Forum Report
12th February 2019 Hyatt Regency, Addis Ababa
FOUNDING PARTNERS Contents
4 Executive Summary
6 Opening Session
10 Launch of Healthcare and Economic Growth in Africa Report
12 Launch of ABCHealth
13 Call to Action
14 The Great Debate
18 Parallel Sessions: Domestic mobilisation of funds for health Parallel Sessions: Insights from successful public-private 20 partnerships Parallel Sessions: Transforming the health landscape through 22 research and innovation
24 Interview: Halima Aliko-Dangote and Didier Drogba
26 The Forum in Photos
32 Sponsors
34 Media Coverage Annex 1: Executive Summary of Healthcare and Economic 36 Growth in Africa Report
40 Annex 2: Key Messages
41 Annex 3: Speeches
3 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
Executive Summary
he Africa Business: Health Fo- Messages of support were also re- that health outcomes to Africa are as rum, held on the margins of the ceived from H.E. President Abdel Fat- equitable as they are in other parts of African Union summit in Addis tah El-Sisi of Egypt and H.E. President the world… We must win this fight to TAbaba on 12th February 2019, Uhuru Kenyatta of Kenya, delivered by fix health in Africa.” The coalition will was the culmination of efforts by Aliko H.E. Hala Zayed, Minister of Health and be a bridge between the private and Dangote Foundation, GBCHealth and Population of Egypt, and H.E. Sicily Ka- public sector, close the data gap, help the UN Economic Commission for Afri- riuki, Health Cabinet Secretary of Ken- channel greater investments in the ca (ECA) to help mobilise private sec- ya, respectively, and from H.E. Rupiah sector as well as share best practice tor resources and expertise in order to Banda, former President of Zambia. and create networks. strengthen health systems and con- It was agreed that governments sequently transform health outcomes Launch of Healthcare and need to do more to provide the right across the continent. Economic Growth in Africa report conditions to make healthcare attrac- Aigboje Aig-Imoukhuede, Co- The Forum saw the official launch of tive and profitable for the private sec- Chair of GBCHealth and Co-Founder the Healthcare and Economic Growth tor. However, it is not just a question of ABCHealth, explaining the urgent in Africa report. This 87-page docu- of money and resources. Countries need for action, remarked that Africa ment provides a strategic direction with similar per capita budgets can has made great advances in health- for African countries to better engage have vastly contrasting outcomes. So care spending but still lags behind in with the private health sector and ac- there’s a need to learn from each other achieving the targets of UN SDG3 for celerate improvements in health. It ex- and appy best practice. Solutions were health and wellbeing. With govern- amines Africa’s healthcare challenges presented around the way to mobilise ments unable to make up this funding and highlights opportunities for the domestic funds for health and the role gap, it is time for the private sector to private sector. of PPPs and innovation to accelerate play a much bigger role. Michel Sidibé, Executive Director of and scale up impact. This message was underlined by UNAIDS, introduced the report, saying Vera Songwe, Executive Secretary of that it was the first of its kind for the Parallel sessions the ECA. “Let’s talk about how we can continent. Addressing the leaders of In the afternoon, expert panels debat- bring the public and private sector to- the public sector, he called upon them ed crucial issues for the development gether to ensure that Africa’s health- to strengthen their partnerships with of Africa’s healthcare sector in three care is funded,” she said. the private sector to make healthcare parallel sessions: “Mobilisation of do- The keynote remarks of Aliko an area where the private sector could mestic funds for health” looked at the Dangote, Chairman of Aliko Dan- invest and ensure that the people of opportunities in this increasingly im- gote Foundation, delivered by Halima Africa have access to better and more portant area; “Insights from successful Aliko-Dangote, Trustee, Aliko Dangote accessible healthcare products. public-private partnerships” reviewed Foundation, emphasised the need for Lead author, Saurabh Sinha of ECA, cases of high-performing PPPs that a multi-stakeholder approach and for presented the report’s key findings, could be replicated across the con- private sector to become more en- drawing attention to the continent’s tinent; and “Transforming the health gaged in issues surrounding health, annual healthcare financing gap of landscape through research and inno- given its criticial importance to devel- $66bn, which he said the private sector vation” examined the role of innova- opment and, directly and indirectly, can help to bridge. He drew attention tion in increasing domestic capacity to private sector growth. “With the to the potential for the private sector, to solve health challenges. All of the launch of ABCHealth, business leaders with the value of healthcare opportu- sessions provided recommendations can now make commitments and con- nities in Africa’s healthcare sector es- for business and policymakers. tribute directly to a healthy and pros- timated to be worth $259bn by 2030. perous Africa,” she said on his behalf. “The facts speak for themselves,” he Conclusions Governments alone cannot be ex- said. At the end of the day’s main busi- pected to carry the full mantle but ness, the principals behind the Forum they will need to enable the private Launch of ABCHealth stressed the need for a concerted and sector and other stakeholders to play The Forum also saw the launch of collaborative approach, the multipli- their part. A number of African heads ABCHealth, a platform to crowd-in pri- er effect of a coalition. “The power of of state and government effectively vate sector to work together to make us collaborating has no boundaries,” endorsed the approach being pro- a significant dent in improving health Aigboje Aig-Imoukhuede stressed. He posed at the Forum, committing to outcomes. called for a collective commitment to supporting greater private sector par- “We are inviting businesses, phi- a goal with measurable social impact: ticipation and to work hand in hand lanthropists, civil society, to join the “To those who achieve great things, with them. These were the messages African Business Coalition for Health greater things are expected. And so I of H.E. Prime Minister Abiy Ahmed of – ABCHealth – so that we can build look forward to the greater things that Ethiopia, H.E. President Mokgweetsi a broad-based regional coalition that will come from the coalition.” Masisi of Botswana and H.E. President will do great things,” said Aigboje In the evening, delegates enjoyed Ismail Omar Guelleh of Djibouti during Aig-Imoukhuede in his call to action. a buffet dinner and entertainment by the official opening. “Africans must play their role to ensure Malian musician Salif Keita. n
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to complement government funding.” Africa, she said, has made con- Investing in healthcare in Africa siderable progress in improving its is increasingly attractive for business health outcomes in recent years. and will promote economic develop- From 1990 to 2015, life expectancy ment, enhance productivity, create at birth, a key indicator of population new markets and improve the overall health and economic development, climate in which all businesses oper- increased from 54 to 63 years. Dur- Speakers: ate, he explained. The private sector ing the same period, the number of H.E. Abiy Ahmed, must therefore be encouraged to op- women dying in childbirth and the timise and step up its involvement and number of children dying before the Prime Minister of Ethiopia; contribution to health funding in Afri- age of five nearly halved. H.E. Mokgweetsi Masisi, ca, and this is where the Africa Busi- “The launch of the Continental President of Botswana; ness: Health Forum will play a key role. Free Trade Area last year was a de- H.E. Ismaïl Omar Guelleh “The Africa Business: Health Fo- fining decision for Africa. It shows we President of Djibouti; rum will offer stakeholders the op- have the ability to bring Africans to- H.E. Hala Zayed, portunity to visualise success and gether. We have to do the same for galvanise action amongst companies health,” she said. Minister of Health and Population, across the continent,” he said. “The As an example of the opportuni- Egypt, representing private sector will be able to commu- ties, she said that more than $17bn H.E. Abdel Fattah El-Sisi, nicate and collaborate with govern- a year is spent on importing drugs President of Egypt; ment representatives whilst exchang- into the continent and if that if they H.E. Sicily Kariuki, Health Cabinet ing knowledge and experiences. This could be manufactured here, 16m Secretary, Kenya, representing Forum promises to be an exciting and jobs could be created. “That is the H.E. Uhuru Kenyatta, productive start to a revolutionary purpose of this Forum; it is to say we approach to tackling Africa’s health should no longer export our jobs, we President of Kenya; challenges. I am very excited by the can bring those jobs back.” Aliko Dangote, possibilities for making history here “So,” she said, directly address- President and Chief Executive, Aliko today, in Addis Ababa.” H.E. Abiy Ahmed, ing members of the private sector, Dangote Group, Chairman, Aliko Vera Songwe, Executive Secretary Prime Minister of Ethiopia “take the leap of faith with us at the Dangote Foundation, represented by of the United Nations Economic Com- Economic Commission for Africa, Halima Aliko Dangote, mission for Africa (ECA), stated: “A with the African Union, with our Af- Aigboje Aig-Imoukhuede, Founder and Chariman of Africa Initiative for healthy Africa is a productive Africa; Reinforcing Aig-Imoukhuede’s ar- rican leaders and especially, with the Trustee, Aliko Dangote Foundation; Governance (AIG) and Co-Chair, GBC Health a productive Africa is a prosperous guments, she stressed the importance African youth who expect to have a Aigboje Aig-Imoukhuede, Figure : Africa.” ofFigure bringing : more private sector in- healthy population. Invest in health- Founder and Chairman of Africa Distribution o And health yet, she said, health spending vestmentHealthcare into inancing the continent’s gap health- care.” Initiative for Governance (AIG) cases byto sub-region date fails to meet the continent’s carein selected sector. “Let’scountries talk as about a health and Co-Chair, GBCHealth; in A rica growing healthcare needs. Citing fundingpercentage and let’so A rica s talk about how we Rewriting the healthcare narrative Vera Songwe, Opening Session: findings from theHealthcare and Eco- cantotal bring short all the public and the private The keynote remarks of Aliko Dan- gote, Chairman of Aliko Dangote UN Under-Secretary General and nomic Growth in Africa report, which sector together to ensure that Africa’s ■ Eastern A ricawould be launched later in the morn- healthcare is funded,” she said. Foundation, were delivered on his ■ igeria Executive Secretary of the UN Africa’s governments ■ entral A ricaing, Songwe said, “Only two countries “To attract the private sector, behalf by Halima Aliko-Dangote, Economic Commission for Africa ■ est A rica(Algeria and Namibia) spend more we■ Egyptneed to create an enabling envi- Trustee of Aliko Dangote Foundation. ■ Southernthan A rica 5% of GDP on health, and out-of- ronment.■ Angola And to the African private She conveyed his message that Moderator: Ibrahima Cheikh Diong, pledge support for ■ orth A ricapocket payments are still extremely sector■ South I say Sudan that our leaders are ex- the Forum would identify issues and CEO, ACT Afrique Group high. The report shows us just how pecting■ Morocco you to invest in healthcare find solutions to Africa’s health chal- much of an economic impact can be because■ Ethiopia you will get higher returns lenges with a view to mobilising the improved health made from investing in health”. here■ Kenya – among the best in the world.” will to confront them head-on. The need for private 6% ■ Others investment in Africa’s outcomes for Africans healthcare Figure : Figure : Healthcare inancing gap Distribution o health 22% 32% Ensuring access to quality health- cases by sub-region in selected countries as a care for all of Africa’s citizens at in A rica percentage o A rica s affordable rates is constrained by a igboje Aig-Imoukhuede, the inadequate for Africa’s needs, with a 2 .1% 32.1% scarcity of public resources. Africa Co-Chair of GBCHealth and financing gap of $66bn per annum.” total short all has a current health financing gap co-founder of ABCHealth,■ Eastern Africa, A rica he said, has made some of at least $66bn per annum. Gov- Aopened the proceedings,■ entral progress A rica in funding healthcare, ■ igeria ernment expenditure on health in telling delegates that the coalition will spending between $150 and $250 per ■ all but two countries is less than the engage a new crop of African busi■ - estcapita, A rica but it is still far from what is Egypt31% 9% minimum of 5% of gross domestic ness leaders in the drive to change the■ Southern needed A rica to achieve the UN’s Sustain- ■ Angola product considered necessary for reality of the average African as far■ as orth able A ricaDevelopment Goal 3, which sets ■ South Sudan 3.2% 3. % ensuring adequate health coverage health is concerned. targets in the area of good health and ■ Morocco for at least 90% of the population. “Only partnerships will help solve wellbeing. 4% 5.6% 1 .9% On current trends, and with many the health challenges the continent “It is clear that African govern- ■ Ethiopia competing demands for public re- faces,” he said. “Healthcare in Africa ments alone cannot solve this chal- ■ Kenya 4.5% sources, governments are unlikely to is constrained by scarce public fund- lenge, which6% is further exacerbated by ■ Others be able to meet the health financing ing and limited donor support. Out- our growing population and Africa’s requirements. Therefore it is essen- of-pocket expenditure accounts for changing disease portfolio,” he said.
tial to bring in private sector invest- 36% of Africa’s total spend. Given our “Your Excellencies, distinguished la- Note: Discrepancies in the additions are due to rounding. ment. income levels, it is no surprise that dies and gentlemen, we have no alter- H.E. Mokgweetsi Masisi, healthcare spend in Africa is grossly native22% but to turn to the private32% sector Source: ECA staff calculation based on data from WHO Global Health Expenditure database. President of Botswana
2 .1% 32.1%
6 7
31% 9%
3.2% 3. % 4% 5.6% 1 .9% 4.5% HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
“Let us, through this initiative, re- care could rise to upwards of $11bn in dedicate ourselves to seeking new the next 10 years. sustainable ways of consolidating the “We recognise it is only by harness- gains made thus far in the health sec- ing the strengths, the resources, the tor,” he said. expertise of the private sector, coupled with additional investment by govern- Mobilising expertise ment, that we can uphold the current President Ismaïl Omar Guelleh of Dji- gains and achieve lasting and sustain- bouti said that mobilising expertise, able health solutions in Kenya and in financial resources and innovations Africa in general,” she concluded. n would go a long way towards improv- ing Africa’s healthcare. He said that Africa is today facing a resurgence of diseases that many believed had been eradicated and that new ones are emerging, includ- Opportunities for ing lifestyle diseases such as diabetes, businesses to engage in which is reaching concerning levels. “No country can achieve econom- Africa’s health sector ic development without a physically, mentally and socially fit population,” • Pharmaceutical and medical device he said. industries can focus on healthcare He pointed out that public-private products and services. They can H.E. Ismaïl Omar Guelleh, President of Djibouti partnerships have proven their ef- also invest significantly in delivery fectiveness in countries such as New infrastructure and systems to ena- Zealand, Australia and the UK, where ble their businesses to operate ef- “Governments from both devel- Health must be a priority they have created a virtuous circle. ficiently in new markets. Examples oped and developing countries are The Prime Minister of Ethiopia, Abiy “This must be the case in Africa,” include Astrazeneca, Merck APOC increasingly looking at public-private Ahmed, stressed the importance of he said, adding that he was convinced (river blindness), GSK and Gilead. partnerships (PPPs) as a way to ex- universal health coverage and the im- such partnerships would enable Afri- • Digital technology (IT and tele- pand access to higher quality health portant role the private sector has to ca’s youthful population to grow old coms) companies enable health services by leveraging capital, mana- play in helping African governments in good health. systems by improving communi- gerial capacity, and know-how from to achieve this. Egypt’s Health and Population cations and the ability to process the private sector. Drawing attention to the fact that Minister, Hala Zayed, represented information. This has been demon- “With the launch of ABCHealth, only three of the 55 African countries President Abdel Fattah El-Sisi of strated by the pattern of their business leaders can now make com- are currently able to dedicate 15% of Egypt, the incoming chairperson of investments in recent years by mitments and contribute directly to their budget to healthcare as per the the African Union. companies including Intel, Novar- a healthy and prosperous Africa, en- Abuja Declaration, he said it was criti- She said that strong political com- tis SMS for Life, J&J Every Mother abled by collaboration and business cal to “encourage new and innovative mitment to health in Africa is not Every Child, Bharti Airtel, Safari- partnerships. Not only will this be a sources of financing to supplement always matched by increased allo- com and others. social good, but there is a profit po- budgetary support and development cations for health expenditure as gov- • Financial services companies focus tential, and we will drive real, sustain- assistance in the health sector.” ernments face many challenges re- H.E. Sicily Kariuki, Health Cabinet Secretary, Kenya on health financing (e.g. health sys- able action across Africa.” And, while stating that greater at- garding the implementation of policy tem funding, insurance and pay- tention should be given to improving and financing. ment services). Working with part- efficiency in domestic health spend- “Governments should focus on ners, they can raise awareness of ing, he said that the private sector spending and allocating resources ef- the availability of health financing, could “play a vital role in both financ- ficiently,” she said. “[They] can direct contribute to policy and govern- ing and supporting implementation of stakeholders to invest and create a ance decisions, and help generate national health plans.” collaborative environment for parties more demand for their services. President Mokgweetsi Masisi of to work together to achieve health- • Media, communication and en- Botswana called for the public and care goals.” tertainment companies’ products private sectors to work together to rid A notable success story has been and services can be used to deliv- the continent of social ills such as mal- the proactive fight against the Hepa- er health messages to people, for nutrition, abject poverty and disease. titis C virus in Egypt, the country with example through radio, television, “We must, therefore, collectively com- the highest prevalence of the disease social media or text messages. mit to fostering this strategic partner- in the world. Negotiations with the Innovative examples include Glo- ship and I shall do on behalf of the Re- private sector enabled the provision bo TV, BBC and DMI. They can be public of Botswana today,” he said. of relevant drugs at low prices and used to mobilise resources in inno- He went on to invite the private enabled millions of Egyptians to be vative ways. sector to explore the opportunities screened for the virus. • Logistics and transportation com- available in Botswana, including col- Sicily Kariuki, Health Cabinet Sec- panies like DHL help both the pub- laboration in hospital services, inpa- retary of Kenya, representing Pres- lic and private sectors to maximise tient and outpatient care and pre- ident Uhuru Kenyatta of Kenya, con- supply chain efficiency and meet ventative care such as immunisation. veyed his message that in Kenya, “we customer needs. They can do this “We are open for business and you’re do not struggle in welcoming the pri- in areas such as patient transpor- welcome,” he said. vate sector to support us in delivering tation services, laboratories, clinics He said it was his belief that the public good.” and hospitals. Forum and the report it was launch- She said that the private sector ing would encourage the public and had catalysed progress towards uni- Source: Healthcare and Economic private sectors to work together and versal health coverage in Kenya, and Growth in Africa report Halima Aliko-Dangote, Trustee, inspire businesses to transform the added that the $4.5bn invested by the Aliko Dangote Foundation health sector in Africa. private sector in the country’s health- H.E. Hala Zayed, Minister of Health and Population, Egypt
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care financing was a conservative one, because the cost of healthcare is in- creasing. About 20 countries are health stressed, meaning they have an above average disease burden, low govern- ment expenditure on health, high out- of-pocket expenditures, low density of health professionals, high levels of gov- ernment debt (as percentage of GDP), and low GDP growth rates. Taken to- gether, these indicators suggest severe limitations in public provisioning of health, highlighting the urgent need to target these countries, which are locat- ed mostly in West and Central Africa, for immediate action. The report highlights different ways of mobilising domestic resources, in- cluding increasing tax revenue through new taxes and improved tax adminis- tration, reducing the debt burden by increasing borrowing, debt-to-health swaps, and reducing illicit financial out- flows. Sinha pointed out that the size of the latter are in some cases higher than the financing gap. The report’s Lead Author, Saurabh “If the illicit financial flows could be Sinha of ECA, presents findings to Report Launch: reduced, maybe more money could be delegates made available for healthcare spend- Michel Sidibé, Executive Director, UNAIDS (l) and Aigboje Aig-Imoukhuede, ing,” he commented. Founder and Chairman of Africa Initiative for Governance (AIG) and Healthcare and Co-Chair, GBCHealth, display copies of the Report Opportunities “There is a huge potential for the pri- Economic Growth vate sector [to invest in African health- care],” said Sinha. International con- sulting firm McKinsey & Company in Africa estimates the value of opportunities in Health spending in Africa Africa’s healthcare by 2030 at $259bn, with the potential to create 16m jobs. remains inadequate to meet Less than 2% of the medicine con- sumed in Africa is manufactured on the growing healthcare financing he launch of the Healthcare and $66bn per annum, which the private continent. Imports cater for more than Economic Growth in Africa re- sector can help to bridge. 70% of the pharmaceutical market, needs and rising demands port was one of the highlights Total spending on healthcare in meaning that Africa spends $14.5bn on T of the Forum. The 87-page re- African countries lies in the 5%-6% pharmaceutical imports annually. More port prepared by the UN Economic range, although in per capita purchas- medicines could be manufactured in Commission for Africa (ECA) provides ing power parity (PPP) terms it almost Africa through PPP engagement, tak- a strategic direction to enable African doubled from $150 to $292 between ing advantage of improved access to countries to better engage with the 2000 and 2015. Out-of-pocket spend- Africa’s markets as the Continental private health sector and thereby ac- ing remains the highest spending Free Trade Area gains pace. celerate improvements in health. It ex- component in healthcare. Other areas of engagement for the amines in detail the state of healthcare Across the world, as countries private sector are in the areas of labora- across the continent and provides rec- became richer, they tend to spend tories and diagnostics, service delivery ommendations for government and more on healthcare. “Unfortunately, and financing, skills development, re- the private sector. in Africa there is a huge variation,” search and capacity building, health in- Introducing the session, the Ex- said Sinha, pointing out that only a surance, and digital health innovations. ecutive Director of UNAIDS, Michel few countries are following the world He ended by highlighting the key Sidibé, said, “Achieving our health trend line and many are not spending recommendations of the report for goals is not a matter of political will, it as much as they should at their level governments: focus on achieving is a matter of political choice. We want of income. broad-based economic growth and to hear ‘I will do the right thing and put Similarly, as countries become prudent macroeconomic management; Speakers: my money here, in health’.” richer there should be a decline in out- identify innovative sources for financ- Michel Sidibé, The report’s Lead Author, Saurabh of-pocket expenditure, but in Africa ing healthcare; allocate sufficient re- Executive Director, UNAIDS; Sinha of ECA, presented the key find- this is not happening. “This is some- sources in health-associated sectors; Saurabh Sinha, ings, saying that Africa was healthier thing unusual and worrying,” he said. enhance regulatory systems and create Chief, Employment and Social in 2015 than in 2000, despite diseases He said that as countries become rich- suitable conditions to attract private in- and epidemics recorded over the peri- er, exteral funding may decrease but vestors. n Protection Section, Social od. However, health spending in Africa governments may not be spending Development Policy Division, UN remains inadequate to meet growing more on health. For further details of the findings and Economic Commission for Africa, and healthcare financing needs and rising He also noted that the estimate of recommendations of the report, see Lead Author of the Report demands, creating a financing gap of a $66bn per annum shortfall in health- Annex 1. Leading figures line up on stage at the end of the launch
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Call to Action: ‘We must ensure that we fix health in Africa’
A host of leading figures celebrate the launch of ABCHealth Launch of ABCHealth: A vision to inspire business to transform health in Africa
he morning session of the Fo- care throughout the continent,” said rum saw the launch of the Af- Aliko Dangote. “In Africa, govern- About ABCHealth rican Business Coalition for ments typically control the delivery of Addressing Africa’s systemic health THealth (ABCHealth), the key healthcare. This is why when Aigboje challenges is not something that a highlight of the Forum. The culmina- Aig-Imoukhuende approached me single government or company can tion of efforts by Aliko Dangote Foun- with the idea of a pan-African coali- do alone. Creating a lasting impact he co-founder of ABCHealth, Aigboje Aig-Imoukhuede, “My call to action is simple,” he said. dation and GBCHealth, this coalition tion of private sector companies to requires collaboration among a Aigboje Aig-Imoukhuede, ad- Co-founder of ABCHealth “We have no choice. You have no choice. of businesses, philanthropists and de- focus on improving healthcare out- range of stakeholders committed dressed the Forum with an im- addressing delegates There is no alternative. We must win this velopment institutions will help com- comes, I immediately agreed.” to developing the right tools to Tpassioned call to action before fight to ensure that we fix health in Africa.” panies contribute more directly to Aigboje Aig-Imoukhuede ex- promote accountability and coor- the cutting of the ABCHealth cake. He called upon businesses, philathro- meeting national and regional health plained that he had already seen dination, sharing risks and exper- He began by expressing his ap- pists and civil society to make their com- goals. through his work for GBCHealth what tise and disseminating learning. In preciation for “the usual suspects”, mitments known and to join ABCHealth to With the aim of improving the the private sector can do in the war co-operation with global business- those people who are usually only one “form a broad-based regional coalition that standard of living, quality of life and against disease and pandemics. es, philanthropists and develop- step removed any time the needle has will do great things.” overall health of all Africans, it will “African companies across Africa ment institutions, been shifted in Africa. Africans must “We will be getting in touch with all of help to generate progress in critical should lead the fight. Africa bears a ABCHealth will unlock synergies He said that he loved coalitions be- you,” he said. “The organisation is up and health areas while providing guidance huge disease burden. Our burden,” to enable business to play a key cause they gather the collective pow- fight to ensure running.” to companies on how to maximise the he said. “It’s now time for us to step role in helping governments meet er of the usual suspects: “Fifty usual He thanked the co-sponsors of the fo- value and impact of their investments. up to the plate. We launch the African national and regional health goals. suspects is not enough; 1,000 is not that health rum, Zenith Bank and Access Bank, for their A video was streamed for dele- Business Healthcare coalition today. The aim is to improve the stand- enough. We need thousands across support, saying that he was sure that “many gates in which Aliko Dangote, Chair- I invite all private sector leaders, all ard of living, quality of life, and the Africa. I am glad to see so many in the outcomes are many more” would join them. “I invite more, man, Aliko Dangote Foundation, and members of civil society, to join Aliko overall health and wellbeing of all audience right now,” he said. God bless you,” he concluded. Aigboje Aig-Imoukhuede, Co-Chair of Dangote Foundation, the Global Busi- Africans. “So it is really simple,” he said. as equitable in Halima Aliko Dangote, Trustee GBCHealth and co-founder of ABCHe- ness Coalition for Health in this fight The coalition will be an effec- “This morning we have spoken about of Aliko Dangote Foundation, followed him, alth, explained the reasons for setting to eradicate health challenges across tive partner for governments to en- the fact that Africa needs help and I this part of the saying: “Our doors are opened. Let’s all up the coalition. Africa.” sure that programmes are efficient, think Africans must play their role in come and make one of the greatest invest- “Africa’s problems are Africa’s op- The video was followed by the un- technically sound, well-communi- this fight to ensure that health out- world as they ments in life tonight, which is health. Let’s portunities. Today, there’s no greater veiling of the ABCHealth logo and the cated and impactful. comes are as equitable in this part of bridge the gap and change the narrative of opportunity than improving health- cutting of the ABCHealth cake. n the world as they are elsewhere.” are elsewhere Africa.” n
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terms of immunisation, not because see how they can contribute to their where governments and the private Above: The panel brought together of funding challenges, but because success. sector are standing together and ask- leading figures from the public and The Great Debate: programme funding is not disbursed The Bank is doing its own research ing what they can do better. Elsewhere, private sectors when it is needed. She said ministries into the diversity of problems in Africa citizens are questioning their govern- should not operate in silos but work so it can look at ways to broaden its ments and waiting for the private sector Health as a major together. interventions. to do the right thing. In Africa, the pri- She asserted that Africa could Gayle Smith, CEO of ONE, said it is vate sector has considerable influence Panellists: raise a large part of the $66bn gap critical for health systems and policies with politicians, which means business Abebe Selassie, economic driver identified in healthcare funding by to be built with prevention in mind. “If can be a catalyst for change in terms of tapping into domestic resources. Sim- we don’t start from the bottom up, we better public policy. Director of the African Department, ply having more efficient tax collec- are never going to get there.” ONE is IMF; tion would go a long way. an advocacy organisation that cam- Competing demands Dr Ajoritsedere Awosika, paigns for and works towards ending Abebe Selassie, Director of the IMF’s Board Director, Access Bank; Giving back extreme poverty and preventable dis- Africa Department, reminded dele- Belay Begashaw, he Healthcare and Economic not just be about how much funding is Dr Ajoritsedere Awosika, Board Di- ease. “We talk a lot about the cost of gates of the difficult balancing act in Director General, SDG Center for Growth in Africa report affirms needed for health; it is also about the rector of Nigeria’s Access Bank, said healthcare and not enough about the reconciling macroeconomic policy with that health is a major driver of optimal utilisation of the resources the organisation takes the concept of cost of not doing things. Starting at the creating space for the private sector. Africa; economic growth, but what governments already have. She said the public good very seriously and to bottom is key.” Governments face many competing Gayle Smith, T challenges do businesses face and a 2016 survey of public health in Af- this end, the bank gives 1% of its an- Smith also highlighted the need budgetary demands for allocation of CEO, ONE Campaign; what can governments do to create a rica showed countries with the same nual profit to projects in health and for transparency in the health sector, limited resources. H.E. Ilyas Moussa Dawaleh, conducive environment for investors per capita expenditure had vastly the environment. Of this 40% is spent saying it is critical in inspiring confi- But, he said, health is a foundational Minister of Economy and Finance, and partnerships? The Forum’s Great different outcomes. “If we are going directly on health, with a focus on in- dence. Key in this regard is the shar- investment. He cited the example of the Republic of Djibouti; Debate brought together leading fig- into public-private partnerships, the novation in partnership with global ing of available data as it can unlock Ebola pandemic in West Africa, where Ngozi Okonjo-Iweala, ures from the public and private sec- public sector must use the resources multinationals such as GE and Phillips. solutions to longstanding challenges. the macro-economic and growth im- tors to better understand each oth- it already has to deliver better out- She said research shows that 67% She cited the example of data being pacts were so large they are still being Chair, GAVI; er’s perspectives and identify ways of comes before we talk about raising of Africa’s disease burden is malaria used by entrepreneurs to create ap- felt today. The outbreak changed the H.E. Situmbeko Musokotwane, working together to transform health- more money.” and Access Bank is joining others in plications and tools that can improve entire growth trajectory of the affected Former Finance Minister, Zambia care in Africa. She said the timing of disburse- efforts to eliminate the disease. Such health delivery. countries, highlighting how essential it Ngozi Okonjo-Iweala, Chair of ments is also key, raising the issue of interventions must be well planned She flagged a third component of is for governments to invest in health- Moderator: GAVI, the Vaccine Alliance, and for- communication between health and and communication with target com- a successful healthcare strategy – rais- care. Ibrahima Cheikh Diong, mer Finance Minister of Nigeria, said finance ministers, saying that, for in- munities is vital as they need to un- ing public awareness and mobilisation. He agreed with Okonjo-Iweala that CEO, ACT Afrique Group that discussion about finance should stance, Nigeria has poor outcomes in derstand disease interventions and Africa is the only continent right now optimising existing resources is im-
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portant to improve health spending great cost to the fiscus, reduces providing more certainty about outcomes. He suggested an index be their incentive to improve health spending and planning over a introduced to measure the effective- facilities at home. longer period. ness of expenditure and related out- • Investing in health is not the same • Failures in health provision need comes to focus the minds of govern- as privatising healthcare. to be highlighted. Although ments in this regard. • Data sharing is critical to improv- countries may learn from success Belay Begashaw, Director General, ing healthcare in Africa. This will stories, they can also learn from SDG Center for Africa, said it is imper- help practitioners understand what has not worked, “leapfrog- ative that new ways of addressing Af- the scale and distribution of the ging” the mistakes others have rica’s challenges be found as past ac- disease burden and help them to made. tions had not proved to be effective. build medical profiles of patients. • Governments need to put in The SDGs may not be new, but they • Harnessing technology effective- place an enabling environment do direct countries to address their ly will play a big role in preventa- for the production of medicines challenges differently and set targets. tive healthcare. to bring down costs and make it “SDGs have huge investment po- • Creating better public facili- easier to invest. tential whether it is health, energy or ties may help to attract African • O n the back of the AfCFTA, gov- education,” he said. health professionals back to the ernments need to look at stand- He also echoed the call of Aliko continent. ardising medicine registration Dangote, Chairman of Aliko Dangote • H aving a longer-term budget requirements across borders to Foundation, for businesses in the pri- cycle that moves away from the make production more attractive vate sector to consider contributing current annual budgeting system and distribution of locally pro- 1% of after-tax profit to healthcare. may help to attract investors by duced drugs easier. n H.E. Ilyas Moussa Dawaleh, Minis- ter of Economy and Finance, Repub- lic of Djibouti, called on Ethiopia and Djibouti to work together to improve Key takeaway points their health delivery systems as he urged more private sector invest- Build a truly African Coalition Always plan ahead ments in Africa’s health sector. He ABCHealth must go beyond the two Resource allocation will impact sub- commented that his government was partners, GBCHealth and Aliko Dan- scription to ABCHealth. Planning moving forward in its collaboration gote Foundation, and ensure it rep- ahead (one-year, five-year plans, with the private sector, but more pro- resents a truly African coalition by etc) will help ABCHealth in the allo- gress needed to be made. having inclusive representation from cation of scarce resources. “One of our major milestones was across the continent. Small and medium-sized en- to get the private sector involved terprises (SMEs) are the engine of so we can provide access to quality Data is key transformation and major employer healthcare to everyone,” he said. “We There is a need for evidence-based of labour in Africa; they should also are still to get there – our services are decision making. ABCHealth can be- be brought into the fold. stretched. We hope this dialogue will come an important aggregator of help us have more partners who can data to help contribute sound policy Collaborations and partnerships come to invest not only in Djibouti but decisions. The right data, if properly can give birth to great things in the region as a whole.” analysed, will help in crafting effec- When resources and expertise are tive and efficient solutions across pooled, it is easier to tackle challeng- Key sector borders. es and make great strides. The suc- H.E. Situmbeko Musokotwane, former cess of the inaugural Africa Business: Finance Minister of Zambia, said it is Utilise technology Health Forum as well as the launch of important that governments regard Technology offers a veritable op- ABCHealth is an indication that the health as a key economic sector and portunity. It will be a critical tool for right collaborations can inspire great find ways to attract investment. Al- ABCHealth to engage with partners things. though Zambia has provided sectors and also to build a strong and effec- such as agriculture with investment tive member base. Technology will Investing in health is good business incentives for years, health has been also offer platforms for greater col- Putting money in the health sector viewed as a social sector and has not laboration and impact at scale. makes social, economic and busi- received the same benefits in this re- ness sense. Investing in the sector gard. Government attitudes towards Be the bridge is, therefore, not just a social imper- health make it difficult for the private The coalition must be an honest bro- ative but an economic necessity with sector to engage. ker that will foster viable partner- huge returns, and that will also ben- “For many years to come the pub- ships between the public and private efit the private sector in general. A lic sector will still remain the key pro- sectors, as well as other committed healthy Africa is a productive Africa; vider of health services on the conti- stakeholders, for the good of Africa. and a productive Africa is a prosper- nent, especially at the primary level,” ous Africa. he commented. “It is important that Create a profitable model for we are here to discuss how we can stakeholders Public-private partnerships can work with the private sector to fill the Since the private sector, to ensure bridge funding deficit gaps.” long-term sustainability of its invest- There is an annual financing gap in Other issues raised included: ments, is driven by a profit impera- the heath sector estimated at over • The need for government of ficials tive, ABCHealth must develop viable $60bn. Governments cannot bear to be forced to use public health business models for the business the burden alone and will need to facilities as this would get them community with a view to helping partner with the private sector and to focus on improving the sector. it find specific initiatives worth in- other partners (DFIs, Foundations) The fact that African leaders re- vesting in. to bridge the gap. ceive healthcare abroad, often at
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omist and Director for Research and Key messages International Cooperation, African Ex- port-Import Bank, linked the impor- Need for honest dialogue tance of spreading healthcare to im- There is need to increase funding for health across the continent. However, proved intra-African trade, stressing ministers of health seem to find it hard to get their ministers of finance to that if pharmaceuticals can be man- increase funding to the health sector. ufactured and exported around the There is a need for deep, honest engagements amongst stakeholders to continent, Africa’s huge drug-import address the gap. bill could be significantly reduced. As well as increasing allocations towards health, spending must be bet- He also argued that as a develop- ter deployed and more efficient. The efficiency of fund usage is as impor- ment finance institution, his organisa- tant as mobilising more resources. tion could play a key role in leveraging finance for health. Donor funds as catalysts “We believe that we have the ca- Utilise donor funds as a catalyst to mobilise other resources going into do- pacity to leverage more private fi- mestic funding for the sector. There are interesting instruments being used nancing by actually injecting initial and case studies of this already working. capital into the sector,” he said. “We have identified healthcare as a very Prioritise cost optimisation strategic sector, and we are investing Cost optimisation should be made a priority. It is not enough to source for heavily in it because we see the poten- funds; ensuring more is achieved with less might be a way to scale up in- tial.” vestments in other subsectors of the health sector. The Bank, he said, will be investing Three ways to improve domestic funds include P (People), P (Policy) $700m in the next three years. and P (Product). There is a need to invest in healthcare professionals, drive Olumide Okunola, Senior Health policies to strengthen healthcare systems and manufacture quality health- Specialist, IFC, supported the idea care products in Africa. In addition, innovative approaches should be ap- that governments must rise to the The panellists listen as Dr Senait Fisseha (centre) introduces the discussion plied to finance. occasion and suggested tax is an ef- fective way to raise domestic funds. “Until you put public financing into healthcare you are not going to make This, she argued, could have nega- up in providing essential services to any progress,” he said. Panellists tive consequences in the future given citizens.” Shivon Byamukama, Deputy CEO Hippolyte Fofack, Chief Economist Parallel Sessions: that the number of young people as a Davies said the average spend by of Babyl Rwanda, argued the need and Director of Research and percentage of the population is grow- African governments on healthcare for greater public and private sector International Cooperation, African ing. “If we are going to realise Africa’s is $29 per capita, compared to $218 collaboration, saying: “You need the Export-Import Bank, representing Domestic mobilisation demographic dividend, we will need to in East Asia, including China. government and the private sector to Benedict Oramah, President and invest in job creation and health.” John Nkengasong, Director of work together to leapfrog into the fu- Martyn Davies, Managing Director, the Africa Centres for Disease Con- ture.” Chairman, Board of Directors, of funds for health Emerging Markets and Africa, Deloitte, trol and Prevention, agreed that the Babyl operates as a provider of AfreximBank; pointed out that Africans should not private sector is vital but argued the digital healthcare in Rwanda and Martyn Davies rely on governments to provide health state has a part to play, too. PPPs Byamukama explained how public pri- Managing Director, Emerging Markets funding but should turn to the private are key to combining public and pri- vate partnerships have been key. & Africa, Deloitte; sector. vate money, he argued, saying: “We “We are leveraging on infrastruc- Olumide Okunola “By and large, the state has not pro- should not only be looking at outside ture with the government,” she said. vided for its citizens,” he said. “Private resources but also inside.” “This is only possible because of gov- Senior Health Specialist, IFC; he mobilisation of domestic that are needed to increase domestic capital therefore should and can step Hippolyte Fofack, Chief Econ- ernment involvement.” Mamadou Biteye resources is increasingly im- resource mobilisation for the health She described how this helped Managing Director, Africa Regional portant for sustaining invest- sector, showcasing good practic- Babyl gather 2m people on its plat- Office, The Rockefeller Foundation; ments in key sectors such as es that could be replicated as well as form with about 2,500 consultations Dr Amany Asfour Thealth. Some governments challenges and lessons learned. to date. Chair of the Trade Promotion are achieving this through efforts such Dr Senait Fisseha, Director of In- Amany Asfour, Chairperson of as tax administration reform, substan- ternational Programmes at the Susan COMESA Business Council, talked Committee COMESA Business tial economic growth, and the use of Thompson Buffet Foundation, and about the need to finance scientific Council and the Vice President of non-traditional financing sources such session chair, began the discussion by research from within the continent so PAFTRAC COMESA; as social/development impact bonds, presenting the problem. Few African that drugs can be domestically pro- Dr John Nkengasong, public-private partnerships and private governments have met the pledge of duced. “We are still now importing Director, Africa Centres for Disease financing. allocating at least 15% of their budget our pharmaceutical drugs from India Control & Prevention; This session addressed both the to health as envisaged in the 2001 and China,” she said. Shivon Byamukama, opportunities and policy requirements Abuja Declaration. Above all, she argued, it is crucial to support and finance healthcare re- Deputy CEO, Babyl Rwanda searchers in order to reduce the im- port bill. Chair Ways to mobilise domestic resources Finally, Mamadou Biteye, Manag- Dr Senait Fisseha ing Director, Africa Regional Office, Director of International Programs, • Increase tax revenue through new taxes and improved tax administration The Rockefeller Foundation, argued Susan Thompson Buffett Foundation • Reduce the debt burden and increase borrowing that multiple sources of funding are • Debt-to-health swaps needed and could include pension • Reduce illicit financial flows funds and DFIs. “We all know there Moderator • Re-allocate budgetary flows and rationalise inefficient fossil-fuel subsidies is a gap,” he said. “But gaps are op- Thokozile Ruzvidzo • Earmark revenues from natural resources portunities and we need to build and Director of the Social Development • Identify innovative financing mechanisms invest.” n Policy Division, ECA A member of the audience puts a question to the panel
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“For PPPs to succeed, we need political will and consensus as to the Key messages needs of the sector and the benefits of engaging the private sector,” he said. Coalitions over silos A clear legal framework with guide- Working in silos might seem con- lines for each role is also needed. venient but setting up coalitions is His country is also trying to im- better for efficient and effective de- prove tertiary care to attract invest- livery on set objectives. This was ev- ment and simultaneously stem the tide ident in the case study from Bioko of citizens who travel abroad to to get Island in Equatorial Guinea, where quality and specialised medical atten- the private sector joined forces with tion. The government estimates that government to reduce infected this leads to a revenue loss of about mosquito bites incidents per capita $500m per annum. from 1,000 to three annually. H.E. Isatou Touray said that the quality assurance of private sector Manage stakeholder expectations providers and their role in improving It is important to align and manage operations was reviewed within The expectations between the gov- Gambia health system. Distance from ernment and private sectors for a health facilities is a serious challenge seamless collaboration. This is best in accessing health and The Gambia achieved through greater dialogue. has contracted out transport of pa- tients to the private sector. Right investments, higher impacts She ended by saying that clarity on Investing time, money and energy legal frameworks, competitive bidding in human capital and R&D are nec- and political will are conditions for essary to help scale up impact.This PPPs. was the takeout from the Ethiopian The last point was taken up by par- PPP presentation, which outlined ticipants who pointed out the need for the government’s ambition and clarity at continental level of PPPs in passion to develop tertiary care in the health sector. A strategic engage- the country and manufacture drugs ment of the private sector towards domestically. national goals and Agenda 2030 and Trust and transparency are key Africa 2063 was important. ingredients of a successful PPP. Fi- Management contracts, outsourc- nance is one area of collaboration. The panel, from left to right: Zouera together the best of what the public ing certain features of health delivery Success will depend on having the Youssoufou, H.E. Isatou Touray, Carl Parallel Sessions: and private sector can offer, pooling and investment in production of health right model and framework for the Maas and H.E. Mitoha Ondo’o resources, thinking and knowledge. products are aspects of PPPs and the partnership to survive. A model is also being developed recent signing of the AfCFTA was aus- Insights from through this collaboration that could picious due to economies of scale. be packaged for use in other coun- Recommedations from the session tries and regions for malaria and other included: Case Study: successful diseases. • National development plans need Malaria Control Project in Bioko The journey, however, is not with- to consider in advance where the out its challenges. These include dif- private sector can play a role and Island, Equatorial Guinea public-private ferent management and operational allocate resources accordingly. Carl Maas styles that can cause conflict, conti- • Models should be explored to see CSR Manager, Marathon Oil; nuity of funding and different expec- how the public sector can make it H.E. Mitoha Ondo’o partnerships tations of potential outcomes and re- attractive for the private sector to Vice Minister of Health and Social sponsibilities. offer supplementary or specialist Welfare, Equatorial Guinea A weakness on the part of govern- services through PPPs. This re- ments is to develop national health quires regular engagement with plans without considering or including the private sector and changing Case Study: the participation of the private sec- of mindsets in government about Public-Private Partnerships in the PPs in health offer significant absenteeism and the high health tor in the process, thus ignoring the the way PPPs operate and where Ethiopian Health Sector opportunities for strengthening costs involved motivated this 15-year symbiotic role companies can play in each other’s obligation lie in the Dr Daniel Gebre Michael healthcare systems across the project. bolstering the services offered by the partnership. Former Director General at Medical Pcontinent. A practical session, This partnership between the gov- public health system. • U sing the example of Equatori- chaired by H.E. Isatou Touray, Minis- ernment of Equatorial Guinea and The second case study focused on Services and Advisor to the Minister al Guinea’s malaria programme, ter for Trade, Regional Integration and three private sector partners has re- Ethiopia’s experience of implementing other countries can see where of Health, Federal Democratic Employment of The Gambia, provid- duced the prevalence of malaria by PPPs in the tertiary (hospitals) sec- similar PPPs can be instituted to Republic of Ethiopia ed an insight into successful PPPs, 75%. The results are substantial, with tor. Dr Daniel Gebre Michael, former solve challenges that will benefit showcasing experiences and success 1,000 infected mosquito bites per Director General of Medical Services the country and still be attractive Chair stories to scale up and replicate. capita annually in 2004 down to three and Advisor to the Minister of Health for the private sector. H.E. Isatou Touray The first case study, presented bites per capita in 2018. in Ethiopia, said there was no doubt • Ensure there is a clear legal Minister of Health and Social Welfare, by Carl Maas, CSR Manager of Mara- The government is also working this collaboration had improved health framework supporting PPPs. Republic of The Gambia thon Oil and H.E. Mitoha Ondo’o, Vice with international experts to locally outcomes and delivery. For example, • Have a third party managing the Minister of Health and Social Welfare develop a malaria vaccine. This is the the collaboration means public servic- relationship, for example an NGO, of Equatorial Guinea, looked at the first project of its kind in Africa and has es are backed up by private services, to make PPPs more attractive to Moderator development and implementation of now reached the clinical trial stage. which has reduced the inefficiency of the private sector, which does not Zouera Youssoufou the Bioko Island Malaria Elimination The outcomes are the result of state health delivery and there is no want to spend time on issues that Zouera Youssoufou MD & CEO, Dangote Foundation Project. Loss in productivity through a collaboration that has brought interruption in services. are outside its core business. n MD and CEO, Dangote Foundation
20 21 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
Data-driven innovation enables faster access to medical information, resulting in fewer tests and saving time spent on health delivery Nancy Wildfier-Field, President, GBCHealth (left), and Dr Matshidiso Moeti, Regional Director for Africa, WHO (right)
e-voucher that registers eligible wom- is being used by governments and re- Left: Samuel Agutu, Founder and en for antenatal and post-natal care, searchers to improve medicine, inter- CEO of Changamka Microhealth Ltd Parallel Sessions: transport vouchers and other outpa- ventions and campaigns. Right: Dr Vèna Arielle Ahouansou, tient needs. Recommendations from the ses- Founder & CEO, KEA Medicals And the company has created a sion included: Transforming the phone-based micro insurance prod- • Improve the data being collected uct, Linda Jamii (Protect the Family). in the public healthcare sector, to Key messages It is an M-Pesa-enabled insurance sav- feed into innovation in the private health landscape through ings plan that automatically converts sector. The private sector could The Power of an individual savings to premiums on reaching the play a leading role in setting up Individuals can make a difference required thresholds. It now covers systems for efficient data collec- and we have seen leaders and in- research and innovation 20,000 families and has been a pio- tion with the public sector sup- novators take a leap to transform neer for the development of other mi- plying the data health outcomes. However, collab- cro-insurance products. • Governments should allocate orations will be key to optimising Dr Vèna Arielle Ahouansou, Found- more funding and capacity to funding and achieving sustainable er and CEO, KEA Medicals, Benin, cre- invest in science, innovation and development at scale. ated the company after a personal technology. This will enable both experience that made her realise that the private and public sector to Technology as a useful tool frican governments are strug- medicine via micro-savings on a mo- medical institutions need to be able scale up innovative solutions to Technology is a unifying platform. gling to provide basic health bile phone application. to access people’s medical history to longstanding challenges and al- It is time stakeholders leveraged services to the whole popula- The application enables patients eliminate mistakes such as giving the low more collaboration. it more for better penetration and Ation, especially in remote are- to get prescriptions from registered wrong diagnosis or using drugs that • Interventions need to be about overall impact. as. In the meatime, private healthcare pharmacies after paying for them with patients are allergic to. more than in the health sector providers remain too expensive to ac- points accumulated on a mobile mon- The company invented a univer- directly but also focused on the cess and are mostly established in ur- ey application. This has enabled seam- sal medical identity that uses finger- health value chain, including nu- ban areas. This leaves African citizens less service and good data sharing. prints, social security and QR codes to trition, developing micro health caught in a financial trap. Every year, JokkoSanté gets commissions from store medical profiles and make them insurance products, alternative millions of Africans fall into poverty completed sales, while workers at par- available to health professionals. Pa- energy solutions and others. This TED-Style Talks due to high out-of-pocket payments ticipating pharmacies earn points for tients can create their medical records is part of a requirement for gov- Adama Kane for healthcare. their performance. on their own profile, which is linked to ernments to look at health more Founder & CEO of JokkoSanté; However, a new movement in Samuel Agutu, Founder and CEO a QR code that any doctor or hospital holistically and focus on preven- Samuel Agutu healthcare innovation is now challeng- of Changamka Microhealth in Ken- can access by just scanning the code. tion, as well as traditional medical Founder & CEO of Changamka ing the status quo. Social enterprises ya said his operation was established The company has 32,000 patients al- services. are leveraging previously underutilised in response to the twin challenges of ready using the platform and 10 pilot • Governments should consider the Microhealth Ltd; resources, such as cheap technology, high maternal mortality rates and poor hospitals. best way to use technology plat- Dr Vèna Arielle Ahouansou to improve healthcare delivery and health financing. He is using the M-Pe- Data-driven innovation enables forms for education and health Founder & CEO, KEA Medicals bridge the growing gap in healthcare sa mobile phone platform to enable faster access to medical information, interventions for rural clinics and access. For African nations, health in- microsavings that would enable wom- resulting in fewer tests and saving remote areas. Chair novation represents an opportunity to en to have greater access to maternal time spent on health delivery. Timely • Use technology to create medical Dr Matshidiso Moeti increase domestic capacity to solve healthcare. The innovations include information provision allows hospitals profiles and history for patients Regional Director for Africa, WHO health challenges. smart card savings through the M-Pe- to be 40% more efficient. that is available nationally by all Adama Kane, Founder and CEO of sa-enabled platform, which allows in- A member of the audience said he clinics to save time with diagnosis Senegalese digital community phar- dividual and third-party contributions had created a platform that enabled and treatment. Moderator macy JokkoSanté, said he founded to health saving plans. patients to be connected to doctors • F ind technology solutions for Nancy Wildfier-Field the organisation to create a simple Agutu also offers a cost-effec- for physical and psychological help. more effective drug distribution Adama Kane, Founder and CEO of President, GBCHealth solution for communities to acquire tive health subsidy in the form of an The data resulting from the initiative across national institutions. n JokkoSanté
22 23 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
Interview On the sidelines of the Forum, Halima become the person he is today. “As tive in transforming healthcare on the supporting each other and solving the succesful people, it is our responsi- continent.” continent’s problems?” she asked. Aliko-Dangote and Didier Drogba talked to Julie Gichuru bility to inspire and support the next In reply, Drogba began by em- about the deeply held values that inspired the event. generation, which is why I am here at Showing the true Africa phasising the ways in which Africa the Forum to engage further in these As the President of the Africa Center and its international reputation have issues,” he said. in New York, Halima’s work also ex- changed. “We have global business Gichuru noted that Drogba’s per- tends to the realm of shaping African leaders like Halima and her father, we Philanthropy and the sonal journey is all the more inspiring narratives and African storytelling. have athletes, who are hugely suc- and relevant as he himself was born in “Our stories and identities have been cessful abroad and on the continent, a Red Cross hospital. She asked him defined by others with little appreci- bringing their experience, talent and importance of giving what was at the top of his mind as he ation of our true selves, and we want desire to improve the continent with participated in the Forum. to challenge that and show the true them,” he said. He replied that he is doing as much Africa.” But his message to fellow Africans back: In conversation with as he can to improve health across Af- Regarding investment, the health was that “although we have a voice rica, but that it isn’t easy. “We have to sector and a host of other areas, the and a platform, and represent you on come together to have a real impact,” continent is growing and Halima be- the global stage to some extent, with- Halima Aliko-Dangote and he said. lieves that “the sky is the limit”, which out you we are nothing.” Turning to Aliko Dangote Foun- is what she aims to demonstrate “Only together can we make dation, Gichuru highlighted its in- through the Africa Center. changes and can we be the trans- Didier Drogba strumental role in helping Africa deal Gichuru brought the conversation formation that we want to see, only with the Ebola crisis, as well as other to a close by speaking of the drought together can we rewrite Africa’s nar- important work to combat malnutri- that hit the Horn of Africa in 2010 rative, so that she is known as a conti- tion. Halima elaborated regarding the and which extended from Somalia to nent of excellence,” he concluded. Foundation’s work on food and nutri- Kenya, where many were facing star- tion, and how this also relates to the vation. Attitudes need to change African Business Coalition for Health “We were imploring Kenyans on In her final remarks Halima empha- n the sidelines of the Forum, and my biggest fans are from Africa. Halima asserted that everyone has (ABCHealth), which was launched at TV to donate what they could, and in sised that “self-sufficiency is key” TV anchor and media per- All the kids dreaming about becom- a role, regardless of their own person- the Forum. one month we were able to raise $10m for the continent and for health. “A sonality Julie Gichuru host- ing the next Drogba, the next Samuel al means or circumstances. “In terms of polio eradication for from ordinary people’s donations. The healthier population results in an im- Oed a candid conversation on Eto’o, mean a lot to me… you cannot She said, “It doesn’t matter what example, we partnered with the gov- reason I tell this story is that you have proved workforce, with greater pro- philanthropy and the importance of forget them. I have children of my you have. You can give back and con- ernment and the Bill & Melinda Gates both highlighted the importance of ductivity and profitability.” giving back, especially on a continent own, and when I go to hospital and tribute with money, but also with sup- foundation,” she said. “There were a being an inspiration, when you have She said that attitudes still need to where governments cannot bear the visit sick kids and their families, I say port, prayer, and time. For the good lot of pains and gains, but we scaled this status, this public platform and change: “If you see putting funds to- brunt of delivering social necessities to myself, ‘These could be my own of humanity.” through and when you form a co- the responsibilities that come with it,” wards health as a cost, then you have alone. She opened the conversation children.’” Gichuru asked Drogba what he alition, you see how much further she said. already failed. It must be seen as a by asking Halima Aliko-Dangote, Trus- Gichuru went on to ask what can would say to African youths who feel you can go together and what can “What final message do you have crucial investment, and if you don’t in- tee of Aliko Dangote Foundation, to be done to better build African phi- a sense of victimhood. He replied be achieved. I therefore believe that for Africans about how we can rally vest today, you are going to pay heav- talk about what had inspired the phil- lanthropy in order to truly transform that there is always hope and empha- ABCHealth is a very important initia- and come together as a community, ily tomorrow.” n anthropic journey of her father, Aliko the realities on the continent. sised that dreaming had helped him Dangote. Halima said that her father’s phi- lanthropy dated back to well before he registered the foundation in 1994, When you form and described the influence of his mother in shaping the outlook of the a coalition, you whole family. She recalled the way her grand- see how much mother would take the family to vis- it the sick in hospital. “Her idea was further you can that you have to live the person’s life, even if it is only for 10 minutes, to try go together and understand it, to have the conver- sation and then to assist them in any and what can way you can,” she said. Gichuru observed that this “be- be achieved ing together in spirit” reflected what some communities in Africa call ubun- tu – the spirit of humanity – which is sometimes translated as “I am be- cause you are”. Turning to Didier Drogba, she ob- served that he too had embarked on philanthropic work early in his career. Most notably, he stood up when Côte d’Ivoire was in crisis, calling for an end to his country’s civil war. More recent- ly, the celebrated footballer has set up a foundation to address the country’s challenges in the healthcare sector. When asked why this work matters to him and what inspires him, Drogba said, “I love my country, my continent,
24 25 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
The Forum in photos
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3 1. Arriving at the Forum, from 6 left to right, Vera Songwe, Executive Secretary, UN Economic Commission for Africa; H.E. Ismail Omar Guelleh, President of Djibouti; Aigboje Aig-Imoukhuende, Founder and Chairman of Africa Initiative for Governance and Co-Chair, GBC Health; Michel Sidibé, Executive Director, UNAIDS; and H.E. Abiy Ahmed, Prime Minister of Ethiopia 5 2. From left to right: Vera Songwe, Executive Secretary, UN Economic Commission for Africa; H.E. Mokgweetsi Masisi, President of Botswana; Michel Sidibé; and Zouera Youssoufou, MD & CEO, Aliko Dangote Foundation 3. Delegates assemble outside the conference room 4. Speakers and delegates take their places in the conference hall 5. Moderator Ibrahima Cheikh Diong, CEO, ACT Afrique Group, introduces the opening session 6. H.E. Abiy Ahmed, Prime Minister of Ethiopia, addresses delegates
26 27 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
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4. Cutting the cake to celebrate the launch of the ABCHealth Coalition 5. Aigboje Aig-Imoukhuende Founder and Chairman of Africa Initiative for Governance and Co- Chair, GBC Health (left); and Mercy 3 Machiya, Acting CEO, ABCHealth (right)
1. Saurabh Sinha, Lead Author of the Healthcare and Economic Growth in Africa Report, presents its findings to delegates 2. From left, displaying the Report: Vera Songwe, Executive Secretary, UN Economic Commission for Africa; Didier Drogba, retired footballer; Halima Aliko-Dangote, Trustee, Aliko Dangote Foundation 3. From left, displaying the Report: Didier Drogba, retired footballer; H.E. Sicily Kariuki, Health Cabinet Secretary, Kenya; Michel Sidibé, Executive Director, UNAIDS; Halima Aliko-Dangote, Trustee, Aliko Dangote Foundation; Nancy Wildfier-Field, President GBCHealth; Ngozi Okonjo- Iweala, Chair, GAVI; Zouera Youssoufou, MD & CEO, Aliko Dangote Foundation; Vera Songwe, Executive Secretary, UN Economic Commission for Africa; Aigboje Aig- Imoukhuende, Founder and Chairman of Africa Initiative for Governance and Co-Chair, GBC Health
28 29 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
1. Malian musician Salif Keita provides evening 7 entertainment for delegates. Behind him, from left: Yvonne Ike, Trustee, Aliko Dangote Foundation; Halima Aliko Dangote, Trustee, Aliko Dangote Foundation; Julie Gichuru, CEO, Animus Media; Ibrahima Cheikh Diong, CEO, ACT Afrique Group; Zouera Youssoufou, MD & CEO, Aliko Dangote Foundation; Didider Drogba, retired footballer; Vera Songwe, Executive Secretary, UN Economic Commission for Africa; Aigboje Aig-Imoukhuende, Founder and Chairman of Africa Initiative for Governance and Co-Chair, GBC Health 2. Delegates relax in the cocktail area 3, 5 and 6. Delegates enjoy dinner 4. From left: Ibrahima Cheikh Diong, CEO, ACT Afrique Group; Nancy Wildfier-Field, President GBCHealth; and Angela Adebayo, Trustee, Aliko Dangote Foundation 7. Halima Dangote, Trustee Aliko Dangote Foundation, addresses delegates at the dinner 8. Julie Gichuru addresses delegates at the dinner 9. From left: Nomaza Nongqunga Coupez, Founder, Undiscover Canvass; Aigboje Aig-Imoukhuende, Founder and Chairman of Africa Initiative for Governance and Co-Chair, GBC Health; Yvonne Ike, Trustee, Aliko Dangote Foundation; and Angela Adebayo, Trustee, Aliko Dangote Foundation 10. Niniola Soleye, MD, Dr Ameyo Stella Adedevoh (DRASA) Health Trust (left); and Dr Benjamin Ohiaeri, Chief Medical Director, First Consultants Medical Centre (right)
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30 31 HEALTH FORUM: 12TH FEBRUARYHEALTH 2019, FORUM: HYATT 2019 REGENCY, DELEGATE ADDIS HANDBOOK ABABA
SPONSORS
Zenith Bank’s health Access Bank’s social and well-being initiatives and health investments
t Zenith Bank, we remain committed to the multimillion-naira Iga-Idunganran Lagos Island high prevalence of maternal mortality in Nigeria and furthering the economic, cultural and social Community Healthcare Centre, it also equipped the other parts of Africa. To date, the scheme has funded development of our host communities, facility with modern medical instruments, to meet 105 families across Nigeria, Ghana and Rwanda for A through community-based initiatives and the needs of Lagos Island residents. Zenith Bank also medical procedures worth about $500,000, with over philanthropy. Our goal is to create enduring value supported the building of a Sickle Cell Centre in Delta 50 babies born, successful infant bone surgeries and and improve the quality of life in communities where State. In this vein, Zenith Bank donates equipment fibroid treatments, partnerships with hospitals and we operate. to hospitals across the country, such as the state-of- healthcare associations, and the acquisition of over The bank understands the role of the private the-art ambulances at the National Hospital in Abuja, 800 specialist healthcare providers. sector as a driver of the economy and has aligned and the incubators and other medical apparatus for ‘Malaria to Zero’ – an innovative financing platform its corporate social responsibility (CSR) projects neonatal care at the University of Calabar Teaching designed to galvanize private sector resources and accordingly, to improve the health and welfare of Hospital in Cross River State, among others. capabilities for sustained support, to address market socially-excluded populations. We partner with The bank’s other initiatives to support Nigeria’s failures impeding the malaria elimination program in discerning local and global stakeholders in the health continued economic development and the improved Nigeria – was a high-impact programme representing sector with the aim of achieving the UN Sustainable welfare and well-being of its population include the bank’s first step towards complementing Development Goal (SDG) 3 – ensuring healthy lives donations to the Federal Government Flood Disaster government’s effort in achieving its malaria pre- and promoting well-being for all at all ages. Fund, the provision of disaster relief materials to elimination goals by 2020. The focus areas include Consistent with this strategic target, Zenith Bank flood and market fire disaster victims in several increasing the coverage of Indoor Residual Spraying has committed to a multibillion-naira investment in states, and support for displaced victims of terrorism (IRS), Seasonal Malaria Chemoprophylaxis (SMC), its “Big War against Cancer” initiative. This project in the north-east. management of severe malaria, demand creation, involved the purchase of 10 mobile cancer diagnostic In line with its socially conscious approach, in-country research and capacity building, as well as and treatment centres (MCC) – the first of its Zenith Bank retains top-class private hospitals where or us at Access Bank, we believe that investment increasing access to Long Lasting Insecticide Treated kind globally – in partnership with the Committee medical facilities are provided for employees and in health is non-negotiable; it is the smart Nets (LLIN). Encouraging Corporate Philanthropy (CECP), a non- their immediate families free of charge. In addition, thing for businesses to do. When people enjoy Other initiatives aligned to our principle of profit organisation. The MCC, nicknamed PinkCruise, we partnered the VisionSpring and Catholic Optical Fbetter health, they are more productive and corporate philanthropy which we have invested in is a clinic on wheels with state-of-the-art facilities for Outreach ‘Clear Vision Project’ in sponsoring over when productivity is high, communities thrive and, by include community outreach programmes leveraged the screening, follow-up and treatment of cancer. 500 school children to undergo free eye screening extension, the economy prospers. on internationally recognised days, such as World The PinkCruise is designed to take integrated health in Lagos State, where corrective glasses and eye Since 2008, our strategy and decision-making Health Day, World Malaria Day and World AIDS Day prevention to the grassroots in all six geo-political treatments were administered to as many as needed processes have been benchmarked against amongst others. We also have partnerships with zones of Nigeria and has impacted over 5,000 them. international best practices. This has inspired our organisations such as the HACEY Health Initiative, citizens yearly with its free diagnostic initiative. The As a socially responsible organisation, Zenith approach to sustainability, ensuring our social and Corporate Alliance on Malaria in Africa (CAMA), project is ongoing and is expected to impact over Bank’s staff volunteering project – Red-Jar Initiative health investments align with globally accepted Nigerian Business Coalition Against Aids (NIBUCAA), 30,000 more Nigerians by the end of 2019. – has provided succour to several charity homes. practices. Private Sector Health Alliance (PSHA) and a host of Similarly, the bank in collaboration with the This project involves the placement of red jars in all We have invested in a number of initiatives and NGO partners. Private Health Sector Alliance Foundation sponsored Zenith Bank branches to collect voluntary donations projects targeted at improving health outcomes in Our sustainability initiatives with high-profile the emergence of a world-class private-sector-led from staff for onward donation to orphanages Africa, as well as collaborated on several initiatives partners often lead to greater outcomes than initially coalition that focuses on saving nearly one million and care centres across the country. This altruistic focused on health. Over the years, our input in expected. For example, Access Bank’s partnership lives through child and maternal healthcare projects. initiative is a passionate way for not just the bank, health has been consistent, resulting in awards and with ACT Foundation, in the form of donating grants This laudable venture’s aim was to accelerate but our individual staff to show love, solidarity, recognitions that have reinforced our status as a to NGOs for selected health, leadership, environment Nigeria’s Universal Health Coverage Priorities in line and reciprocity to the less privileged in our host socially responsible organisation. and education projects, has resulted in the funding with the United Nations’ SDG 3. communities. n Being a leader in the sustainability space, we remain of about 140,000 projects so far. Our GMD/CEO, As part of Zenith’s philanthropy, the bank has committed to this path as we continue to enhance our Herbert Wigwe, sits as Co-Chair, Nigerian Business provided countless medical interventions for low- contribution to addressing critical health issues across Coalition Against Aids and Chair of the Nigerian Health income individuals faced with various life-threatening Africa. This is what informed our 2010 $1m pledge for Innovation Marketplace. Also, the bank sits as co- medical conditions. This initiative complements the the fight against HIV/AIDS, Tuberculosis and Malaria; chair, Corporate Alliance on Malaria in Africa, Member, government’s efforts at improving life expectancy in an action that was recognised as a first of its kind Global Coalition on Health and Member, Private Sector the country by providing medical assistance to the from an indigenous African private-sector company to Health Alliance of Nigeria (PSHN). under-privileged. combat the triple pandemic of AIDS, Tuberculosis and At Access Bank, we are particularly strategic about The bank is also involved in various primary Malaria under the umbrella of the Global Fund. our community investment programs and sustainability health care projects – a testament to its commitment Our workplace policy program on HIV/AIDS, initiatives. Thus, we maintain an altruistic approach to to healthcare delivery in local communities. Zenith Tuberculosis and Malaria, which was initiated in 2012, social investments which has led to the deployment Bank has consistently supported the provision of has been implemented across all our offices and of several successful Corporate Social Responsibility access to primary healthcare facilities across the subsidiaries in Nigeria, including 3,000 SMEs across (CSR) programs. We believe in leveraging new and country to help meet the national SDG 3 targets. Africa. existing partnership opportunities to create value and For example, in efforts to reduce the infant mortality We have also developed the Maternal Health amplify our impact in the health-space for the benefit rate, Zenith Bank not only funded the construction of Service Support (MHSS) scheme in response to the of all Africans in Africa.n
32 33 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Media coverage
• Weber Shandwick provided communications support across major news hubs in Africa – Nigeria, Kenya, South Africa, Senegal and Ethiopia – and engaged with both regional and international media. • Following the event, strong media mentions and coverage were recorded in well-respected top-tier platforms such as All Africa, Le Pointe Afrique, The Star, The Guardian Tanzania, La Afrique Tribune and Ventures Africa.
The total reach of all print and online coverage received is estimated at 41, 729, 544
Qualitive Analysis Annexes
• 50 pieces of coverage were positive. Only 14 pieces of coverage were neutral. • The neutral coverage received signifies that the journalists published the press release the agency shared with them verbatim. • P ositive coverage signifies that the press release was altered/edited from original format received or developed from the journalists’ perspectives and experiences, thus indicating a good understanding and appreciation of the event.
34 35 HEALTHHEALTH FORUM: FORUM: 12TH 12TH FEBRUARY FEBRUARY 2019, 2019, HYATT HYATT REGENCY, REGENCY, ADDIS ADDIS ABABA ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK
Annex 1: Executive Summary of Healthcare and Economic Growth Report There is an urban bias in the lo- cation of physicians: in 23 of the 25 The Healthcare and Economic Growth in Africa report launched at the Forum countries with comparable data, the provides a strategic direction for the way governments and the private sector can percentage of total physicians in ur- ban areas far exceeds the proportion work together to improve the continent’s healthcare. This Executive Summary of the urban population. outlines its main findings. The burden of financing healthcare Total spending on healthcare in Afri- ca remained within a narrow band of between 5% and 6% of GDP in the pe- riod 2000–2015 on average, although Key findings of the in per capita terms, it almost doubled from $150 to $292 (in constant PPP dollars) with wide variation across Healthcare and Economic countries. On average, healthcare in Africa is predominantly financed through out- Growth in Africa report of-pocket expenses (36%) and do- mestic resources (35%), with external aid accounting for 22% of total health expenditure. National health systems in most countries struggle with in- sufficient and inequitably distributed resources and the poorest countries bear a disproportionately high share Left: A doctor examines a child. dents to the spread of infectious dis- of the burden of disease and injury, Africa needs more skilled health eases. At the same time, urban lifestyle yet have fewer resources for financing professionals changes lead to a rise in non-commu- healthcare. nicable diseases. National healthcare Expenditure targets as a percent- systems need to adapt quickly to the age of government budgets compro- Challenges in improving challenge of coping with a heavy and mise the flexibility of finance min- healthcare in Africa growing caseload of communicable istries to make allocative decisions Africa is undergoing rapid demo- and non-communicable diseases si- across various competing require- graphic, urban and epidemiological multaneously. ments. Health needs and the availabil- transitions that will have profound ef- Africa’s average disease burden ity of funds for healthcare differ signif- fects on the type, quantity and cost of declined from 927 to 538 disabili- icantly across countries, and there is healthcare services for the future. ty-adjusted life years (DALYs) per no consensus on how much countries With fertility rates that are still 1,000 population in the period 2000– should spend on the health sector. In Above: Workers in a pharmacy. Pharmaceuticals is an area that is ripe for high, in spite of declining mortality 2016, but there has been a change in 2001, member States of the African private investment in Africa rates, most countries are experienc- disease profile. The average share of ing rapid population growths of be- communicable diseases in the total tween 2.5% and 3% per annum. Afri- disease burden on the continent is Union committed to allocate at least ca’s population is expected to double still in excess of 50%, and the average Key messages of the report 15% of their annual budgets to health- from 2015 to 2050 with concomitant share of non-communicable diseases • Robust economic growth creates more fiscal space for public investment care, commonly referred to as the changes in the age structure. By 2050, has increased from 26% to 37% in this in healthcare. Most countries in Africa witnessed strong economic growth Abuja target, but few countries have the ageing population group in Africa period, signifying a rising double bur- of 5–6% per annum over the period 2000–2010. Growth recovered in 2016 achieved this target. will increase by more than 100m. It is den of disease. and is projected to remain strong in the coming years. Economic growth is There is an estimated health fi- a population group with very specific Africa has among the lowest den- necessary but not sufficient to improve health outcomes. Health matters nancing gap of $66bn per annum for roviding access to quality health needs. The competition for re- sities of skilled health professionals in for economic growth, though the link between health and economic growth the continent based on the threshold healthcare at affordable rates is sources is likely to become sharper as the world. Against the global thresh- is complex. of 5% of GDP for government expend- the single most important chal- countries struggle to increase access old of 23 health professionals per • Ensuring access to quality healthcare for all at affordable rates is con- iture. Against the required $114bn in P lenge facing Africa today. In the to healthcare for the younger popula- 10,000 population, 13 of the 47 coun- strained by a scarcity of public resources. Africa has made significant pro- current dollars, governments in Africa context of scarce public funds, as well tion groups. tries for which data are available have gress in health outcomes, particularly since 2000, though out-of-pocket spend approximately $46bn. This is a as limited and unpredictable external Africa is urbanising rapidly and by less than five health professionals per expenditure, the single largest component (36%) of total healthcare ex- conservative estimate that is likely to assistance, the private sector can play 2035, the majority of its population 10,000 population. Scarce resources penditure on average, creates financial barriers to access health services increase over the years. More than half a critical role in helping countries im- will live in urban areas. Rapid urban are misallocated as many countries and puts people at risk of impoverishment, slows down poverty reduction of this amount is required by Egypt prove their health outcomes. growth provides opportunities but produce more physicians when more and exacerbates inequalities. (19% or $12bn) and Nigeria (32% or The Healthcare and Economic unplanned growth gives rise to dense- nurses are required to deal with com- • Africa has a current health financing gap of at least $66bn per annum. Gov- $21bn). Growth in Africa report, drawn up by ly packed slums, which exposes resi- municable diseases. ernment expenditure on health in all but two countries (Algeria and Namib- the UN Economic Commission for Af- ia) is less than the minimum of 5% of gross domestic product, which is con- Resource mobilisation for health rica (ECA) under the overall leader- sidered necessary for ensuring adequate health coverage for at least 90% financing ship of Vera Songwe, Executive Sec- of the population. On average, countries need to increase public spending Africa’s tax-to-GDP ratios are among retary, ECA, Aigboje Aig-Imoukhuede, There is an estimated health on health by 2.5 times. On current trends, and with numerous competing the lowest in the world. Tax revenues Co-Chair GBC Health and Zouera demands for public resources, governments are unlikely to be able to meet are the most important component of Youssoufu, CEO/MD ADF, provides a financing gap of $66bn per the health financing requirements. domestic resources, and raising them strategic direction for the way govern- • The private sector needs to leverage the African Continental Free Trade has been at the centre of many domes- ments and the private sector can work annum for the continent based Area to invest in many under-invested sectors at a continental level. For tic reforms and regional and interna- together to improve health outcomes instance, Africa manufactures less than 2% of the medicines it consumes. tional initiatives. These efforts helped and quality healthcare that is accessi- on the threshold of 5% of GDP Imports cater for over 70% of the pharmaceutical market in Africa worth increase on average the total taxes to ble to all. On the following pages we about $14.5bn. up to 19.3% of GDP in 2015 in Africa. summarise its findings. for government expenditure In general, low-income countries and
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igure igure istribution of health ealthcare financing gap cases b sub region in selected countries as a in Africa percentage of Africa s total shortfall ■ astern Africa ■ Central Africa ■ igeria HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 2019 DELEGATE HANDBOOK ■ est Africa ■ g pt ■ outhern Africa ■ Angola ■ orth Africa ■ outh udan ■ orocco igure igure ■ thiopia Recommendations ealthcare financing gap istribution of health ■ en a What should governments do? cases b sub region in selected6% countries as a • Focus on achieving broad-based in Africa percentage of Africa s ■ thers economic growth and prudent total shortfall macroeconomic management ■ astern Africa that includes strengthening of debt management frameworks ■ Central Africa ■ igeria ■ g pt and strategies; improved tax ad- ■ est Africa 22% 32% ministration to increase tax rev- ■ outhern Africa ■ Angola enues; strengthening of financial ■ orth Africa ■ outh udan administration to reduce illicit ■ orocco 28.1% financial32.1% flows; and prioritising ■ thiopia public funding for health by re- ■ en a ducing fossil-fuel subsidies and 6% ■ thers other wasteful expenditures; • Identify innovative sources for financing healthcare such as De- 31% 9% velopment Impact Bonds and debt-to-health swaps; 22% 32% • A llocate sufficient resources in 3.2% 3.8% health-associated sectors such 28.1% 32.1% as water and sanitation to re- duce the extent of communi- Business opportunities in the 4% 5.6%cable18.9% diseases, and undertake Source: ECA staff calculations using data from mass awareness campaigns to healthcare and wellness sector the review of PPP cases. N=178. 4.5% reduce non-communicable dis- 31% 9% eases; and in Africa are estimated to be non-resource-rich countries place a Gambia, Ghana, Nigeria and Zambia. health-stressed: Benin, Cameroon, • E nhance regulatory systems for worth $259bn by 2030, with the greater reliance on indirect (as op- In 22 countries,3.2% the3.8% average an- Central African Republic, the Demo- improved governance of pub- posed to direct) taxes than do high-in- nual value of illicit financial flows far cratic Republic of the Congo, Congo, lic-private partnerships, create potential to create 16m jobs come countries and resource-rich exceeds the health financing4% gap.5.6% This 18.9%Côte d’Ivoire, Guinea, Guinea-Bissau, suitable conditions to attract pri- countries. This could be a result of the suggests that by reducing these illicit Mali, Mozambique, Niger and Zambia. vate investments, provide other low levels of formal sector employ- flows, governments can4.5% fund health- They are below the acceptable thresh- incentives such as strengthen- There is considerable scope to lev- than 10% of the public-private part- ment in lower-income countries and care and other social sectors in these olds on five of the seven indicators. ing infrastructure, and improved erage the capital and capacity of the nerships. Moreover, over half of the 178 non-resource rich countries. countries. These 20 countries need to be prior- internet connectivity, and pro- private sector to complement gov- cases reviewed were located in just 10 “Sin taxes” serve the dual purpose In six countries, military spend- itised for immediate attention. mote intra- African trade in ernment financing and increase in- African countries. This indicates une- of increasing government revenues ing as a percentage of GDP exceeds health products and services. vestments. Increasingly, governments qual distribution of such partnerships. and discouraging the consumption of public spending on health. Countries Role of the private sector in are turning to the private sector to Despite the potential benefits of products detrimental to health such as have their own security requirements, financing healthcare in Africa What should the private improve quality and deliver value for public-private partnerships, private money, build infrastructure, provide alcohol, tobacco and sugary drinks. but given the importance of improved Developing effective health financ- sector do? sector involvement and contributions South Africa, with the highest obe- health outcomes for the future wellbe- ing mechanisms and harnessing the staff and training, improve productiv- to financing in Africa have not been • P romote private sector invest- sity rates in Africa, other than North ing of their populations, governments strengths of the private health sector ity, undertake social marketing, and optimised. Ten countries benefit from ments in health sectors such as Africa, introduced the Sugary Bever- could consider prioritising health in are key strategies to address the in- enhance procurement. 51% of the PPPs on the continent and ages Levy in 2018 to raise prices for their budgetary allocations. creasingly complex health challeng- the pharmaceuticals, medical The interest in public-private part- are engaged in only a small number soda and other sugary drinks, with the Results-oriented innovative financ- es in the region, particularly to help education and digital technolo- nerships is driven by a number of of areas. Challenges in enhancing aim of reducing obesity rates by 10% ing mechanisms such as Develop- bridge the health financing gap of gies that are presently under-in- factors: the rising costs of delivering the role of the private sector include by 2020. Morocco’s revenues increase ment Impact Bonds and Social Impact $66bn per annum. Fiscal space for in- vested; healthcare as populations age; the the lack of effective dialogue among in 2017 with a surtax on alcoholic Bonds have been launched in some creased government spending is con- • B uild upon the recently-signed shift in disease profile in Africa to- stakeholders; weak regulation and drinks, tobacco, and gambling that countries. For example, important les- strained in many countries. Govern- African Continental Free Trade wards non-communicable or chronic policies specifically related to health also aims at protecting Moroccans. On sons can be learned by other countries ments can only do so much, and the Area (AfCFTA) to identify mar- diseases; changing lifestyles with in- financing schemes and strategies; and the other hand, Kenya with the highest from the Cataract Bond in Cameroon. private sector is an important contrib- ket opportunities and invest in creased urbanisation; and costly and a poor environment in terms of ease of rate of diabetes in Africa, other than There is an urgent need to improve utor to providing healthcare in Africa. countries or create manufactur- rapidly advancing medical technolo- doing business. North Africa, faced stiff resistance and health outcomes in health-stressed Business opportunities in the ing hubs in the sub-regions; gies. Opportunities for the private sector had to withdraw a tax aimed to reduce countries. To target the countries healthcare and wellness sector in Af- • Co mply with the regulato- For example, UNAIDS has pro- to engage need to be properly aligned consumption of sugar. with maximum health needs, the re- rica are estimated to be worth $259bn ry mechanisms and oversight posed a fast-track strategy to end to a country’s public health goals, in- Debt servicing constrains govern- port uses a combination of thresholds by the year 2030, with the potential to measures aimed to curtail trade the AIDS epidemic as a public health cluding better access and affordabili- ments’ availability of discretionary covering seven indicators, such as create 16m jobs. There are numerous mispricing and tax evasion; threat by 2030. The estimated price ty for the poor to access high-quality resources and limits the fiscal space. opportunities for the private sector to tag to achieve this on a global scale healthcare and medicines. Public-pri- domestic government health expend- • Work with governments through There are concerns about the rising iture, out-of-pocket expenditure, den- invest in laboratory and diagnostics, is approximately $26bn per year until vate partnerships in health need to be various modalities, including level of government debt and debt sity of skilled health workers, average pharmaceuticals, skills development, 2030. The cost of treating diabetes is institutionalised with public and pri- sustainability in several countries. disease burden, government debt and research and capacity-building, and public-private partnerships, to estimated at $2,300 per patient per vate risk-sharing, well-structured and In Africa, total debt service has in- the annual GDP growth rate. digital health innovations. Investing in crowd in more private sector year in Africa. aligned to achieve the 2030 Agenda creased from 1.6% of gross national Eight countries are severely health- health in Africa is increasingly attrac- investment aligned to achieve A review of the current public-pri- for Sustainable Development. Evi- income in 2011 to 2.6% in 2017. The stressed: Angola, Chad, Mauritania, tive to the for-profit private sector. It is the health-related Sustainable vate partnership cases in health in dence suggests that public-private average interest-to-revenues ratio in- Nigeria, Sierra Leone, South Sudan, estimated that 14% of all business op- Development Goals and the as- Africa revealed that two-thirds are partnerships are effective models for creased from 5% in 2012 to an estimat- Togo and Zimbabwe. They are below portunities in the health and wellbeing pirations of the African Agenda located in Eastern and West Africa development in part because of their ed 10% in 2017. The interest cost ex- the thresholds on six of the seven in- sector globally will be in Africa, sec- 2063. (see Figure 1). Central Africa, with the ability to expand, reach and multiply ceeds 20% of revenues in Burundi, the dicators. Another 12 countries are very ond only to North America with 21%. poorest health outcomes, has less impact. n
38 39 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 2: Key messages from the Africa Business: Health Forum Annex 3: Speeches Aigboje Aig-Imoukhuede welcomed delegates to the Forum with an analysis of why the private sector needs to become more involved in Africa’s healthcare sector and how the Forum will offer stakeholders the opportunity to galvanise action across the continent Welcome remarks by KEY MESSAGES FOR THE FORUM opian PPP presentation, which out- TECHNOLOGY AS A USEFUL TOOL lined the government’s ambition and Technology is a unifying platform. COLLABORATIONS AND passion to develop tertiary care in It is time stakeholders leveraged it Aigboje Aig-Imoukhuede, PARTNERSHIPS CAN GIVE BIRTH the country and manufacture drugs more for better penetration and over- TO GREAT THINGS domestically. all impact. When resources and expertise are Trust and transparency are key Founder and Chairman pooled, it is easier to tackle challeng- ingredients of a successful PPP. Fi- KEY MESSAGES FOR ABCHEALTH es and make great strides. The suc- nance is one area of collaboration. cess of the inaugural Africa Business: Success will depend on having the BUILD A TRULY AFRICAN of Africa Initiative for Health Forum as well as the launch of right model and framework for the COALITION ABCHealth is an indication that the partnership to survive. ABCHealth must go beyond the two right collaborations can inspire great partners, GBCHealth and Aliko Dan- Governance (AIG) and things. DOMESTIC RESOURCE gote Foundation, and ensure it rep- MOBILISATION resents a truly African coalition by INVESTING IN HEALTH IS GOOD NEED FOR HONEST DIALOGUE having inclusive representation from Co-Chair, GBCHealth BUSINESS There is need to increase funding for across the continent. Putting money in the health sector health across the continent. Howev- makes social, economic and busi- er, ministers of health seem to find it DATA IS KEY ness sense. Investing in the sector is, hard to get their ministers of finance There is a need for evidence-based therefore, not just a social impera- to increase funding to the health sec- decision making. ABCHealth can be- tive but an economic necessity with tor. There is a need for deep, honest come an important aggregator of hile Africa has made significant holder in the quest to fix Africa’s health. This is huge returns, and that will also ben- engagements amongst stakeholders data to help contribute sound policy progress in funding of healthcare, surprising given that investing in healthcare in efit the private sector in general. A to address the gap. decisions. we are still very far from where we Africa is increasingly attractive to the business healthy Africa is a productive Africa; As well as increasing allocations The right data, if properly ana- Wneed to be to achieve SDG Goal 3. world and will promote economic develop- and a productive Africa is a prosper- towards health, spending must be lysed, will help in crafting effective Healthcare in Africa is constrained by among ment, enhance worker productivity, create new ous Africa. better deployed and more efficient. and efficient solutions across borders. others scarce public funding and limited donor markets and improve the overall environment The efficiency of fund usage is as support. Out of pocket expenditure accounts within which businesses operate. PUBLIC-PRIVATE PARTNERSHIPS important as mobilising more re- UTILISE TECHNOLOGY for 36% of Africa’s total healthcare spend. It may look ambitious but it’s certainly not CAN BRIDGE FUNDING DEFICIT sources. Technology offers a veritable op- Given our income levels it is no surprise that impossible. The private sector must be encour- There is an annual financing gap in portunity. It will be a critical tool for healthcare spend in Africa is grossly inade- aged to optimise and step up its involvement the heath sector estimated at over DONOR FUNDS AS CATALYSTS ABCHealth to engage with partners quate to meet Africa’s growing health needs, and contribution to health funding in Africa. $60bn. Governments cannot bear Utilise donor funds as a catalyst to and also to build a strong and effec- leading to a financing gap of $66bn per annum. We have seen what global private sector play- the burden alone and will need to mobilise other resources going into tive member base. Technology will It is clear that African governments alone ers accomplished in the fight against the AIDS partner with the private sector and domestic funding for the sector. also offer platforms for greater collab- cannot solve this challenge, which is further ex- epidemic through powerful coalitions such as other partners (DFIs, Foundations) There are interesting instruments be- oration and impact at scale. acerbated by our growing population and Af- GBCHealth. This is an indication of the power to bridge the gap. ing used and case studies of this al- rica’s changing disease portfolio. We have no of consolidated effort which Africa’s growing ready working. BE THE BRIDGE alternative but to turn to the private sector to private sector can bring to solving our health PUBLIC-PRIVATE PARTNERSHIPS The coalition must be an honest bro- complement government funding. challenges. COALITIONS OVER SILOS PRIORITISE COST OPTIMISATION ker that will foster viable partner- Our continent accounts for less than 2% The Africa Business: Health Forum seeks to Working in silos might seem con- Cost optimisation should be made ships between the public and private of global health expenditure even though our increase and deepen multi stakeholder collab- venient but setting up coalitions a priority. It is not enough to source sectors, as well as other committed very fertile people account for 16% of global oration, by offering stakeholders the opportu- is better for efficient and effective for funds; ensuring more is achieved stakeholders, for the good of Africa. population and carry 26% of the global disease nity to visualise success and galvanise action delivery on set objectives. This was with less might be a way to scale up burden. By 2050 Africans will account for more across the continent. The Forum affords the evident in the case study from Bioko investments in other subsectors of CREATE A PROFITABLE MODEL than 50% of global population growth, much of private sector a platform to communicate and Island in Equatorial Guinea, where the health sector. FOR STAKEHOLDERS that coming from my country, Nigeria – a great collaborate with government representatives the private sector joined forces with Three ways to improve domestic Since the private sector, to ensure opportunity and at the same time a ticking time whilst exchanging knowledge and experienc- government to reduce infected mos- funds include P (People), P (Policy) long-term sustainability of its invest- bomb should we fail to fix our health systems es. This Forum promises to be an exciting and quito bites incidents per capita from and P (Product). There is a need to in- ments, is driven by a profit imperative, quickly. That is why we have gathered here to productive start to a revolutionary approach to 1,000 to three annually. vest in healthcare professionals, drive ABCHealth must develop viable busi- see how together we can fix health in Africa. tackling Africa’s health challenges. I am very policies to strengthen healthcare sys- ness models for the business commu- The private sector and the public sector work- excited by the possibilities for making history MANAGE STAKEHOLDER tems and manufacture quality health- nity with a view to helping it find spe- ing together as partners have the potential to here today, in Addis Ababa. n EXPECTATIONS care products in Africa. In addition, cific initiatives worth investing in. change Africa’s healthcare from doom and It is important to align and man- innovative approaches should be ap- gloom to progress and results. age expectations between the gov- plied to finance. ALWAYS PLAN AHEAD Africa’s private sector have great capacity ernment and private sectors for a Resource allocation will impact sub- to be relevant partners, and our participation in seamless collaboration. This is best INNOVATION IN HEALTHCARE scription to ABCHealth. Planning Africa’s health ecosystem will not be new. Op- This Forum achieved through greater dialogue. THE POWER OF AN INDIVIDUAL ahead (one-year, five-year plans, etc) portunities for private-sector engagement to NOTE Individuals can make a difference will help ABCHealth in the allocation advance the Sustainable Development Goals The speeches includ- promises to be a RIGHT INVESTMENTS, and we have seen leaders and inno- of scarce resources. and improve Africa’s health outcomes have ed in this Annex are a HIGHER IMPACTS vators take a leap to transform health Small and medium-sized enterpris- been acknowledged across sectors and pro- product of transcrip- productive start Investing time, money and ener- outcomes. However, collaborations es (SMEs) are the engine of transfor- moted by the development community as well tion during the Forum gy in human capital and R&D are will be key to optimising funding and mation and major employer of labour as private companies themselves. However, in and in some instances to funding Africa’s necessary to help scale up impact. achieving sustainable development in Africa; they should also be brought many areas of potential engagement the pri- have undergone minor This was the takeout from the Ethi- at scale. into the fold. vate sector remains an underinvested stake- paraphrasing. health challenges
40 41 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches
In her remarks, Vera Songwe underlined the many opportunities for the private sector to behind its success. We are working, of course, invest in healthcare, thereby not only getting good returns but also ensuring that Africa with Aliko Dangote in Nigeria, to make sure that Nigeria signs the AfCFTA; we hope that it is healthy and prosperous will happen soon enough. With the continent’s big economies joining the AfCFTA, we will be Address by a much better economy. We are also launching a report today, called Healthcare and Economic Growth in Africa. It is Vera Songwe, an important report because it looks at what the private sector is doing in healthcare on the continent. The report will tell you that more Executive Secretary, than half of the public-private partnerships (PPP) in health are concentrated in 10 coun- tries on the continent; yet we are a continent United Nations of over 50 countries. So, we need more private sector involve- ment across our continent. The report will Economic Commission show you the areas in which the private sec- tor can do well and do good business. What we are doing as the Economic Commission for for Africa Africa, is ensuring that we can work with our partners, both in the private sector and in the public sector to define what those spaces are. It is obvious that public-private partnerships have sometimes not produced the results that we need on the continent. However, we have excellent examples e started the Forum last year be- where it has worked. Kenya is one of the lead- ing you to invest because you do have a good cause African leaders come to ing countries that has PPP engagements that return and when you invest on the continent, Addis every year for the African Let’s talk about are working quite well, where health provision the returns you get are much higher than you WUnion Summit and participate is accessible and affordable to those in the ru- would get anywhere else. So, take the leap of in events that the private sector is often not how we can bring ral areas as it is to those in the urban areas. We faith with us at the Economic Commission for aware of. We thought maybe we should cre- are also working with Egypt to look at health Africa, with the African Union, with our African ate a platform and space in Addis Ababa that the public and the insurance where the public and the private leaders and especially, with the African youth offers an opportunity for our leaders and pri- sector can ensure that everyone’s healthcare who expect to have a healthy future. vate sector to engage on Africa’s pressing private sectors is taken care of. The McKinsey Report says that health busi- challenges. It is true, health is a public good and health ness would be $259bn by 2030. We know Last year, we talked about the AfCFTA, the together to ensure is a social good, but you can do a social good that the first-mover advantage is always the African Continental Free Trade Area Agree- and do good business too. This is what we are better advantage, so you have heard it and ment – it is a defining decision for our conti- Africa’s healthcare here to do today; to talk about how we can do you have the numbers as the private sector. nent. It is a decision that essentially says, “We those things, bring them together and ensure We are here, willing and ready to participate are bringing Africa together.” To do that we is funded that as we emerge into the 21st century, we in facilitating your investments, creating a have to bring Africa together in many forums have a continent that is healthy, prosperous public-private partnership environment that is and we decided, as Aig said, to talk about and that will ensure that as Africa integrates, conducive for you. health this year, primarily for two reasons. it integrates in a healthy and economically ro- What we are hoping to do after this Forum The first is that the outgoing chairperson the AfCFTA or are in process of ratifying it. bust way. and over the course of this year is to launch a of the Union, President Paul Kagame, was very The AfCFTA is an amazing decision for the It is my pleasure and my distinct honour couple of innovative financing instruments as interested in the idea of advancing health. The continent. Today, in Africa we import $14.5bn to have leaders of the continent with us today well. Hopefully, working with Botswana, Ethi- second is, we know, as Aig has said, that the worth of drugs from outside the continent. Yet to talk about healthcare in their countries and opia, Djibouti and Egypt, we will explore how public sector cannot fund all of the healthcare business opportunities in the healthcare and how to attract the private sector. To attract we can innovate in the healthcare space. If we needs of our continent but we also know that wellness sector in Africa have the potential to the private sector, we need to create an ena- do that, then next year we will come back to the private sector has experience in the sec- create 16m jobs. bling business environment. We have heard in you and give you results of how well we have tor and has been funding it for a long time in We should no longer export our jobs. Ethiopia the decision to improve its position in been able to crowd-in private finance into the many countries. We can bring those jobs back. For instance, the Doing Business Index and ensure that the healthcare sector in Africa. We also know that a healthy Africa is a pro- Egypt, Cameroon, Kenya, South Africa, are all private sector can come. Once again, thank you for coming. A pros- ductive Africa and a healthy Africa is a pros- countries that are producing generic drugs for It is opportune that Ethiopia is sitting be- perous Africa is a healthy Africa – a healthy perous Africa. So, we decided that we needed diseases that continue to kill our youth. In the side Djibouti. Djibouti was one of the top 10 in Africa is a productive Africa. n a Forum to talk about health and health fund- case of malaria, we could help rid ourselves of the Doing Business Index this year. Botswana ing. So let’s talk about how we can bring the malaria, if we decided that we could produce as well is working to be in the top 10. We hope, public and the private sectors together to en- affordable drugs on the continent. next year when we come here, we will have sure that Africa’s healthcare is funded. The AfCFTA precisely does that. It allows all of you with a business environment that With Africa’s rapid population growth, the us to bring together the expertise that we attracts and continues to attract the private A prosperous demand for health services in Africa will only have on the continent to ensure that we can sector to come and invest in your economies intensify and could be a prosperous business create the jobs needed. As we create the jobs because the message here is Africa’s econo- Africa is a healthy opportunity. The idea of the Private Sector Fo- needed we can also produce healthy societies mies are open for business. rum, started in January last year, was really to and as we produce healthy societies, we pro- The private sector should continue to in- Africa – a healthy demonstrate that we can join two important duce prosperous societies. It is a very simple vest, but more importantly, the African private events. equation. sector should invest in the continent’s health- Africa is a It is no surprise that the leaders who are When we talk about the AfCFTA, we must care. The message therefore to the African here today with us are leaders that have signed recognise that the private sector is a key driver private sector is that our leaders are expect- productive Africa
42 43 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches In his address to delegates, the Prime Minister of Ethiopia detailed the progress his The President of Djibouti told delegates how his country has introduced a universal country is making in healthcare, emphasising the need to improve efficiency in health healthcare system and now envisages capitalising on the proven success of public- spending and the vital role of the private sector in financing national public health plans private partnerships to promote good health for all its citizens Address by Address by H.E. Abiy Ahmed, H.E. Ismaïl Omar Prime Minister of Guelleh, President Ethiopia of Djibouti
nsuring quality healthcare for citizens am delighted to be with you for this Africa The short-term goal for my country is to es- is a fundamental objective of any gov- Business Health Forum organised by the tablish universal health coverage, in order to ernment and while universal health cov- We must capitalise Economic Commission for Africa, GBCHe- be in step with the objectives of the third pillar Eerage is an ambitious goal, it is never- Ialth and Aliko Dangote Foundation. I express of sustainable development. theless a necessary one. Here in Ethiopia, we on public-private my heartfelt gratitude to all those who have Africa is today facing a resurgence of dis- witnessed tremendous improvements in ac- contributed to the organisation of the Forum eases that we believed were under control, and cess to healthcare when we introduced uni- partnership and the fruitful work that you will embark on of others that had almost been eradicated. The versal primary healthcare to all our citizens. to identify and strengthen the connections be- prevalence of certain non-communicable dis- Today, each of our 17,000 villages are linked modalities in tween health and economic growth in Africa. eases such as diabetes has now reached wor- by a national network constituting more than No nation can hope to achieve econom- rying levels. Significant investments have been 14,000 health extension workers.. healthcare ic development without a population that is allocated to the health sector, and particularly That said, there are still some miles left in in good health – physically, mentally and so- to raising the level of technological facilities in reaching the health sector reform goals we wards. We recently enacted a new legal frame- cially. Armed with this conviction, my country our national training programmes for health- have set for ourselves and we are encouraged work on public-private partnerships, which in- has made equitable and universally acces- care professionals. Despite these large invest- by the profound impact to date. It is no coin- cludes the health sector, and has provision to sible healthcare a key priority. Accordingly, ments, you will agree with me that we still lack cidence that in 2012, Ethiopia achieved its mil- enable transparency, fairness and long-term the share of the national budget devoted to advanced infrastructure and that we cannot lennium development goal target of reducing sustainability in its method of engagement. healthcare spending has been continually in- guarantee or secure our supply of basic medi- the under-five mortality rate by two thirds, For instance, the Ministry of Health togeth- creased in order to work towards meeting the cines and pharmaceutical products. three years ahead of the deadline. Life expec- er with the Ministry of Finance is piloting a commitments of the 2001 Abuja Declaration. In Djibouti, with the introduction of univer- tancy has also increased from 52, at the turn high-end, innovative - investment in two gov- In spite of these efforts, a large part of the sal health insurance and particularly with the of the millennium, to 65 by the year 2016. Our ernment-owned hospitals: Black Lion and St. population was still without access to quality universally available, direct third-party pay- ambitions drive our efforts, yet necessity gives Peter. Our main objective in this regard is to re- healthcare. With the introduction of the con- ment system, we have been able to guarantee us little choice. duce healthcare costs by encouraging private tributory scheme extended to all beneficiaries, the payment for every patient’s medical treat- Today, several countries in Africa have uni- sector operators to centralise service delivery, providing partial coverage of healthcare costs, ment to both the private and public healthcare versal healthcare coverage as a working social assuring quality coverage. patients or their families were responsible for sectors. Private establishments can provide provision and yet, only three African Union Another important focus area and invest- paying a part of their treatment costs – and not the necessary services and recover the costs. member states are currently able to dedicate ment opportunity for private investors is ter- an insignificant one. This reform has fostered the development 15% of their GDP to health coverage as per the tiary level medical services. These services are Payment at the point of delivery was a of the most expensive tertiary-level care that Abuja Declaration. In this context, it remains expected to attract medical tourism and re- heavy burden for the citizens concerned, and is deemed the most profitable. It is now high critical that we encourage new and innovative duce the outflow of patients in search of high- significantly contributed to making them poor- time to promote public-private partnerships in sources of financing to supplement budgetary end healthcare services abroad. er. This system, despite its usefulness in filling the healthcare sector generally, and in particu- support and development assistance in the We need to make the health sector our the health funding gap, remained particularly lar, to direct it into areas that have a powerful health sector. priority. We must capitalise on public-private unfair for vulnerable people. impact on public health indicators, for which Greater attention should also be given partnership modalities in healthcare and rec- As such, we noticed that the lack of an in- the most important aspects remain primary to improving efficiency in domestic health ognise that they rely heavily on political will surance system was one of the factors that care, hygiene and nutrition. spending. Access to affordable and quality and require a great deal of interdependence pushed households into poverty. Households Working together in partnership, we can in- healthcare is a key driver of economic devel- between the government and the private op- in both rural and urban areas were exposed crease the efficiency and quality of our health- opment and Africa’s governments have played erators. We have to do our part to ensure the to a variety of stressors that were preventing care systems if we properly direct our resourc- a significant role in the past in making quality success of our collaborative efforts. them from accumulating the property and hu- es. Technological innovation will also play a key healthcare accessible. However, it is time for Finally, I want to stress that our aspira- man capital that could help them escape from role in helping us to develop genuine health in- private sector to play a vital role in both financ- tion to ensure universal access to healthcare poverty. With a view to promoting the right formation systems useful for responding effec- ing and supporting implementation of national should not compromise quality. Our citizens to health for all, without discrimination or in- tively to the various epidemics that can affect health plans. Investing in the health sector is deserve quality healthcare, regardless of age, equality, and also to fight against poverty, the a region or country; develop platforms for the rewarding and indeed, part of corporate social gender and geographical location. Currently, a Republic of Djibouti introduced a universal production and distribution of medicines and responsibility. large number of Africans will not have access health insurance system (AMU). pharmaceutical products; develop high-per- In my view, public-private partnership offers to medical doctors in their lifetime. The special feature of this system is that it formance diagnostic centres; and improve an easy entry point for sustainable health fi- This must change. If “leave no one be- brings the direct third-party payment system training for our medical human resources. nancing. This method, also referred to as private hind” is a mantra for achieving the SDGs, then to all healthcare establishments in the country, Public-private partnerships have proven finance initiative, is a method which in Ethiopia achieving universal health coverage is vital to which has allowed us to remove the financial their effectiveness in a number of countries. we are taking concrete and practical steps to- ensuring Africa is not left behind n barriers to accessing medical treatment. This must be the case in Africa. n
44 45 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches The President of Botswana invited the private sector to invest in his country’s healthcare Speaking on behalf of her President, Egypt’s Health Minister outlined her country’s system as he described the many successes already achieved by public-private ambitious health sector reform programme and stressed the benefits that the AfCFTA partnerships and the areas that could be explored for future collaboration could bring in the development of Africa’s pharmaceutical industry Address by Address by H.E. Mokgweetsi H.E. Hala Zayed, Minister Masisi, President of of Health, Egypt, on behalf Botswana of H.E. Abdel Fattah El Sisi, President of Egypt
et me at the outset extend my sincere services and managed care. And for referral appreciation to the convenience of this at district hospitals we also continue to out- very important Forum aimed at advanc- source soft services, such as, laundry, security, Ling Africa’s health-related development cleaning, catering and clinical waste. ealth and economic performance are enacted. It provides a strategic framework for goals. Equal appreciation goes to the sponsors In addition, my government is currently in interlinked. For a start, wealthier coun- reforming the entire health financing system and to the strategic partners of this event. I am the process of outsourcing services to reduce tries have healthier populations. Coun- and a new health insurance organisation to particularly delighted that this event is clearly backlogs in obstetrics and gynaecology. It is Htries with weak health and education act as a single purchaser. This enables a better aligned to the key aspirations of our Agenda also our desire to, in the near future, provide conditions find it harder to achieve sustained opportunity for the private sector to take part 2063. the following services through existing and growth. Indeed, economic evidence confirms in service provision, as a purchaser organisa- This Forum is vital in our collective pur- new public and private sector avenues, if not that improvement in health and life expectancy tion can contract with any healthcare provider suit of improved universal healthcare. It is also entirely private sector-led initiatives: is associated with an area’s economic growth. conditioned to meet all the quality standards critical for broadening the landscape for pri- (1) General surgery; orthopaedic surgery, as Disease hinders institutional performance, defined by the accreditation body. vate-public sector collaboration, to ensure ac- well as ear, nose and throat specialists; damages productivity, results in workplace Indeed, health provision requires the avail- cess to delivery of quality healthcare services (2) Training of health personnel in different absence, which has its associated cost of lost ability of quality medicines. However, Africa on the continent. cadres by local and international research productivity and represents a significant com- manufactures less than 2% of the medicines it In the case of my country Botswana, I partnerships in critical areas of health; and ponent of a society’s financial burden. Howev- consumes. Therefore, in Egypt, we are working wish to inform you that we have made some (3) Complentary health financing through er, a strong political commitment in health in on creating an enabling environment encour- strides in embracing private sector partner- health insurance schemes. Africa has not always translated into increased aging all investors to invest in pharmaceuticals. ship through the adoption of pluralistic health Having outlined the above, I wish to invite allocation for the health sector due to many We are working on fostering the manufacture service delivery. In this regard, my government the private sector to explore the opportunities challenges that could be related to implemen- of biological and oncological products. has made a strategic and deliberate policy de- available in Botswana for we have just publi- tation and finance. There is much that we still need to do in cision to promote private sector participation cised our budget for the provision of improved In Egypt, significant public financial reform producing plasma products to satisfy Egyp- in the health sector in recognition of the piv- healthcare services and yes, we are open to is continuously being implemented, contribut- tians and the African market. Therefore, we all otal role it plays in the economy. I am pleased business and you’re welcome. ing to physical consolidation. The macro-eco- need to support having an African Continental that the private health sector has demonstrat- Some of the areas that could be explored nomic outlook is showing significant signs of Free Trade Area which would boost the devel- ed the willingness and ability to be engaged for possible collaboration between the pub- stability following the recent liberalisation of opment of the African pharmaceutical indus- as a strategic partner in the long-term in the lic and the private sector include pre-hospi- the exchange rate. Our current health expend- try and intra-African trade in pharmaceuticals. provision of healthcare services in Botswana. tal services; in-patient care; out-patient care, iture is 4.7% of GDP, which is very good com- There is much we still need to do to achieve As a demonstration of my government’s such as, disbursement of ARVs; preventative pared to what previously obtained. the Africa 2063 goals. Countries have already unwavering commitment towards this pub- care, such as, immunisation; diagnostic servic- Let me share with you our current ambitious shown that they can make measured gains in a lic-private sector partnership, we have estab- es; mortuary services; rehabilitation and step- home-grown health sector reform programme, short time. Countries now must build [togeth- lished the sectoral health high-level consulta- down care; research and development and which we call “Hundred Million Healthier”. It er] to overcome common challenges and to in- tive council, commonly known by the acronym pharmaceuticals and manufacturing, as well relies on two main pillars: first, the choice of crease our investment in health. HLCC. Co-chaired by the President, myself and as human resource development. health targets; second, setting time-bounded I very much look forward to working togeth- the President of the private sector. This cre- It is our belief that the outcomes of this targets. er with all African countries to give everyone, ates a platform for collaboration with the pri- Forum and the findings of the report we are The first campaign that we have launched everywhere, access to quality and affordable vate sector and guides engagement towards about to launch this morning, will paint a pic- is screening and treatment for hepatitis C and healthcare. n access to cost efficient health quality services. ture through which public and private sector non-communicable diseases. We chose these We meet at least four times a year. can mutually work together towards a sustain- health targets as they accounted for a high Among the key achievements my country able health economy and truly inspired busi- burden of diseases and affected a high per- has made in the health sector as a result of the nesses to truly transform the health sector in centage of our population. private-public health collaboration are: Africa. The campaign aims to screen more than Africa (1) Provision of air ambulance services, There’s a lot of work to be done; we are the 50m people in seven months. To date, around through engaging local companies for air lift- people to lead in that regard and we, the lead- 30m have been screened and treated in only manufactures ing patients; ership of Africa, are ready for the challenge five months. That’s the beauty of a time-bound (2) Utilisation of intensive care units at private ahead. ambitious target; it forces you to change – it less than 2% of hospitals by public hospitals; Let us, through this initiative, rededicate forces all the health community, public, private (3) Public to private referrals for specialist ser- ourselves to seeking new sustainable ways of and NGO to reorder their priorities, focus and the medicines it vices, such as, organ transplants, haematolo- consolidating the gains made thus far in the revolve around the campaign. gy, oncology, vitreoretinal, dialysis, cardiology health sector. n A new social health insurance law has been consumes
46 47 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches Kenya’s Health Secretary shared the thoughts of her President with the Forum, saying that Kenya recognises the important role of public-private partnership in building on the gains the country has made in healthcare and working towards a sustainable future Address by Sicily Kariuki, Cabinet Secretary for Health, Kenya, on behalf of H.E Uhuru Kenyatta, President of Kenya
bring special greetings from His Excellency ble healthcare. In particular, philanthropic in- cy, President Kenyatta, four years ago, where the President Uhuru Kenyatta, who would terventions are becoming an effective con- specialised medical equipment has been out- have liked to be here but had to make his tributor to sustainable development, creating sourced from private providers. This has led to It is only by Iway back home last evening. value for both business and society. This alone equitable access to specialised services such Allow me, therefore, to share his thoughts isn’t enough, however, and we need to move as renal dialysis, intensive care services, thea- harnessing the with you this morning. I start with congratu- into sustainability. Thus, efforts to take philan- tres and, therefore, surgeries, diagnostics are lations on the occasion of the launch of the thropy to turn business into a truly transform- now all available at the very hard-to-reach, lo- the strengths, Healthcare and Economic Growth in Africa ative force for health should be encouraged. cal areas in Kenya. This equipment, in which report, recognising that ultimately, invest- The government of Kenya recognises the we also have ICT capacities, also enable shar- the resources, the ment in health has an influence on macro and important role of public and private partner- ing of limited specialisms across the country micro-economic conditions of any country. ships in complementing partners’ resources especially in rural areas where we are able to expertise of the Health is, therefore, a determinant of the eco- as well as government resources in healthcare share resources and give feedback to patients. nomic, social and political aspects of develop- delivery. In Kenya, my President would like to I will give one more example. One where we private sector... ment. This is what we believe in Kenya. say, “We do not struggle in welcoming the pri- have partnered with a group of private sector However, allow me to recognise that sus- vate sector to support us in delivering public pharmaceutical industries to build a capacity that we can tained investments are required to leverage good.” And it is for this reason that we have of hosting and reversing NCDs using SDG17 on on gains that the continent, and indeed Kenya, continued to work on the ease of doing busi- strategic partnership as their entry point into achieve lasting has made during the MDG era and to ensure ness and are proud to recognise that only last my country. targets that were not achieved then are fast- year, we managed to move to the 61st position As we recognise the great opportunities health solutions tracked as part of the SDG aspirations. having worked our way through from 129 out that come with the private sector in Kenya, The SDGs represent a fundamental para- of the 190 countries ranked in the year 2013. we also recognise significant challenges that digm shift and acknowledge the role of vari- Public-private partnerships in health have may require to be addressed to ensure health ous partners in the transformation of people’s catalysed progress towards attainment of uni- equity. Here, we are looking at issues to do lives and in the delivery of quality and afforda- versal health coverage in Kenya. The private with quality and therefore, we have to up the sector has made investment in different pri- standards of quality monitoring and feedback ority areas of the health system, ranging from to the private sector. We also have to look at risk pooling, out-patient and in-patient care, issues of having a sound legislative and policy a technical level, at the ministerial level, where retail, pharmaceutical to health education, nu- framework that would support sustainability I chair with the private sector, a ministerial Efforts to take trition, diagnostics, logistics amongst others. of private sector investment in Kenya. We do forum to look at what the private sector is Currently, we have $4.5bn invested by the also recognise the need for us to have frame- running through the opportunities, the chal- philanthropy to private sector in our health sector. It is project- works that allow for continuous and coherent lenges they are facing, and this leads onto a ed in a survey conducted last year that we can consultations with the private sector. next steps conversation where His Excellen- turn business grow this in Kenya to upwards of $11bn in the Finally, I wish to conclude by saying that cy, President Kenyatta, chairs a presidential next 10 years. With a double burden of com- Kenya is cognisant of the fact that the private roundtable, where all the issues that affect the into a truly municable and non-communicable diseases, it sector is not just to be taxed but can also en- private sector are debated. is clear to us in Kenya that we need to mobilise gage in shared value solutions for develop- We recognise it is only by harnessing the transformative private sector resources to support the efforts ment. As we go through rebalancing of the strengths, resources and expertise of the pri- that we are making. Kenyan economy, the government is open to vate sector, coupled with additional invest- force for health I am happy to note that, for example, we dialogue with the private sector, additional ment by the government, that we can uphold have leveraged private sector innovations and business models and social impact investment the current gains and achieve lasting and sus- should be attained accelerated and improved health that will improve health service delivery in tainable health solutions in Kenya and in Afri- outcomes through the managed equipment Kenya. And it is for that reason that we have ca in general. I want to congratulate the brains encouraged service programme launched by His Excellen- set a conservative framework as a country at behind this initiative. It will count for much. n
48 49 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches Halima Aliko-Dangote conveyed her father’s message to the Forum, saying that the The Executive Director of UNAIDS addressed the subject of universal health coverage, challenges for healthcare in Africa present an opportunity for business and calling for insisting that health is a human right and calling on Africa’s leaders to strengthen their the leveraging of public-private partnerships to bring about health-centric development relationship with the private sector to help build a stronger, healthier Africa Address by Address by Halima Aliko-Dangote, Michel Sidibé, Trustee, Aliko Dangote Executive Director, Foundation, on behalf UNAIDS of Aliko Dangote, Chairman of Aliko he world is changing rapidly and today, we must begin to consider a different Dangote Foundation narrative, a different paradigm, to deal The late Kofi Twith universal health coverage. In the context of the current times, it is impossible to Annan once talk about universal health coverage from only the public sector. This is because innovation opined that health is not being driven by governments anymore. elcome to the inaugural African better health. The idea is for all well-meaning Rather, innovation is being driven by the pri- is not a blessing to Business Health Forum 2019. I’d leaders across the continent to participate. vate sector. like to convey my thanks and ap- With this coalition, we hope to help business- Today, we must consider artificial intelli- wait for but rather Wpreciation, especially to the Heads es achieve long-term success by creating a gence and digital health. Disruption by innova- of State and their contribution towards PPPs healthier workforce and society. tion is what powers the strongest economies it is a human right and also trying to see how we can bridge the I believe that private sector leaders have and in a world where disruptive technology financial gap, looking at health in our continent. a strong role to play. As a businessman and is making steady inroads into virtually every to be fought for. We all know of the strong relationship be- through my Foundation, I am committed to area of our lives, it is essential to apply the tween health and economic growth and devel- working with governments and key stakehold- same principle to health. He is right opment. Healthy populations live longer, are ers for the development of impactful health in- I remember when I joined UNAIDS; we more productive, and save more. itiatives in Africa. were giving 18 pills a day to a sick person. We The Healthcare and Economic Growth in In my own country, I have advocated for a would have never, have reached 22m people the public and private sectors will be a part Africa report prepared by UNECA, GBC Health private sector led health trust fund from a 1% on treatment if we were not working with the of it because I am convinced that this Forum’s and Aliko Dangote Foundation, reveals the ex- net profit deduction that the private sector private sector to completely change the dy- message of financing the health of our people tent of the problem – and the opportunity at would contribute to support the public health namic that exists today, namely to treat a sick across the continent could become a reality. hand. In Africa, governments typically control sector. person with only one pill a day. And soon, it I want to highlight that this report also the delivery of healthcare services but that is My objective and wish for this Forum and will be one injection every four months. sheds light on how innovation can bring an never enough. Governments from both devel- hereafter is that we leverage the full power If Africa must achieve universal coverage, added value to what we are doing across the oped and developing countries are increasing- of public-private partnerships, to ensure that technology in all its disruptiveness must play continent. The message is this – Africa’s health ly looking at public-private partnerships (PPPs) we can help shape a health-centric agenda for a leading role and the private sector must be outcomes will change for the better only when as a way to expand access to higher quality Africa’s accelerated development. its driver. the continent’s public and private sectors health services by leveraging capital, manage- I thank you for your attention, your contri- However, universal healthcare is about work together. The key is leadership. rial capacity, innovation and know-how from bution to the Africa Business: Health Forum fighting inequality and pursuing social justice. Leadership is critical. More so is making the private sector. 2019, and for your spirit of partnership. n The late Kofi Annan once opined that health is the choice to lead. Prioritising healthcare fi- The World Bank has highlighted public-pri- not a blessing to wait for but rather it is a hu- nancing is a choice but Africa is now at a junc- vate partnerships across a variety of sectors, man right to be fought for. He is right. Without ture where that choice is a necessity. Stake- and I believe this to be apt to the discussions health being a right for every single individu- holders in both the public and private sectors that follow from this Forum – it is clear that al, it will be impossible to achieve the global must have the will to execute actions that will PPPs can play an important role in mobilising We hope to help 2030 goals. change health outcomes –––– policies benefi- additional forms of financing and closing the How can we go for a sustainable develop- cial to the sector must be pushed; investments infrastructure gap. We need to look at innova- businesses achieve ment goal, when we are seeing vulnerability in must be made; resources must be commit- tive ways to mobilise private investment and different parts of our world? From Baltimore ted. Conversations and actions should not be how to embed the SDG targets into PPP pro- long-term success to Bamako, the vulnerabilities are ever present made in isolation anymore. jects and operations. – people left behind, people not having access I recall the many discussions with Ngozi Africa’s healthcare systems require signif- by creating to quality healthcare. It is clear that public Okonjo-Iweala, then Nigeria’s Minister of Fi- icant investments to meet the needs of their sector alone cannot deliver the gains, private nance, where I pushed for collaboration be- growing populations and economies, change a healthier sector must be involved. tween her ministry and the Ministry of Health the patterns of diseases, and achieve the inter- This reality is made clearer with the health because I believed then, and still do, that in- nationally agreed development goals for Africa. workforce and report that will be launched in the course of vesting in health is not a cost, it is not an ex- Today, we are launching ABCHealth – a this Forum. And I am particularly happy that penditure; it is an investment with real returns coalition of private sector actors engaged for society Africa’s current and future leaders in both that will change people’s lives.
50 51 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches Annex 3: Speeches In his concluding speech, Aigboje Aig-Imoukhuede underlined the importance of working with political leaders to bring about change, and called upon the partners in the African Business Health Coalition to achieve great things Closing remarks by
Only very few countries have been able to achieve the goals set out in the Abuja Decla- Aigboje Aig-Imoukhuede, ration. It is essential that Africa does not slip on that accord. Creating the environment that will encourage private sector to invest in Founder and Chairman health is key. On a recent trip to Awasa here in Ethiopia, I was very impressed with the health services being provided by community health of Africa Initiative for workers through the use of mobile phones. This achievement was made possible by pub- lic-private sector partnership. Governance (AIG) and Co- To the organisers of this Forum I want to thank you for this meeting and before I con- clude, I want us to remember that many of our Chair, GBCHealth countries are facing serious problems with re- gards to investing in health. Without serious investment it is impossible to fight any emerg- ing epidemics like Ebola, for example. We can change Africa’s health narrative. I want to appeal to all of you as a leaders of our continent; to make sure that universal n terms of conclusions, I’d just like to share health coverage becomes a reality. We must with you some of the thoughts that I have also fight stigma, discrimination, and bring the had throughout the day’s programme. The The power of the notion of inclusiveness into whatever we do. Iprogramme has been very powerful, very Thanks for being with us; thanks for making educative and very emotional. Indeed, those Healthcare and this meeting a reality. three factors, you will find, are critical in taking We heard my sister the Minister of Egypt on health challenges. Economic Growth talking about local drug production. It’s a People ask, “Why ABCHealth?” ABCHealth cause for which I have fought for over many confesses very transparently to learning from in Africa report is years. The challenges are plentiful – for ex- what has happened globally in terms of best ample, our continent bears 26% of the world’s practices for how private companies and indi- phenomenal disease burden but we produce only 3% of the viduals in the private sector can come together medicine we consume, yet the global phar- to complement and reinforce the role of gov- maceutical market is projected to grow from ernment in the health area. help our leaders make those political choices. $14bn in 2017 to $22bn by 2025 representing Health is a public good; and let me assure They have the will, but it is not easy to make a threefold increase in only eight years. This you that no government that has any wisdom those choices on their own. The private sec- alone presents a public-private sector part- will delegate the responsibility for health to the tor can be a very strong force to just get them nership opportunity for improving health out- private sector, simply because if you do so you over that last step; that last mile that is the dif- comes through access to drugs, health and are at very great risk of losing many votes. For ference between a hospital and no hospital. jobs all leading to a prosperous Africa. that reason a company or an individual in the The second thing is this: there are immeas- Our potentials are limitless. Working to- private sector will have to learn how to work urable things to do. There are uncountable gether, we can build the Africa of our dreams. n with government in order to make any pro- things to do in Africa. Investing in health in Af- gress. Access to leaders is fundamental. The rica, whether it is for financial or social gain, discussion and challenge at GBCHealth was, will always be impact investing because of the “Why isn’t the African private sector working size of our challenge and the size of the gaps with the AU on health issues?” It was obvious involved. Therefore, if you try to make an im- We can change – why aren’t we working with the AU on health pact in Africa without knowledge and data, as issues? many have said here and in the parallel ses- Africa’s health So, when Vera called me and said she was sions, you tend to make mistakes. putting together the private and the public The power of the Healthcare and Eco narrative. I want to sectors in Addis under the aegis of the AU nomic Growth in Africa report is phenomenal. meetings last year, I jumped on the opportu- I thought I knew health in Africa, and as I read appeal to all of you nity. Vera, knowing that I’m a man of finance, this report, and read it again and again, I real- thought I would want to talk about infrastruc- ised how uninformed I was. This shows you the as a leaders of our ture, trade and so on, and I said “No, no, no – I power of what we can do when we bring the only have an interest in health.” right parties to the table. continent; to make What we have done today, having great Af- The next thing is commitment. Commit- rican leaders in the same room, is to take the ment to health concerns is not easy, for some sure that universal opportunity to influence political will. Without of the reasons that I have mentioned before. political will I can assure you we are not going Take for instance ABCHealth’s co-founder health coverage to make much progress. Aliko Dangote, whose commitment to health But the issue of political will, as Michel said, is – pardon my pun – both infectious and con- becomes a reality is not a lack of will but a need on our part to tagious. This is a man who I have seen pull
52 53 HEALTH FORUM: 12TH FEBRUARY 2019, HYATT REGENCY, ADDIS ABABA
Annex 3: Speeches
his teeth out speaking to primary healthcare workers, speaking to government officials at all levels in Nigeria, working with Bill Gates, and having non-stop brainstorming sessions starting at 8am that don’t finish until 10pm. These are not stories, but things I have seen numerous times. This is a man who has visited more IDP camps in Nigeria than prob- ably anybody in the private sector. For him to find the time to do this, for him to give himself to this – understand that he is passionate and he is committed. But, through pains and gains, he has learnt that to make headway in health philanthropy, you can’t do it alone. You need partners; you need collaborators. This is a very powerful lesson for us. ABCHealth is a coalition. None of us can do it alone; that is why we have a coalition, and the power of us collaborating has no boundaries. Finally, you know, when you are doing so- cial good, it’s important for you to have fun, because there are going to be down periods. There are going to be tough times, you are go- ing to look at certain things you take on and say to yourself, “OK, fine.” We wake up and we say we want to eradicate malaria from half of Ethiopia – it’s not going to be easy. Or from all of Ethiopia – it’s going to be tough. There are going to be disappointments. And for that reason, I find that those organ- isations that take on health most effectively are those who have very strong, resilient cul- tures where people come together and con- nect at the personal and emotional level. So the issue of personal relationships is key and critical. I’ve formed relationships with people in UNECA that I never knew… These relation- ships are mission-critical if you want to sustain this journey in making an impact on health. I’ll round off by saying this whole day has been really terrific. It’s been a labour of love, working towards this from last year. I am really thrilled that it has gone well. I am very proud of all of you and all you’ve done. To those who achieve great things, great- er things are expected. So I look forward to the greater things that will come from the or- ganisations that have come together to form ABCHealth. n
ABCHealth is a coalition. None of us can do it alone; that is why we have a coalition, and the power of us collaborating has no boundaries
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