By Sakhile Dube
Johannesburg February 2020. The lack of infrastructure is one of the key challenges facing the healthcare systems in Africa. We should not look at healthcare infrastructure only as in brick and mortar, it is broader than that – comprising of healthcare workers, technology and linkages with patients and the community.
Without a doubt, we do not have sufficient healthcare infrastructure to function effectively. According to the latest report from IFC, Africa needs over 500 000 additional hospital beds, about 90 000 physicians, 500 000 nurses, and 300 000 community health workers. In addition to this gap, an estimate of about $25-$30 billion in new investment will be needed to meet Africa’s health care demand in the next decade.
Covid-19 taught us that an effective response depends on the presence of a strong healthcare infrastructure. With only a few countries able to spend over $40 a year per person that the World Health Organization considers the minimum for basic health care, we are then forced to rethink more investments in healthcare.
Healthcare investments should be done smartly. Smart investments should be open to newer funding models of healthcare infrastructure, looking at it both as social infrastructure investment and as a different asset class. Such investments should include an understanding of what the minimum viable product is for a facility and its operations, and be geared towards sustainability. Sustainable healthcare infrastructure can open up more market forces to be at play in reshaping the industry for future epidemics. While healthcare ought to be regulated, it should be more open for the private sector to play even more.
Other countries in Asia, the USA and Europe have pivoted their investments into research to be useful in setting them squarely on the road to getting a vaccine for future use. With Africa lagging in investments including both day to day healthcare operations and research, we have little to pivot from and simply are demanding that a vaccine should also be available for us which is another healthcare cost.
In addition to what we have learnt from other continents, we need to adopt localized healthcare infrastructure innovations and solutions. We also need to be agile and rethink our financing models. Blended financing is an option and de-risking some of the financings by using donor investments and crowdfunding has been seen to work.
We have seen the blessing in disguise of Covid when some of the digital platforms were catapulted into action. Digitization often construes less contact, less manual and less face to face interactions. These are all ideal for the prevention of the spread of Covid. When reimbursement models can facilitate this, it’s a no brainer to align the incentives of all the players in the healthcare value chain. The role of digital healthcare infrastructure is to enable healthcare as an industry to be scaled without the requisite lifting that often takes healthcare projects decades to be executed.
The healthcare industry is dependent on things that have been done the same way for centuries. It is difficult to execute the requisite processes and procedures to respond to an epidemic that is primarily community transmitted and where case management requires well-trained specialists given its novelty. It also becomes difficult to initiate younger innovative professionals in some of the spaces. In this case, more mentorship programs are needed at a scale to particularly develop the human capital side of healthcare.
Sakhile Dube is a writer and an activist passionate about healthcare. She is a graduate of Rhodes University and the University of South Africa. Currently pursuing her Masters in Journalism and Media Studied at the University of Witwatersrand.