The future of healthcare in Africa is at serious risk of collapse, warns Dr. Githinji Gitahi, a prominent leader in global public health and CEO of Amref Health Africa. Dr. Gitahi highlights the critical challenges African healthcare systems are facing, particularly the rise of non-communicable diseases (NCDs) such as cancer, diabetes, and hypertension, which are rapidly becoming the leading cause of death across sub-Saharan Africa. Despite the growing burden of these diseases, health services in the region remain underfunded and ill-equipped to handle the escalating demand for care.
The Shift from Infectious to Chronic Diseases
In recent years, foreign aid to Africa has been primarily directed toward combating infectious diseases, such as HIV, tuberculosis, and malaria. While these efforts have made significant progress in controlling these diseases, they have come at the expense of addressing chronic diseases, which are now affecting an increasing number of individuals across the continent. The World Health Organization (WHO) reports that NCDs, including heart disease, diabetes, cancer, and respiratory diseases, are becoming an increasingly prominent cause of death in sub-Saharan Africa. In 2000, NCDs accounted for 24% of deaths in the region, but by 2019, this figure had risen to 37%. Projections suggest that by 2030, NCDs will surpass infectious diseases as the leading cause of death across the region.
The rise of NCDs in Africa is being driven by several factors, including the adoption of unhealthy, Western-style diets, urbanization, less physically active lifestyles, and air pollution. These changes are leading to a sharp increase in the prevalence of diseases like obesity, hypertension, and diabetes. According to Dr. Gitahi, these factors, combined with the current state of the healthcare system, are creating a perfect storm that could lead to the collapse of Africa’s health services in the coming years.
A Health System Straining Under the Pressure of NCDs
Dr. Gitahi’s warning is stark. “Africa has a big risk of collapse of health systems in the next few years because of NCDs,” he states. In many African countries, NCDs already account for 50% of all hospital admissions, yet the majority of the care for these diseases is paid for out-of-pocket by individuals, a burden that most cannot afford. According to Dr. Gitahi, over 80% of NCD care in the region is funded privately by patients, and many African governments lack the financial resources to cover the cost of treatment for chronic diseases. This leaves many patients without access to the necessary medical care, resulting in avoidable deaths and worsening health outcomes.
The inability of African governments to address the rise in NCDs is compounded by their reliance on foreign aid, which has historically focused on infectious diseases that could pose a threat to donor countries. This foreign aid has played a critical role in combating diseases like HIV and tuberculosis, but has done little to address the chronic disease crisis that is now sweeping across Africa. As a result, the continent’s healthcare systems are ill-prepared to tackle the growing epidemic of NCDs, leaving many people vulnerable to preventable conditions that could lead to death or disability.
The Role of Multinational Corporations and Lack of Government Action
Dr. Gitahi also points to the role of multinational corporations, which continue to profit from the sale of unhealthy products such as tobacco, alcohol, and sugary foods, as a major contributing factor to the rise in chronic diseases. He believes that African governments are failing to regulate these industries effectively, and that politicians are too focused on short-term goals, such as winning elections, rather than tackling long-term health challenges that could have a profound impact on future generations.
“Aid is not charity,” Dr. Gitahi explains. “It is strategic investment by a country to protect its own internal interests.” He argues that while foreign aid has been directed toward addressing infectious diseases that pose a risk to the donor countries, there is little support for NCDs, which affect millions of people in Africa but are often seen as less urgent by the international community.
Dr. Gitahi believes that African governments must take greater responsibility for managing the rising burden of chronic diseases. This means enacting stronger regulations to reduce the consumption of unhealthy products, increasing investment in healthcare infrastructure, and prioritizing prevention efforts. Governments should also look to successful models in other parts of the world, such as Western countries, which have implemented policies to limit the marketing of unhealthy foods to children and have introduced taxes on tobacco and alcohol to fund health programs.
The Impact of US Aid Cuts on African Health Programs
The situation is further exacerbated by recent changes in global health funding, particularly the reduction in U.S. overseas aid. Under the administration of former President Donald Trump, the U.S. government imposed a freeze on much of its overseas aid spending, including funds allocated to health programs in Africa. Dr. Gitahi acknowledges that Amref Health Africa’s operations have been affected by these funding cuts, with some of its staff placed on unpaid leave due to the uncertainty surrounding future financial support.
“We do about $250 million of work a year,” Dr. Gitahi explains, “and $50 million of that is actually U.S. government partnerships.” He stresses that despite these setbacks, there is hope that the funding will resume after a 90-day review period. However, the long-term consequences of these cuts are still uncertain, and many health programs in Africa are at risk of being delayed or canceled altogether.
The Need for Efficient Governance and Taxation of Unhealthy Goods
Given the financial challenges facing many African governments, Dr. Gitahi suggests that countries on the continent must find innovative ways to fund healthcare services. He proposes the introduction of taxes on unhealthy goods, such as sugary drinks, tobacco, and alcohol, with the proceeds being earmarked for health programs. This could help generate the revenue needed to address the growing burden of NCDs and improve access to care for millions of Africans.
In addition to this, Dr. Gitahi calls for greater efficiency and accountability in the use of public funds. Governments must work to reduce corruption and ensure that health resources are used effectively to address the most pressing health needs. This includes improving the availability of essential medicines, expanding access to healthcare services, and investing in the training and retention of healthcare workers.
Solidarity and Global Cooperation: The Key to Africa’s Health Future
Ultimately, Dr. Gitahi believes that Africa’s health challenges can only be addressed through global cooperation and solidarity. He stresses that weak healthcare systems in Africa pose a risk not only to the continent but to the entire world. “When you have a weak health system in any country,” he says, “it is like having an insecure airspace in any country. That poses a risk to the entire world.”
He also emphasizes the importance of a unified approach to global health that goes beyond donor countries’ self-interest. African governments need to be supported in their efforts to address NCDs, and the international community must recognize that health security is a global issue that requires a collective response.
Dr. Gitahi’s warnings about the collapse of Africa’s healthcare system due to the rising burden of chronic diseases are a stark reminder of the urgent need for action. While foreign aid has played a critical role in addressing infectious diseases, it is clear that more attention must be paid to the escalating health crisis posed by NCDs. African governments must step up their efforts to address the root causes of these diseases, while the international community must recognize that health security is a global issue that requires collective action.
Without urgent intervention, Africa’s health systems could face collapse in the coming years, and millions of people across the continent could continue to suffer from preventable diseases that could be managed with the right resources and infrastructure. The time for change is now, and it is up to all of us to ensure that Africa’s health future is one of hope, equity, and sustainable development.