Opinion: Embrace a profit-driven approach to health care funding

Health systems worldwide face a common adversary: chronic underfunding. To address this, it is essential to recognize health care as a service industry for investment, leveraging tools like telemedicine and innovation. While stakeholders have long recognized the issue of underfunding, the root causes extend beyond financial constraints, encompassing technical limitations, infrastructure deficits, and inadequate resource allocation, all of which inversely stem from the fundamental issue of funding. To address this, we must accept that we all need a strong health care system. Traditionally, health care financing has been viewed through an altruistic lens, focusing solely on the sick and vulnerable. However, this perspective overlooks the broader socioeconomic impact it has on everyone and possible alignments with profit-driven sectors like financial markets. Consider the current intersection of technology, innovation, and finance — domains characterized by principles of risk, reward, profit, and loss. These principles have long fueled growth across sectors. Yet health care, which should ideally cater to the entire global population, remains disconnected from these profit-driven frameworks. So how can we bridge this gap? Reengineering the relationship and language The African Union may be on the right path here with its New Public Health Order, which appropriates the responsibility of championing solutions of innovative health financing on multisectoral groups. Moving away from traditional altruistic models, this approach aims for sustainable investment and outcomes beneficial for all. This trend is buttressed by the remark of Saudi Arabia Deputy Minister for International Development Ryadh Mohammed Alkhareif at the International Development Association’s IDA20 midterm review that highlighted a growing focus on investment-driven approaches in development financing. Shifting away from traditional donor-led fundraising shows a blend of profitability and social responsibility that can potentially replace traditional philanthropy. What is striking and important to note are further steps taken by the African continent to position for investor entry. Insights from the 2023 International Conference on Public Health in Africa showcase a conscious effort to improve the value chain of health care systems. From increased job creation in vaccine manufacturing by key institutions like the African Development Bank and Institut Pasteur de Dakar to addressing infrastructure deficits to support its export capacity, a great opportunity exists to tear the vortex wide open in a way that, first, enables a remodeling of health care as a service industry that serves all — not just the sick, expanding both its shareholder, stakeholder and investor base; and secondly, aligns health care with broader global trends in sustainable development finance, instituting a balance between market efficiency and competition. Where does human capital and profitability fit in this framework? One major challenge facing health care systems, particularly in the global south, is the phenomenon of brain drain. Health care professionals often face difficult choices due to disparities in compensation between countries. The lure of higher salaries in economically prosperous regions prompts many professionals to seek opportunities abroad, leaving their home countries struggling to retain skilled workers. In Africa, governments grapple with inflation, economic instability, and competing priorities, making it challenging to prioritize health care expenditure. As a result, health care provision is often seen as unfeasible or low priority, exacerbating the issue of brain drain. To address this challenge, African countries must reconsider their approach to health care delivery. Instead of clinging to the notion of free or cheap care, they should recognize health care as a vital service industry with the potential for significant economic impact. By attracting investment and innovation, countries can create environments that not only retain skilled professionals but also stimulate economic growth. Turkey's health care model could serve as an example for African nations. It is characterized by a 4.5% gross domestic product investment and a $15 billion allocation for medical infrastructure and local manufacturing, resulting in some 750,000 annual medical tourists, with an expected rise to 1 million. African nations can adopt similar strategies by investing in innovative treatment centers and fostering research and development in neglected areas that can draw skilled medical professionals from other regions. This would strengthen their health care systems and address some of the root causes of brain drain. Additionally, it is imperative to explore the role of technology in revolutionizing health care delivery and financing. Bridging the communication gap The key to securing funding for health care lies in a shift toward adopting financial market models, particularly emphasizing return on investments. This entails transforming health care into a viable investment opportunity, attracting shareholders and consumers alike. Telemedicine stands out as a strategy, offering efficient patient reach while maintaining accessibility, cost-effectiveness, and quality. Despite global advocacy for free universal health care, persistent costs necessitate innovative funding approaches, whether from individuals or through government subsidy. Leveraging digital platforms and fintech innovations not only optimizes costs but also can appeal to investors well-versed in financial principles. With its advantageous demographics and a viable economy, Africa is poised for success. Therefore, these considerations should inform the continent's engagements, particularly within forums like the Group of 20 major economies, shaping its future.