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AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS?

AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS?. SARALA NAICKER Division of Nephrology University of Witwatersrand Johannesburg, South Africa. FACTS. second largest continent- over 30 million square kilometres 53 countries > 760 million population Population growth 2.3%

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AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS?

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  1. AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS? SARALA NAICKER Division of Nephrology University of Witwatersrand Johannesburg, South Africa

  2. FACTS • second largest continent- over 30 million square kilometres • 53 countries • > 760 million population • Population growth 2.3% World Bank Report, 2002

  3. World Bank Report, 2002 • life expectancy at birth: 47 years • infant mortality: 91/ 1000 live births • maternal mortality: 175-200/ 100 000 live births • HIV/AIDS: 28.5 million persons infected > 18 million deaths

  4. ECONOMIC DATA • SubSaharan Africa: < $1 per day 291 million • North Africa: < $2 per day 30% of population

  5. Annual healthcare expenditure • Uganda: US$ 9 per person • Tanzania: US$ 3.2 per person • Mozambique: US$ 2.0 per person • UK: US$ 1780 per person

  6. South Africa: Expenditure • Health care: R33.2 billion $100per capita per year 3% of GDP • Crime/ violence: 6% of GDP

  7. DOUBLE BURDEN OF DISEASE • Botswana: HIV/AIDS 333000 39% of population 15-49 yrs Non-communicable disease: increase in cancer DM HPT

  8. Physicians/ 100,000 Population • Niger 3.5 • Benin 5.7 • Ghana 6.2 • Cameroon 7.4 • Togo 7.6 • Ivory Coast 9.0 • Nigeria 18.5 • USA 279 Rockeller Foundation, 2003

  9. BRAIN DRAIN FROM AFRICA • Ghana: 60% medical emigration • Zambia: 50/600 graduates in public sector • South Africa: 30-50% emigration annually • Zimbabwe: 360/1200 still practising in 2001 • Sudan: 17% emigration in 1985-1990

  10. NURSING BRAIN DRAIN • Ghana: 2000 in one year • Zimbabwe: 18000 nurses abroad • South Africa: nurses with greatest expertise

  11. Cost of medical emigration • Each professional: loss of $184000; cost of training a doctor in UK £ 200-250,000 • South Africa (1997): loss of R67.8 million ($10 million)

  12. Can Africa solve its own health problems?

  13. The first step…….

  14. NEPAD Primary responsibility for success rests on governments and people of Africa

  15. Governmental agreements • Education and training in Africa in African institutions • Trainee returns home after training period- no brain drain to South Africa

  16. ISN Fellowship • Training according to needs of home institution • Trainee returns to render service to home country

  17. PREVENTION PROGRAMMES • Botswana: non-communicable disease surveillance, prevention and control • Egypt: Schistosomiasis eradication • South Africa: smoking, HBV vaccination, CKD prevention programmes • Uganda: HIV/AIDS

  18. INTERNATIONAL PARTNERSHIPS • Government ministries of health • International agencies • ISN • WHO • Other • Academic centers • Foundations • Pharmateutical companies

  19. INTERNATIONAL PARTNERSHIPS • Build capacity • Job creation • Alleviation of poverty • Education and appropriate training of healthcare workers eg. in prevention • Public education/ health promotion

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