The Future of Healthcare in Africa

PERSPECTIVE

By Obinna C. Oriaku

Introduction:

How much does Africa spend on healthcare? By all accounts, healthcare in Africa remains the worst in the world. Per capita expenditure by African countries fall woefully short of the minimum WHO recommendations of $44.00 per person. Brain drain complicates the situation by denying Africa the human capital necessary to build out a robust system. Conversations  are ongoing about the best way to mitigate this challenge. We propose one solution to this vexing problem.

The Problem:

In their recent article, the International Finance Corporation (IFC), a World Bank Group, estimated that in the next decade, sub Saharan Africa would need up to $25 – $30 Billion in new investments to meet its healthcare needs. This money, they believe would be needed to go towards building out hospital beds; production, storage & distribution of pharmaceuticals as well as training and hiring tens of thousands of doctors and nurses. They also state rather bleakly that “ health care in Sub-Saharan Africa remains the worst in the world, with few countries able to spend the $34 – $40 a year per person that the World Health Organization considers the minimum for basic health care.”

Let’s juxtapose this assertion with the reality on the ground in Africa, using Nigeria as an example. Since the 1980’s, there has been a constant migration of highly qualified professionals out of Nigeria seeking greener pastures abroad. This so-called brain drain, initially a mere trickle, has become a veritable exodus as the political and economic realities in Nigeria have worsened. The reality today is that most (if not all) young doctors and nurses complete their training with one eye on the lookout for the next opportunity to immigrate to the west where there is a promise of both a more fulfilling career and a more comfortable lifestyle. To demonstrate, according to a 2021 report, there are over 10,000 Nigerians in the NHS, England.

The Human Resource for Health in their article published in 2017 stated that in the last decade, about one Africa-educated doctor was migrating to the USA per day. Between 2005 and 2015, International Medical Graduates (IMGs) from Africa increased by 27%. That number is estimated to be more than 17,000 today. The Association of Nigerian Physicians in the Americas, (ANPA) has over 4000 doctors and other healthcare professionals in its ranks.

Attempted Solutions:

At present, a lot of groups organize medical missions at great personal cost to help alleviate the healthcare needs in their home countries. These missions serve a great purpose and bring a lot of hope and relief of suffering to many. However, by the very nature of these trips, the impact, though profound, may not be sustainable in the long run. These dedicated healthcare professionals at great personal expense, leave their jobs here to answer the call to serve the motherland. One of our colleagues actually died of a heart attack while on one of these missions because when he needed it, the resources to save him from a massive heart attack was not available to him.

The international donor community and philanthropic organizations (Bill Gates Foundation, the World Bank, et al) have played an important role in reducing the impact of such communicable diseases as HIV/AIDs, polio, malaria and tuberculosis. A new crop of healthcare facilities are also springing up in major metropolitan centers in Nigeria such as Lagos, Abuja and Port Harcourt that have been designed, built and run with western standards in mind. These however only serve the very well heeled who would otherwise travel abroad for their care. These hospitals have in mind the thriving medical tourism industry in Nigeria, estimated to be about $1.2B – $1.6B per year. Unaccounted for are the millions of Nigerians that cannot afford this rarified access. In 2019, Nigeria’s healthcare expenditure per capita was $71.00. This is as compared to the per capita expenditure of Australia ($5,187.00), Canada ($5,418.00) and South Africa ($547).

A New Dawn:

The recent rapid acceptance of telemedicine, which was boosted by the Covid 19 pandemic, is an opportunity to deliver quality healthcare to sub-Saharan Africa in a predictable and cost effective manner across geographies at the fraction of its present cost. The ability to eliminate travel and security costs alone, not to talk of lost productivity from the healthcare professional’s primary job all portend a new way of doing things that would benefit both the giver and receiver of care. We have designed SocratesMD with this solution in mind. We are leveraging Nigerian born or Nigeria affiliated healthcare professionals to bring care to our loved ones on the continent at a fraction of the cost of traditional care. We can also extend our services to provide after hours specialty coverage to large hospitals in Nigeria, taking advantage of the 5 – 6 hour time difference (depending on time of year)  between the USA and Nigeria. Our physicians come from all specialties including internal medicine, cardiology, gastroenterology, oncology etc. In the meantime, we are also developing a network of affiliated hospitals, pharmacies and diagnostic labs to help deliver the last mile of care to our patients.

Conclusion:

The challenge of delivering quality healthcare across the teeming population of Africa is daunting. No one solution addresses all aspects of the problem. As economic and security challenges worsen across the continent, or for that matter, if another pandemic were to shut the world down, medical missions to Africa and reverse migration of African born experts become wishful thinking. The high level of adoption of mobile technology across Africa for communication, social media interactions, banking etc provides opportunity to leverage this technology to reach a greater number of people with quality healthcare at an affordable price point. SocratesMD is uniquely positioned to bring about this change by harnessing the brain trust of the African diaspora to effect change in Africa.

Obinna C. Oriaku, MD, MBA, FACP, CPE

SocratesMD

4500 South Tryon St, Charlotte, NC 28217