A path toward wealth and security: Investing in the health of Africa’s
people

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By Jim Yong Kim

Africa needs much more investment from the private sector to build its
roads, energy and communications infrastructure. But for countries to make
the most use of that infrastructure, they also need to invest more in
people — - in brain power and “gray matter” infrastructure, to realize
their demographic dividend that fuels inclusive economic growth.

This week in Nairobi, Kenya, at the sixth Tokyo International Conference on
African Development, African countries and their partners must grasp this
unprecedented opportunity to chart a course toward universal health
coverage, or UHC. This initiative, which is being led by the government of
Japan, a global champion of UHC, is critical to Africa’s future growth and
prosperity. The World Bank Group will announce today a $15 billion
commitment over the next five years to accelerate universal health coverage
in Africa.

Better health and survival rates — particularly for mothers and children —
are linked to economic growth. The evidence is overwhelming: The Lancet
Commission on Investing in Health found that survival gains contribute
disproportionately to economic growth in Africa. Improved early childhood
nutrition, early stimulation and early learning programs extend school
completion and improve learning outcomes, and in turn, increase adult
wages. The commission also found that investments in universal health
coverage pay off at a rate of as high as 10 to 1.

Our alignment around UHC needs to, first and foremost, assess the current
state of health in Africa. Continued high levels of mortality for mothers
and children, along with high rates of undernutrition, are top priorities
where accelerated progress is possible and necessary. These must be
balanced with the growing demands for chronic care associated with
non-communicable diseases such as high blood pressure and diabetes.
Africa’s brave and successful struggles with neglected tropical diseases
such as guinea worm and river blindness, along with its meteoric progress
in the fights against malaria and HIV, are evidence of what is possible.

Yet the recent outbreaks of Ebola, yellow fever, and new cases of polio in
Nigeria are sobering reminders of the shared responsibility that all
countries have in making sure that their health services are not only
universal in name —but in practice. Against this challenging landscape of
health needs, African leaders need to embrace ambitious reforms in services
and financing.

Frontline primary health care services led by community health workers,
with appropriate referral for essential hospital care and emergency
outbreak response capacity, are the defining service pillars of universal
health coverage. Breakthroughs in these models of care are in evidence
across the continent.

But universal coverage of essential services requires a fundamental shift
in the way health care is financed. UHC means changing from a pay-as-you-go
system — which punishes the poor for being sick and led to the
impoverishment of more than 11 million people in Africa in 2014 alone — to
pre-paying for health, which promotes prompt access when people are ill,
and protects the poor. We need to put money directly in the hands of poor
women, through cash transfer programs that offer universal health,
education and nutrition entitlements to these women and their children, and
are strongly associated with inclusive growth.

Donor assistance needs to more effectively support UHC expansion in
countries. Through the Global Financing Facility, we are working with
countries to achieve smarter, scaled and sustainable financing for their
health sectors. We know, however, that even the best-prepared and financed
health systems can be overwhelmed in the context of an epidemic. This is
why at the G7 meeting in May, we launched the Pandemic Emergency Financing
Facility, an innovative, fast-disbursing global financing mechanism
designed to help stop the next outbreak before it becomes an epidemic.

We must continue to invest in what works – such as the scale-up of bed nets
to protect people from malaria, the use of drones to deliver life-saving
medical supplies to remote villages, and the deployment of thousands of new
community health workers across Africa. We can harness this potential more
systematically and ultimately create more jobs while delivering better
health outcomes.

With the right investments, we can save the lives of millions of people,
help people lift themselves out of extreme poverty, and ensure that all
people are healthier and live longer and more productive lives. This is
within Africa’s reach, and one foundation for the prosperity of the
continent will be commitments to universal health coverage.

*The author is President of the World Bank Group*.

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