African Development Bank plans to build resilient health systems

The African Development Bank has described the COVID-19 crisis as an opportunity to reassess, rebuild, and better position Africa’s health care defense system against future pandemics that could be even deadlier.

In his remarks at the bank’s annual meetings Friday, AfDB President Akinwumi Adesina characterized the state of health care infrastructure on the continent as “appalling.”

“If you are sick in Africa, you need prayers. A lot of prayers,” he said. “Health facilities — when they exist — they are several kilometers away. For many Africans, only 51% of the public health facilities have basic water and sanitation, and electricity is available only in 33% of the health care facilities.”

He said the continent’s reliance on imported vaccines and drugs has left it at the mercy of the rest of the world, as evidenced by the COVID-19 era’s vaccine inequality and nationalism that have largely limited Africa’s ability to acquire doses.

To better position the continent for future health emergencies, Adesina said priority should be given to local production of vaccines, developing Africa's pharmaceutical manufacturing capacity, and building health care infrastructure.

The future could perhaps bring the outbreak of a disease that is as easily spread as COVID-19, as deadly as Ebola virus disease, and as difficult to develop a vaccine for as HIV, suggested John Nkengasong, director at the Africa Centres for Disease Control and Prevention, during the meetings.

With this in mind, he said the continent’s defense strategy needs to be reinforced by improving Africa’s health workforce and manufacturing capacity for diagnostics, vaccines, and treatment.

“You don’t build health systems within a pandemic; you build health systems before the pandemic,” Nkengasong said.

Dr. Matshidiso Moeti, the World Health Organization’s regional director for Africa, said COVID-19 has been a reality check for Africa, which hinged its hope largely on global solidarity.

“In the example of access to COVID-19 vaccines, this has highlighted the need for self-reliance,” she said. “So we have to consider how local production can be developed in ways that are sustainable and that capture a certain proportion of the demand market, and assure other African countries of access to supplies even when there is no pandemic.”

In an interview before the meetings, Atsuko Toda — AfDB’s acting vice president for agriculture, human, and social development — said the bank and the continent must come to terms with the fact that strengthening health systems should be an economic imperative, considering that Africa is estimated to lose about $2 trillion annually due to reduced productivity associated with poor health and premature death.

“So we really need to look at health in the context of economic growth and resilience,” she said.

Toda said the bank is prioritizing scaling initiatives for African vaccine manufacturers by offering direct lending or indirect equity investment and technical assistance.

Likewise, the bank is also aiming to help shape demand by supporting the development of a vehicle to pool demand from African countries and ensure long-term vaccine uptake.

Toda expressed confidence in African countries working together to leverage the power of their unity.

“African countries responded to calls to come together to pool their resources together so that it [Africa] can actually be able to talk to the vast manufacturers and be able to get better pricing,” she said.

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