and Thailand are few and far between.
Recognizing the value of such partnerships, Amref Health Africa and the Public Health Foundation of India hosted a series of regional consultations to allow experts and policymakers from the Global South to share learnings and best practices around UHC implementation.
Over the past year, these consultations have brought together government representatives, technical experts, private sector actors, and intermediary and donor organisations from the Global South. They have delved deep into individual country experiences on a range of topics, including strengthening health systems, the importance of community-led innovation, the role of private and non-state actors, and the need to develop accountability mechanisms for UHC.
The consultations served as a critical reminder that governments alone cannot achieve UHC; all partners have a role to play. The private sector, for example, can provide funding and fill existing healthcare service delivery gaps, as well as offer experience and capabilities to complement and strengthen the public sector.
The private sector can also deliver and scale innovations, whether to reach a large volume of beneficiaries or to meet local needs in low-resource settings. Knowledge-sharing platforms anchored by an intermediary organization can help encourage private and public sector engagements and maintain accountability from all partners.
The consultations also reinforced the need to incentivize the research, development and scale-up of new technologies. Digital and mobile-based solutions are transforming health outcomes in many countries in Africa and Asia, from training of health workers in remote locations to reporting on local medicine stocks using mobile phones.
When scaled, such innovations have enormous potential to improve access to and availability of essential health services and products.
These and other learnings from the Global South consultations were showcased by Amref and PHFI on the side-lines of 72nd World Health Assembly earlier this year. With UHC gaining traction on a global scale, and the UN having organized a High-Level Meeting on UHC in September, we hope that the voices and journeys of the Global South continue to be reflected in the outcomes of such collaborative platforms.
By brokering knowledge across countries, partners and initiatives, we can do so much more together than any one party can do alone. So let us come together—as enablers, as intermediaries, and as a community – to make sure everyone can access quality healthcare without feeling a burden on their pockets.
Dr. Githinji Gitahi is Group CEO, Amref Health Africa & Dr. Srinath Reddy is President, Public Health Foundation of India.
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