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What impact is COVID-19 having on private healthcare and healthcare financing in Africa?

Guest post by Robert Comba, The Africa List

“In Ghana, the situation is quite similar to a lot of developing economies: the public sector tries to meet the demand for healthcare but the demand is quite significant.” Dr Elikem Tamaklo is speaking to us on the phone from Accra. He is the Managing Director of the Nyaho Medical Centre, Ghana’s oldest private group medical practice. Although accurate data can be a little tricky to come by, he estimates that the public sector provides around 40% to 60% of the countrys healthcare, the rest is delivered by private providers.

 Around the world, COVID-19 is presenting challenges for how public and private healthcare providers work together, but also an imperative for them to do so. There is perhaps nowhere where this issue is more pronounced than on the African continent, where – according to the IFC – the private sector delivers around half of all medical products and services.

 Responses to the coronavirus are, understandably, being led by national governments but need to factor in the significant number of private healthcare providers. So, how do private organisations ensure their voices are heard? Dr Tamaklo says it’s about actively engaging with the government ahead of time: “A lot of the work we’ve been doing is with the Ministry of Health, trying to incorporate the private sector into their planning,” he says.

Communication is vitally important, according to Dr Tamaklo, because in his experience, people with coronavirus symptoms have typically gone to a private hospital first for a consultation and to give a sample for testing. However, it’s the public sector facilities in Ghana that have received the training in how to handle patients with COVID-19 symptoms. “That was the first place where the dichotomy became apparent. There was no coordination between the public and private,” he said.

 Dr Tamaklo is a member of The Africa List, a network of more than 750 private sector leaders in six African countries, including Ghana. The Africa List also operates in Uganda, where another of our members, Kawalya Kanyerezi, is the Executive Director of Kampala Hospital, a 100 bed private hospital in the country’s capital.

Mr Kanyerezi estimates that 60% to 70% of Uganda’s healthcare is provided by the private sector. He told The Africa List’s podcast that the dialogue over coronavirus is improving the relationship between the public and private sectors in Uganda: “Normally, I think the private sector runs on its own. It’s in this pandemic that we are trying to work with [the government] but a lot of this pandemic is being run by the government taskforce. Representatives from our [industry] federation sit on the presidential roundtable and I think the Ministry of Health have received a lot of insight from them. As the private sector we have been giving advice and trying to pre-empt situations. They seem to appreciate where we are coming from.”

 In Ghana, Dr Tamaklo holds out similar hope for the future of the relationship but, it’s fair to say, is exercising a little more caution: “It’s dependent on how far it goes in changing the structure of public-private relationships. There’s a lot of hope for us in the future, if we can close on the right structure and communication, in terms of getting into a rhythm of meetings, dialogue and creating an office that fosters the relationship.”

 On a broader scale across the continent, there do appear to be signs that coronavirus is improving collaboration on healthcare between public and private sectors, and international organisations, too. You can see it through the public-private partnership the African Union and the Africa Centres for Disease Control and Prevention set up, called the Africa Covid-19 Response Fund, which aims to raise more than $150 million. Its supporters so far include several of the larger African banks, private equity funds, healthcare companies and the UK government’s Department for International Development (DFID). 

 Maina Sahi, Strategy Director at the UK’s CDC Group (not to be confused with the Centre for Disease Control), a major investor in healthcare in Africa, sees this collaboration only getting stronger: “This pandemic has shown that a very collaborative healthcare policy, innovation and supply chain environment is super critical. It’s not just in a pandemic but it will eventually be for other areas as well, whether that’s cancer or communicable diseases, for example.”

 A similar collaborative approach is being taken by MedAccess, a social finance company CDC Group set up to improve access to medical supplies. Since the pandemic hit, MedAccess has been working with both private companies and UN agencies to explore ways of providing guaranteed finance to ensure COVID-19 treatments and vaccines are affordable for people with lower incomes. MedAccess’ CEO, Michael Anderson, told us how they’re pushing themselves further: “We are testing the limits of our model and we’re doing new things we haven’t done before. We are, for example, compressing our due diligence process and we are taking risks, so that companies can make production decisions, bring those products to market and get them disseminated quickly.”

 The way MedAccess is working with others and being creative is echoed by organisations in Africa and across the world, as everyone adapts to a new normal. Back in Accra, Dr Tamaklo thinks this is the best way of getting through this pandemic: “The biggest lesson I’ve learnt is to keep hope alive, because hope allows you to innovate. In the innovation and in the creativity, is where you can find all sorts of solutions.” 

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