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Health Care Systems: Time for a Rethink Pain from Crash in Commodity Prices

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Health Care Systems: Time for a Rethink Pain from Crash in Commodity Prices December 2016–March 2017 www.un.org/africarenewal Health care systems: time for a rethink Pain from crash in commodity prices Migrants risk all for Africa's hopes for "better" lives new UN chief CONTENTS December 2016–March 2017 | Vol. 30 No. 3 4 SPECIAL FEATURE COVER STORY Health care: from commitments to action 5 Gains made in fight against malaria 6 It’s time to rethink medical insurance Exercise is key to good health. AMO/T. Omondi 8 Diagnosing Africa’s medical brain drain 10 Lifestyle diseases pose new burden for Africa 12 Public health schemes: Getting it right Dr. Matshidiso Moeti : We can improve health systems in Africa 14 Editor-in-Chief 18 Mental illness: Invisible but devastating Masimba Tafirenyika 20 India’s medical tourism gets Africans’ attention Managing Editor Taking health services to remote areas 22 Zipporah Musau 24 Dying from lack of medicines Sub-editor ALSO IN THIS ISSUE Kingsley Ighobor 26 Young Ghanaians risk all for a "better" life Staff Writer 28 Africa most affected by refugee crisis Franck Kuwonu 30 Commodity prices crash hits Africa Research & Media Liaison 32 Africa welcomes new trade initiatives from Japanese investors Pavithra Rao 34 Morocco flexes muscles as it seeks AU reinstatement Ihuoma Atanga Design & Production DEPARTMENTS Paddy D. Ilos, II 3 Watch: Africa’s high hopes for the new UN chief Administration 38 Wired: Portable ultrasound device to tackle child mortality Dona Joseph 39 Book review 39 Appointments Distribution Atar Markman Cover photo: A doctor examines a young girl in Nairobi, Kenya. AMO/ George Philipas Interns Amelia Tan Africa Renewal (ISSN 2517-9829) is published in supporting organizations. Articles from this Juliette Martin English and French by the Strategic Communications magazine may be freely reprinted, with attribution to Division of the United Nations Department of Public the author and to “United Nations Africa Renewal,” Information. Its contents do not necessarily reflect and a copy of the reproduced article would be appre- Africa Renewal is published by the United the views of the United Nations or the publication’s ciated. Copyrighted photos may not be reproduced. Nations, New York, on recycled paper. Address correspondence to: Subscribe to Africa Renewal The Editor, Africa Renewal Africa Renewal offers free subscriptions to Room S-1032 individual readers. Please send your request to www.un.org/africarenewal United Nations, NY 10017-2513, USA, Circulation at the address to the left or by e-mail to Tel: (212) 963-6857, Fax: (212) 963-4556 [email protected]. Institutional subscriptions facebook.com/africarenewal are available for thirty-five US dollars, payable by international money order or a cheque in US dollars E-mail: [email protected] drawn on a US bank, to the “United Nations” and twitter.com/africarenewal sent to Circulation at the address to the left. 2 AfricaRenewal December 2016–March 2017 AFRICA WATCH QUOTABLES UN Photo/Manuel Elias We need to empower women. Give women a voice in the decision-making process. Give women a political voice where they can champion for their own welfare. And, Secretary-General Ban Ki-moon (right) meets with António Guterres, Secretary-General-designate. of course, for us United UN Photo/Eskinder Debebe Nations, we need to do our part. Margaret Chan, Director-General of the World Health Organization (WHO), Africa’s high hopes for new UN chief addressing a Regional Committee for Africa in Addis Ababa, Ethiopia BY IHUOMA ATANGA world’s most important job, the question remains: what does his appointment Politics affect the prices in s the world waits in anticipation for mean for Africa? the market, the maternal the beginning of a new era in global Born in Lisbon in 1949, Mr. Guterres A mortality rate, whether diplomacy, António Manuel de Oliveira has spent much of his professional life in our children can obtain a Guterres commences his term as the new politics and public service. Before occu- quality education. Politics Secretary-General of the United Nations. pying the position of Portugal’s prime even decide the repro- Diplomats at UN headquarters minister from 1995 to 2002, he held ductive rights of women. rushed to congratulate Mr. Guterres, various posts within the Socialist Party Therefore, we must ensure 67, when he was selected out of a pool from 1974 to 1995. He served as president that our political repre- of 12 candidates vying for the position of the Socialist International until 2005, sentatives expand and last October. South Africa’s ambassador, when he was elected high commissioner protect our rights. Jerry Matthews Matjila, referred to him for refugees (UNHCR) — head of the UN Leymah Gbowee, Liberian Nobel Peace as a “friend of Africa.” Others took to agency tasked with protecting the rights Prize Laureate and UN development social media to congratulate him. and well-being of refugees. During that advocate in an interview Africa, like the rest of the world, time the number of people displaced by with Global Education will be watching closely as he turns conflict and persecution rose from 38 Magazine his attention to issues of global peace million in 2005 to over 60 million in and security, humanitarian assistance, 2015. UN Photo/Rick Bajornas climate change and the 17 Sustainable As high commissioner, Mr. Development Goals (SDGs) that will Guterres headed one of the drive the global development agenda in world’s largest humanitarian the next decade or so. organizations, which at While his experience with Rwanda, the end of his term had South Sudan and Somalia, among more than 10,000 staff other crisis regions, makes him an apt candidate for what some consider the see page 37 AfricaRenewal December 2016–March 2017 3 In our continuing special coverage of Sustainable Development Goals (SDGs), we profile SDG 3, whose aim is to ensure healthy lives and to promote the well-being of all ages. We review the state of health care systems in Africa, with analyses of how to address some of the obvious health challenges the continent faces. HEALTH AND WELL-BEING A doctor exams a child at Rwamagana Hospital in Eastern Province, Rwanda. Rwanda Ministry of Health Health care: from commitments to action Governments should concentrate on providing basic health care and affordable drugs f there is one area that vividly sums In 2001, African countries agreed to leading cause of deaths in the region. WHO up Africa’s development challenges, allocate at least 15% of their budgets to announced last year that the global inci- it is the field of health. Every year, health care. Yet 15 years later, only six coun- dence of malaria had finally been slowed, lack of access to basic health care, tries (Botswana, Burkina Faso, Malawi, largely due to a massive rollout of mosquito Imostly caused by poor funding, contrib- Niger, Rwanda and Zambia) have met this nets, anti-malaria medicines and use of utes to millions of deaths, untold suffering commitment. Even in these countries, uni- insecticides. and harrowing health tragedies on the versal access to decent health care is still Over the past decade, thanks to height- continent. unrealized. ened emphasis on prevention, treatment According to the World Health Organi- It takes a lot of ingenuity to turn the ship and care, the rate of new HIV infections is zation (WHO), Africa carries 25% of the around. For example, Rwanda has man- slowing down as more infected people are world’s disease burden but its share of global aged to setup a national health insurance receiving antiretroviral drugs. health expenditures is less than 1%. Worse scheme which now covers 91% of all Rwan- Africa’s key challenge, however, is con- still, it manufactures only a fraction—less dans. This is in sharp contrast to other fronting what still needs to be done. Gov- than 2%—of the medicines consumed on the African countries where medical insurance ernments should concentrate on providing continent. A majority of Africans, mostly schemes cover, on average, less than 8% of access to basic health care and affordable the poor and those in the middle-income the population, according to WHO. drugs, training more community health bracket, rely on under-funded public health There are a few bright spots in fight- workers and extending medical insurance facilities while a small minority has access ing some diseases. Africa is finally making coverage through creative partnerships to well-funded, quality private health care. headway in the fight against malaria, the with the private sector. 4 AfricaRenewal December 2016–March 2017 Gains made in fight against malaria Africa is finally making headway in its decades-long fight against malaria BY AMELIA TAN he World Health Organization (WHO) announced in Decem- ber 2015 that the global inci- dence of malaria had finally Tbeen slowed, thanks in large part to a massive rollout of mosquito nets, anti- malaria medicines and indoor residual spraying of insecticides. The news was particularly welcome in Africa, where the disease has been the deadliest. Malaria is caused by parasites that are transmitted to people through the bites of infected female anopheles mosquitoes. Between 2000 and 2015, malaria mor- tality rates in Africa fell by 66% among all age groups. Among children under five, who are the most vulnerable to the disease, fatal- ities fell by 71%, from 694,000 to 292,000 deaths, during the same period. Progress in the use of mosquito nets HEALTH AND WELL-BEING has been impressive. WHO data shows that in 2000, just 2% of the 667 million people A nurse takes blood sample from a baby to test for malaria in Manhia, Mozambique. AMO/ L. W. living in sub-Saharan Africa at that time slept under mosquito nets.
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