AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS

1
AFRICA CAN SOLVE ITS OWN HEALTH PROBLEMS?

• SARALA NAICKER
• Division of Nephrology
• University of Witwatersrand
• Johannesburg, South Africa

2
(No Transcript)
3
FACTS

• second largest continent- over 30 million square
  kilometres
• 53 countries
• gt 760 million population
• Population growth 2.3
• World Bank Report, 2002

4
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
• gt 18 million deaths

5
ECONOMIC DATA

• SubSaharan Africa lt 1 per day
• 291 million
• North Africa lt 2 per day
• 30 of population

6
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

7
South Africa Expenditure

• Health care R33.2 billion
• 100per capita per year
• 3 of GDP
• Crime/ violence 6 of GDP

8
DOUBLE BURDEN OF DISEASE

• Botswana
• HIV/AIDS 333000
• 39 of population 15-49 yrs
• Non-communicable disease
• increase in cancer
• DM
• HPT

9
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

10
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

11
NURSING BRAIN DRAIN

• Ghana 2000 in one year
• Zimbabwe 18000 nurses abroad
• South Africa nurses with greatest expertise

12
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)

13
Can Africa solve its own health problems?
14
The first step.
15
NEPAD

• Primary responsibility for success
• rests on governments
• and people of Africa

16
Governmental agreements

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

17
ISN Fellowship

• Training according to needs of home institution
• Trainee returns to render service to home country

18
PREVENTION PROGRAMMES

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

19
INTERNATIONAL PARTNERSHIPS

• Government ministries of health
• International agencies
• ISN
• WHO
• Other
• Academic centers
• Foundations
• Pharmateutical companies

20
INTERNATIONAL PARTNERSHIPS

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