Welcome to the Improving Healthcare in Africa blog!

My goal is simple: To define sub-Saharan Africa's high priority healthcare problems and invest in solutions that will benefit current and future generations. This blog is the starting point of this mission.

I spent the first half of my life in Ghana, the initial country in sub-Saharan Africa to gain independence from colonialization and currently one of Africa's most stable democracies. Growing up in the capital city of Accra, I witnessed firsthand how decades of underinvestment in healthcare led to the avoidable deaths of close family members and friends. When I graduated from high school in Ghana in the early 2000s, the official life expectancy was 59.2 years. Two decades later, the figure is now 66.3 years.

This improvement in life expectancy belies the fact that medically avoidable deaths and sub-standard care are still prevalent in Ghana and other parts of sub-Saharan Africa. A routine procedure such as a hernia surgery can lead to fatal complications due to lack of skilled medical personnel and/or unchecked negligence. In rural and peri-urban areas, during maternal emergencies family members sometimes have to carry pregnant women on their backs (or hire a motorbike-taxi if they can afford it) to transport these women to a hospital because of inadequate ambulance services. Some women have to give birth on bare floors due to inadequate maternity beds, if they are lucky enough to make it to the hospital.

Ghana is far from being alone when it comes to healthcare issues like these. In most of Africa a cancer diagnosis is a death sentence. In neighboring Ivory Coast, the world's leading producer of cocoa, 74% of breast cancer cases are diagnosed at stage III or IV, when irreversible damage has already occurred. In the Republic of Congo, that figure is even higher at 87%. Demand far exceeds diagnostic capacities because of a dearth of infrastructure and personnel. More than 20 countries in Africa do not have a single Radiation Therapy (RT) center; by contrast, the United States has 2,555 RT centers. Kenya, considered to be one of the brighter spots on the sub-Saharan Africa healthcare landscape, has one oncologist for every 3,000 cancer patients, compared to 150 in the United States and China. Most countries in Africa do not have a single native radiation oncologist.

Over the past twenty years, Ghana and many other countries in sub-Saharan have made some progress in improving healthcare for their people. Some countries (including Rwanda, Nigeria, and Ghana) have established national health insurance schemes that provide coverage to some segments of their population, while others have taken bold steps towards the Sustainable Development Goals (SDG) such as reducing child mortality. However, sub-Saharan Africa is now facing a double disease burden of both infectious and non-communicable diseases, and this is currently straining healthcare systems there. According to the World Health Organization (WHO), diabetes, cancer, heart and respiratory diseases will be the leading causes of death in Africa by 2030. Getting ahead of this challenge would require a quicker pace of progress over the next decade. Currently, sub-Saharan Africa spends less than 5% of GDP on healthcare, significantly less than the 9% spent in 2022 by the OECD, a region that has a lower overall disease burden. More than twenty years after the 2001 Abuja Declaration—a pledge signed by all 53 African countries at that time to devote 15% of their budgets to healthcare—many of these countries are still nowhere near this goal. In the Southern Africa Development Community (SADC) region (which is made up of 16 countries), the average annual allocation to healthcare is only 5.3% of national budget. Without the required investment and innovation, some sub-Saharan African healthcare systems, already overstretched in the pre- and post-pandemic era, may collapse in the near future.

Africa is home to the world's youngest population, with 70% of people under the age of 30

The story of healthcare in Africa is not all dire. With the youngest population in the world (70% of sub-Saharan Africa is under the age of 30) and an incredible ability to innovate in the face of challenges, Africa is capable of rising to the challenge of developing agile, sustainable, and scalable healthcare solutions to keeps its people healthy and productive. A vital and healthy population can help propel Africa into the next century of prosperity. Some studies have suggested that a one-year increase in life expectancy could lead to an increase in GDP per capita by about 4%. For Africa to become the next manufacturing hub like China or the source of skilled tech resources like India within the next 20 years, the time for action is now.

To mitigate these challenges facing healthcare in Africa, I have developed a three-fold mission:

• To define the key problems of affordability, quality, and equitable access

• To propose solutions to these problems

• To partner with private and public stakeholders to deliver these solutions.

So, what can readers expect to see in this blog? My target readership is both African and non-African, cutting across stakeholders such as policy makers, investors, medical personnel, students, humanitarians, ordinary citizens, knowledge seekers, representatives from both for-profit and non-profit organizations, including pharmaceutical companies, and more. Readers can expect the following from this blog:

• Solution-focused analysis of the key healthcare issues facing African countries built around this 6-piece framework that was inspired by Ezekiel Emanuel's book "Which Country Has the World's Best Health Care?"):

  • Coverage

  • Financing

  • Payment and Reimbursement

  • Delivery of Healthcare Services (Infrastructure and Human Resources)

  • Pharmaceuticals

  • Innovation

• Country spotlights highlighting the practices that model countries are employing successfully to keep their populations healthy and productive—showcasing lessons that African countries can learn from them, and, hopefully, impart to others.

• Synthesis of my conversations with healthcare stakeholders inside and outside Africa.

• First-hand account of my interactions with various health systems in different countries and what learnings can be applied to African countries.

This blog is only my starting point to help improve healthcare in sub-Saharan Africa. Let's embark on this journey together.

Join me in my mission!