Afrika Verein and German Healthcare Alliance host a satellite event at World Health Summit 2019
What kind of German healthcare industry investments are African governments calling for – and how do these relate to the new forms of collaboration championed by the OneHealth approach and the Global Action Plan for Healthy Lives and Well-being for All? This article reports on the 6th German African Healthcare Forum convened under the patronage of the Federal Ministry for Economic Cooperation and Development (BMZ).
On 30 October 2019 Christoph Kannengiesser, CEO of the Afrika Verein, Roland Goehde, Chairman of the German Healthcare Alliance, and Stefan Liebing, Chairman of the Afrika Verein, jointly opened the 6th German-African Healthcare Forum which was held under patronage of BMZ. Around 250 delegates, many of them representing the German healthcare industry, had assembled in the packed conference hall at Berlin’s RIU Plaza Hotel to learn more about opportunities to invest in Africa’s healthcare sector – for good reason.
According to Liebing, healthcare spending in Africa currently stands at 54 billion Euros. ‘This is a market not to be forgotten by the German healthcare industry. We need to take a closer look at Africa, and not only in relation to health.’ Through its recently launched Development Investment Fund ‘AfricaConnect’, BMZ provides loans to German and European companies who want to sustainably invest in Africa’s growing markets. This provides a good basis for the development of business in Africa, according to Liebing, but there is always more that can be done. ‘We need to strengthen or create our own customers. Where African healthcare institutions don’t have the funds to just buy products, let’s think about pay per use and co-investments. We now need new disruptive business models to take the next step that is so urgently required.’
‘Without healthy people, there’s nothing we can do’
The Vice President of Liberia, Jewel Howard-Taylor, began her keynote address by thanking the German government for its support during and after the Ebola crisis, enabling Liberia to establish new surveillance mechanisms for the detection, containment and treatment of infectious diseases (see also this recent article). ‘Liberia has made a record turnaround and we are really grateful and want to say it here at this forum.’ Other countries facing outbreaks could now learn from Liberia: ‘Use the experience from our country, there is no need to reinvent the wheel.’
Howard-Taylor expressed her agreement with the Forum’s focus on cross-sectoral collaboration and linked this to the OneHealth approach, which is assuming a prominent place in international discussions. According to Howard-Taylor, the concept of OneHealth resonates with many Africans: ‘Africa understands the interrelated circle of life – human, plants, livestock, and the environment – and this gives us a bit of an edge when it comes to new integrated programmes.’ Yet the integration needs to happen not only with specific interventions, but also in national and global politics. The important role health plays in the 2030 Agenda should be seen as opportunity by decision-makers at all levels: ‘Use health and well-being as a linchpin to make our one world a better place for everyone and not just for a few.’ This should concern all of us, no matter where we sit and what kind of institution we represent: ‘If we don’t have healthy people, there’s nothing we can do.’
African health ministers invite investment in digitalisation and beyond
In the panel discussion that followed, ministers of health from Ethiopia, Guinea-Bissau, Mali, Sierra Leone and Uganda, as well as the Health Commissioner for Lagos State in Nigeria, shared insights into the situation in their countries’ healthcare systems and outlined the kind of external investments they are hoping for. The discussion was moderated by Judith Helfmann-Hundack, a BMZ-commissioned Development Scout with the Afrika Verein.
The need for support with IT-infrastructure was a recurring theme, with Uganda’s Health Minister Dr Jane Ruth Aceng being particularly frank: ‘A challenge for many African countries is data collection in real time. If you want to come to Uganda to invest, invest in data. For decision-making during outbreaks, but also for the management of health services we need data and we need it real quick. And,’ she added for good measure, ‘I don’t want any more pilots. I need an investor who will invest across the entire country in statistics, and then we can benefit from one another.’
Sierra Leone’s Health Minister, Professor Alpha Wurie, emphasised the importance of rebuilding his people’s trust in the healthcare system following the Ebola epidemic, in which many patients and health care workers died because effective outbreak response plans had not been in place. Sierra Leone is currently increasing the size of its health workforce by 40 per cent, from 10,000 to 14,000 health care employees. Effective laboratory services, including IT systems that can relay tests results without delay, are another building block for regaining the population’s confidence. ‘We still have a long way to go, but we are getting there,’ said Wurie.
Dr Magda Robala Silva and Michel Sidibe, the ministers of health of Guinea Bissau and Mali, respectively, agreed that digitalisation is one way to ensure that state-of-the-art health expertise is brought to facilities countrywide, even in resource-poor settings like those they come from. Sidibe invited German industry to consider investing in a Mali-wide digital dispensary network ‘to reach people quickly with all the healthcare knowledge that exists today.’
For Dr Lia Tadesse, Ethiopia’s Health Minister, a country’s efforts to improve population health has to start at the community level and encompass actors beyond just the health sector and beyond government. In a large and diverse country like Ethiopia, a multitude of partners have to be pulled in to ensure access and equity. German industry is welcome to join these efforts, be it in the fields of pharmaceutical manufacturing, tertiary health care or digitalisation. Ethiopia’s government commits to creating an environment conducive to collaboration and partnerships that cut across silos and borders.
Professor Akin Abayomi, Health Commissioner for Lagos, Africa’s largest megacity with a population of 24 million, spoke about the particular threats to which densely populated, water-rich environments like his city are prone: ‘Our focus is building biosecurity resilience through primary health care structures, the base of the healthcare pyramid.’ Sustainable health financing is equally important: ‘We have tried to make health free for all, but I don’t think any state in Africa can sustain a free health strategy – it is simply too expensive.’ In Abayomi’s view, statutory health insurance allows governments to run sustainable healthcare systems whilst encouraging people to take responsibility for their health care by paying annual contributions. Summing up the investment priorities for Lagos, Abayomi named infrastructure, human resources and training, health financing and eHealth. ‘If you have any experience introducing national health insurance schemes, we’re open for discussions.’
Two cordial invitations
Echoing earlier panelists’ pleas, Abayomi concluded with a call for one particular healthcare partnership of global dimension: He invited Africa’s sizable diaspora of health professionals to join efforts to strengthen their countries’ healthcare systems. ‘We are anxious to attract you home, whether for short-term visits or permanently. Just don’t forget your home!’
At the close of the panel discussion, Jane Ruth Aceng, the Ugandan Minister of Health, also extended a warm invitation. She encouraged everyone present to attend the first World Health Summit regional meeting to be held in Africa, which will be hosted and organised by Makerere University and the Government of Uganda in April 2020. ‘We have a beautiful country. Come and see for yourselves!’
Anna von Roenne and Karen Birdsall,