October 27, 2021

While still putting together the dots: why can’t Africa prioritise public health?

5 min read

In 2014, the whole of West Africa was in a panic. The sub-region was struggling with the Ebola viral disease, the worst health crisis in the 21st century that killed thousands of poor people in the three most affected countries in the Mano River Union (Sierra Leone, Guinea and Liberia).

Water1
Most communities in Africa rely on stream water for household use

By Alpha Bedoh Kamara


It was total devastation for the three countries, social, political and economic activities grounded and mothers afraid to touch their children.

The crises, severe and devastating, exposed the nakedness of the healthcare systems of the three countries and lack of foresight and preparedness by the governments despite tremendous support by the international community, United Nations, and other international bodies, to address healthcare systems in Africa.

Though the crises are over, the people are still on edge because the healthcare systems are still unstable. Accessibility to affordable standard healthcare is a dream for millions of poor people and whiles the governments seems to impress the international community with laudable policies, millions of poor people still depends on bush doctors for healthcare.

The clinical aspect of healthcare is a total failure in most African countries considering the poor response of public healthcare. The challenges webbed: poor healthcare infrastructures, high rate of poorly trained healthcare providers, corruption, exploitation, and disregard of duty.

These challenges are the enigma in healthcare in Africa, but again, while African countries are still putting together the dots, why can’t public health be prioritised so that millions of people will be able to take better decisions to live better healthier lives?

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In 2015 alone, there were 214 million new cases of malaria reported – UNICEF

Public health enables a nation to protect and improve the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases.

The Ebola crisis, prevalence of malaria, tuberculosis (TB), HIV/AIDS, hepatitis, cholera, typhoid, and others, are diseases that can best be addressed with sustained and effective public health management systems; unfortunately, these communicable diseases, which could be controlled and stopped from spreading with just information and policy implementation, are causing millions of deaths each year.

According to the World Health Organization, ‘diarrhoea disease is the second leading cause of death in children under five years old and kills around 760 000 children under five each year.’

Lack of in-depth public health understanding by African governments continues to haunt the wellbeing of millions of people in the continent and like what befell West Africa in 2014, amidst the many other communicable and curable diseases; a similar fate will do worse because the leaders are still waiting for the international community to address local challenges.

During the Ebola pandemic, The WHO had to carry out the nationwide supply of Artesunate–Amodiaquine in the three affected countries to control the growing death rate, because more people were dying as a result of malaria. And like malaria, many people in Africa are dying due to high blood pressure, diabetes, and diarrhoea, diseases which can best be taken care of through protection.

The prevalence of raised blood pressure is highest in Africa; with prevalence rates over 40%, affecting both men and women.

Also, a new report from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington highlights the substantial prevalence of diabetes in Africa.

According to the 2015 Global status report on road safety, the WHO African Region had the highest rate of fatalities from road traffic injuries worldwide at 26.6 per 100 000 population for the year 2013 and over 85% of all deaths and 90% of disability.

Faced with a high rate of illiteracy, unemployment and poverty, political instabilities, climate change impact, and communicable diseases burden, African governments should prioritise public health response to protect the people. It is a shame that only a few African countries can boast of a research-based public health national centre that focuses on their country’s health burden. The rest depends on the WHO and other international agencies such as UNICEF to carry out the work.

There is so much that needs to be addressed, the way of life, such as the influence of religion, cultural practices and food to public health, also influence of mining activities and agricultural activities, budding construction and manufacturing industries.

Unfortunately, abuse and violations dictate affected mining communities as perpetration by government officials and investors continued with impunity without the due process of international standards. Communities are exposed to chemicals and forced to abandon their communities, like in Kono District, East of Sierra Leone, wildlife has disappeared and water facilities destroyed, affecting community members.

The Kono situation, like other mining activities throughout the country, will be better addressed if the government prioritised the public health status of the country by ensuring proper research structures for each of the issues affecting the general populace.

Like Sierra Leone, Guinea and Liberia face the same situation as can be said of most African countries. And though understandably investment is good for the economies, yet the interest of the people must be first and thus the importance of ensuring their protection from exposure to health hazards.

The United Nations and foreign governments are doing their best to intervene not because they like the faces of the leaders, but are doing so because they feel for the millions of people burdened with curable diseases.

The most vulnerable are the women and children, and the elderly, who makes the majority of the population. Health ministries will argue they have pragmatic healthcare reforms and infrastructures in place but how they impact on the wider public is the bane of contention. There is absolutely nothing for millions of people in Africa to hold onto as information from national public health officials guiding them about the health impact of their way of life.

Of course, governments always have something to point to as justification of public health engagements: spending millions of donor money on ‘world health day commemorations, water day, etc.’ and over budgeted flyers placed around urban towns for the few illiterates to read, while throughout the year the various health burdens eat the fabrics of society and monies already pilfered ending in private pockets.

People are dying in silence! It is time issues that need local interventions be taken care of because it only needs political will and right policies to make that happen.

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