We have to move quickly to strengthen fragile health systems says Amref director

There is an undeniable link between health and climate change, and Africa is especially vulnerable. For example, coastal waters have become more suitable for the transmission of Vibrio pathogens, according to the 2022 Lancet Countdown on health and climate change(opens in new tab/window). The report compares the period of 2012 to 2021 with a similar span a half century earlier: 1951 to 1960. Researchers found that the number of months suitable for malaria transmission increased by 13·8% in the highland areas of Africa, while the likelihood of dengue transmission increased by 12%.

More recently, the COVID-19 pandemic precipitated decline of already struggling health systems.

Recently, I spoke with one of our Amref colleagues about the correlations between climate change and health. Desta Lakew(opens in new tab/window) is Group Partnership and External Affairs Director for Amref Health Africa(opens in new tab/window) — which is leading the upcoming Africa Health Agenda International Conference (AHAIC)(opens in new tab/window) in Kigali, Rwanda, from March 5 to 8.

The theme for this year’s AHAIC is “Resilient Health Systems for Africa: Re-envisioning the Future Now.” What are the major challenges you see facing healthcare systems in Africa?

Africa’s health systems face a myriad of challenges. These include longstanding ones such as inadequate infrastructure and financing, insufficient health workforce and a high infectious and non-communicable disease burden, as well as the more recent climate-related health crises like rising food insecurity, frequent outbreaks of diseases such as malaria, monkeypox and Ebola and limited access to clean water and sanitation.

Since we held the first AHAIC in 2014, we have seen a significant increase in the number of climate and health emergencies recorded on the continent and survived a global pandemic that threatened to completely decimate our fragile health systems. In that time we have also seen the establishment of the African Medicines Agency (AMA), the achievement of autonomy for the African Centres of Disease Control and Prevention (Africa CDC), capacity building for vaccine manufacturing in Africa and growing regional cooperation, all of which point to our potential to surmount these challenges — no matter how daunting they seem.

Are there major steps forwards that you’d like to see actualized in the near future, for building resilient healthcare systems in Africa?

The past few years have shown us that strong and resilient health systems are critical for our continent to ensure equitable access to health for our people. This year’s conference theme is a call to action to guide what we feel needs to be done to move united in our purpose to strengthen Africa’s health systems and ready ourselves for the future now. Perhaps one of the crucial steps towards achieving this is strengthening regional cooperation and speaking in one voice. We need to leverage our diversity and strengths to come up with sustainable, inclusive, equitable health policies for Africa by Africa while at the same time acknowledging that we have no time to waste if we are to recalibrate the course of climate change and health on the continent. It is time for us to move beyond the same rhetoric we have heard for the past few years and commit to action.

The conference program(opens in new tab/window) is an ambitious one. What are you most looking forward to discussing at AHAIC 2023?

We are very excited about all of the conversations that will be taking place. However, what makes me super excited is an area that we have not seen adequately addressed, which is the intersection of climate change and health. This is such a critical and timely issue for us, and based on our experience and the ominous projections of the impact of climate change in Africa’s health outcomes, this could not have come at a more important time. We have to move quickly to strengthen fragile health systems through greater regional and global cooperation, scaling up health financing in the midst of economic crises, bridging the global north-south divide, building a fit-for-purpose African health workforce, and tapping into the power of communities to drive innovation and solidify ownership of Africa’s health agenda.

Amref has long been a champion of enhanced regional cooperation, and this conference offers us — and our partners — a platform to bring Africa’s leaders across all levels to find a means to achieving the goal of a united, prosperous, healthy continent.

We are also very excited to be the first global health conference held in Africa that is seeking to mainstream climate into health talks and vice versa. With mounting evidence on the strong linkages between the two, we believe that the only way to tackle these intertwined challenges is to address them together, and AHAIC will be the first convening of its kind to focus on climate change as a key determinant of health.

Is there a call to action — or hope for the future — you’d like to share with readers?

There is the saying that “insanity is doing the same thing over and over and expecting different results.” My call to action is that we as leaders of this continent, advocates for our people, re-think how we work in partnership and across sectors to own our narrative, leverage opportunities for collective action and ensure that we work find tangible solutions for improving the health of our continent. This means alignment, prioritization and responsible investment in our health systems.

Everyone can use their voices and platforms to bring attention to the issues that truly matter — the collective health and wellbeing of both people and planet being one of them — and to actively participate in discourse and action that will bring us closer to creating the world we want for ourselves and future generations.