Disease is causing an “astounding” drain on Africa’s economy, costing the continent almost $2.4trn each year. The Daily Telegraph reports that this is according to the World Health Organisation (WHO) which said the continent’s economy will continue to suffer unless African governments ramp up spending on health.
In 2015, 630m years of healthy life were lost in Africa through early death, disability and ill health, costing the economy trillions in terms of lost workforce productivity.
“I think the message is very simple: it’s wasteful not to invest in health,” Dr Matshidiso Moeti, WHO regional director for Africa, is quoted in the report as saying. “Health is a good investment, and where countries are grappling with different strategies to grow GDP, it would be really unwise to ignore this fact.” Moeti added that it was “astounding” that Africa accounts for 40% of the global loss of GDP due to workforce ill health. “This is something that we need to note with concern,” she said.
The report says the Africa Health Forum report stressed the high economic cost of continuing the status quo. If health care improvements are sustained at the current rate, Africa would lose almost $1.7trn in GDP in 2030. But if the ambitious Sustainable Development Goals (SDGs) are achieved, this figure would be just $892bn – reducing lost productivity by almost half. “When you compare the investment costs to what we lose annually, it is such a small price to pay,” Grace Kabaniha, health economist at WHO Africa, is quoted in the report as saying. “Achievement of the critical health SDG targets, including universal health coverage, would contribute to poverty eradication efforts on a large scale.”
Non-communicable diseases have overtaken infectious diseases as the largest drain on productivity, accounting for 37% of the disease burden, while five countries – Democratic Republic of the Congo, Ethiopia, Nigeria, South Africa and Tanzania – accounted for almost half of the total years lost in healthy life across Africa.
The report says the Africa Forum Health report adds to a growing body of evidence suggesting that investing in health boosts economic development through strengthening so-called “human capital.” “Minds have to shift, we need to focus on preventing disease,” Dr Arlindo Nascimento de Rosario, minister of health and social security for Cape Verde, is quoted in the report as saying. “There is no amount of money you can pour into a system that will make people healthy if you spend lots treating the diseases, and do not promote good health and prevention.”
Yet there are concerns that for many countries health spending is moving in the wrong direction; between 2000 and 2015, health spending as a proportion of the total budget dropped in 25 countries. And only three countries spent more than 15% of GDP on health – despite numerous political declarations from Heads of States to reach the target.
But Moeti said in the report she believed Africa was moving in the right direction. “What I’m confident about is that countries will progress towards universal health care by 2030. I am seeing countries already taking practical steps to translate political commitments into investment. That has not happened in the past,” she said.
Countries south of the Sahara account for roughly half of the 5m children around the world who each year die before their fifth birthday, while 40% of people with the Aids virus in Africa still do not have access to HIV drugs. “Although much effort has been invested in improving the functioning of health systems in the region, more still remains to be done,” Moete is quoted in an Eyewitness News report as saying.
Universal health coverage is poor or absent across Africa, experts say, a view supported by the lack of statistics about the issue. In 2001, AU countries pledged to allot at least 15% of their annual budget to health. But, the report says, very few – only four by 2014, according to a 2016 World Bank report – have achieved this goal.
Countries deemed high performers include Cape Verde, where 40% of the population have health and unemployment coverage, and Rwanda, where health insurance premiums cost around $3 a year. South Africa last year unveiled a health insurance scheme co-financed by employers and employees that is scheduled to be operational in 2026.
In Ivory Coast, universal health coverage, promised since 2015, should take effect in the coming months, officials are quoted in the report as saying. In Kenya, only around a fifth of the population has health insurance – in December, the government launched a programme for nationwide coverage from 2022.
According to the report, development specialists say out-of-pocket expenditure for health is a major source of impoverishment in Africa. According to the World Bank report, these expenditures rose from $15 per head in 1995 to $38 in 2014, a rise that meant another 11m Africans were falling into poverty each year.