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WHO blames African leaders for health inequality

August 30, 2017

With many African leaders seeking healthcare abroad, the WHO's Director General, Tedros Adhanom Ghebreyesus, is calling on them to take action to improve health care services in their own nations.

Doctors at the Kenyatta National Hospital in Nairobi, Kenya
Image: picture-alliance/dpa/Kenyatta National Hospital

At a meeting of African health ministers in Zimbabwe's premier resort town of Victoria Falls, WHO Director General Tedros Adhanom Ghebreyesus recalls an encounter he will never forget. "I visited Yemen and I met a mother and her malnourished daughter who had traveled for hours to reach the health center. The mother was begging the medical staff to take care of her child," he told delegates. "It’s this moment of human suffering that was my moment of truth." 

The image is a warning for the attending ministers. A recent study by the World Health Organization found that a lack of political will and little financial allocation to the health sector were to blame for health inequalities in Africa.

Read more : Zambia hospitals overwhelmed with too many patients, fewer doctors

Now the WHO head is on a mission to mobilize African leaders to improve health systems if universal health care is to become a reality.

"A focus on all building blocks of the health system will be important," he told health ministers from across the continent on Wednesday. "Be it the infrastructure or human resources, service delivery, information systems, access to medicine and governance." 

WHO Director General Tedros Adhanom Ghebreyesus
WHO Director General Tedros Adhanom Ghebreyesus was formerly Ethiopia's Health Minister and Foreign MinisterImage: DW/T. Woldeyes

Leaders seek health care abroad

47 African health ministers are attending the 67th annual session of the World Health Regional Committee this week. The meeting comes at a time when poor health infrastructure, lack of specialized treatment and provision of medicines has driven several African leaders to seek medical care abroad.

South African Health Minister Aaron Motsoaledi lashed out at African leaders who seek medical treatment outside the continent, describing the practice as a heavy drain on national health budgetary allocations.

"I do not like the fact that Africa is the only continent on this planet in which, when its heads of state are sick, they have to be taken care of in another country - or another continent for that matter," he complained. "The only time when we will say the health systems in Africa are working is if everybody, including heads of state, are able to get treatment within the continent." 

Many African presidents, among them Zimbabwean President Robert Mugabe, Nigerian leader Muhammadu Buhari and former Angolan President Jose Eduardo dos Santos, are known for seeking medical services abroad.

Nigeria's President Buhari after his return from the UK
Nigerian President Muhammadu Buhari has recently returned to his country after three months of medical leave in Britain Image: Reuters/Nigeria Presidency Handout

Health inequalities growing

WHO's regional director for Africa, Matshidiso Moeti, said that health inequalities are fast growing in most African countries owing to the widening social gap between the rich and the poor.

"With the sustainable development goals which were recently adopted by all the countries, we have new opportunities to advance health care and specifically universal health coverage." Moeti said. "We must also place emphasis on resilient, robust health systems that can be delivered to everyone, something that was not emphasized in the Millennium Development Goals."

WHO Director General Ghebreyesus urged countries to allocate more funds to the health sector in order to prevent diseases and, therefore, save money. 

"We should move from a process-based to a results-oriented approach," Ghebreyesus said. "We should try to measure the impact" - for example, the number of lives which can be saved. 

Challenges facing Africa

WHO's report on the progress of health outcomes in Africa shows that non-communicable diseases, tuberculosis and access to mental health services are some of the biggest health concerns affecting African countries.

Yet funding to tackle these problems is lacking: "To some extent, the programs are relatively underfunded and need more resources," Moeti said.

"TB should be given serious attention." Ghebreyesus said. "It is very expensive to treat TB but if we implement preventive measures, this will help us in reducing the cost of treatment."

Read more: Drug resistant tuberculosis a major concern in Ghana

He added: "On the issue of NCDS [non-communicable dieseases] and tobacco, you need to take discussion forward to the African Union. This needs a serious debate and only our leaders can help us improve the lives of the people." 

On mental health, Ghebreyesus said that communities should stop viewing patients suffering from mental illnesses as criminals because they need to receive psychosocial support rather than being put behind bars where their health will deteriorate. 

Old targets, new problems 

Ghebreyesus noted that in order to address the challenges that African countries are facing, governments must comply with the 15 percent Abuja declaration on health financing. This is a pledge that was set by African Union countries in 2001 to allocate at least 15 percent of their annual budget to improve the health sector and at the same time urge donor countries to scale up their support.  

16 years later, data from WHO showed that only one African country has reached this target. Twenty-six countries had increased the proportion of government expenditures allocated to health and 11 had reduced it. In the remaining nine countries there was no obvious trend up or down.

At the meeting in Zimbabwe's Victoria Falls, health experts were in agreement that all roads should lead towards universal health coverage. The question, however, will be whether African leaders will ensure that their citizens have access to this basic human right, as outlined in the sustainable development goals.