Why Africa has to shape the future of its health systems

Africa finds itself ill-equipped to provide its citizens with crucial medical services in response to the growing prevalence of infectious diseases and illnesses that have emerged in the 21st Century, concurrent with a precipitous increase in noncommunicable diseases.

Healthcare systems in many African countries grapple with challenges ranging from outdated health policies, lack of vital medical resources, shortage of proficient healthcare professionals and inadequate infrastructure. Collectively, these deficiencies significantly hinder the capacity for Africa to create effective solutions suited to their populations.

Understanding and combating emerging health threats holds the potential to yield transformative socio-economic benefits for individuals, communities, and nations alike. The urgency for substantial investment in Research and Development (R&D) is undeniable.

The African continent is ‘the birthplace of modern humans’, with corresponding genetic diversity. This presents a remarkable opportunity for R&D investment in Africa to develop tailored health solutions.

By investing resources in cutting-edge research, scientists working in Africa have the potential to decipher the complex mechanisms of underlying diseases, develop innovative diagnostic tools, and formulate effective treatments of and preventive strategies against disease.

Such investments foster the creation of resilient health systems capable of swift response and adaptation to infectious diseases like Ebola, which significantly impact various regions of Africa.

The returns on R&D investment extend well beyond the realm of disease treatment and prevention. Breakthroughs in medical science and technology promote a virtuous cycle of economic growth and societal advancement.

A prime example is the rapid development of Covid-19 vaccines which saved countless lives and played a role in global economic recovery. The successful collaboration between health researchers and private pharmaceutical companies underscores the potential of R&D to drive innovation, create jobs and stimulate economic activity.

African leaders have recognised the pivotal role of R&D, as demonstrated by the 2063 Agenda and the 10-year Science, Technology and Innovation Strategy for Africa of the African Union Heads of State and government. But financial targets for funding health R&D have not been met.

Government officials are reluctant to allocate scarce resources to R&D that may not yield immediate rewards when they are under political pressure to address more immediately visible issues such as food security or access to education.

Africa’s funding of R&D is estimated to be less than 0.5 percent of the continent’s gross domestic product, far below the global average of 1.7 percent.

Only domestic funding for R&D in sub-Saharan Africa can ensure that the African research ecosystem can chart its own research agenda. Because science in Africa continues to be heavily reliant on external funders, it is beholden to the interests and priorities of the nations that provide funding.

Examples of areas where this becomes sensitive and works against African interests include data ownership and investment sustainability. The 2015 Addis Ababa Action Agenda underscores the urgency of mobilising financing from all sources, urging African researchers to diversify funding mechanisms. To realise this, a paradigm shift that facilitates sustainable financing mechanisms and partnerships for health R&D in Africa is imperative.

Sustainable financing mechanisms and partnerships

At its core, diversification requires African governments to pave the way as leaders and create a conducive environment for private investment. This entails them making a concerted effort to identify their long-term health priorities and establish clear, sustainable funding sources and mechanisms that include direct budgetary allocations, public-private collaborations and/or tax incentives for R&D investment.

These strategies should be comprehensively mapped out within-country development policies, with resources allocated accordingly, to stimulate the growth of strong healthcare infrastructures, professional training, retention of skilled medical workers and production of essential medical supplies and pharmaceuticals.

The long-term value of increased domestic investment in R&D must be substantiated by tangible evidence, with proof of concept. By fostering an investment-enabling environment, African governments can instil confidence in potential investors and catalyse strategic partnerships with the private sector.

This collaborative synergy between governments and private entities will accelerate technological advancements and facilitate the rapid translation of research outcomes into practical solutions that directly address critical health challenges faced by African populations. As these innovations gain traction and yield positive returns, the resulting improvements in healthcare access and outcomes will enhance the quality of life for African citizens.

Vincent Okungu is a Senior Health Economist at the University of Nairobi in Kenya.