There is a story that once upon a time, an African was a candidate for a senior United Nations job. His opponents de-campaigned his candidature by arguing that while Africans in general are knowledgeable and very good at talking; they were also very poor at writing, yet the job needed individuals who are both good speakers as well as good writers. In conversation among African professional leaders, we have shared and laughed over this joke/story many times. Indeed we have agreed among ourselves that in fact we know a lot about what happens in Africa but write little about it. We have consoled ourselves that very often it is foreigners who get excited about issues that we live with normally and rush to tell our stories with less depth and many distortions. So what do we need to do to cultivate the writing culture and tell our own stories with depth and accuracy?
The 66th World Health Assembly (WHA), organized by the World Health Organization (WHO), will be taking place in Geneva 20 - 28 May 2013. African delegations must now be busy preparing to participate in this important annual conference on the health of the people of the world. WHO and the WHA remain the most important health institutions in global health despite the challenges WHO faces at the present time. In all the sub-Saharan African countries, there is a senior public health specialist who is resident as the WHO Country Representative with supporting staff and available at all times to provide technical advice as well as technical assistance to the governments and countries. I found this WHO office to be of immense value during my time as Director General of Health Services in the Ministry of Health in Uganda.
In our previous discussions, we have lamented the existence of communication gaps, implementation gaps, ownership gaps, accountability gaps and governance gaps in our health systems. We have also discussed the pursuit of excellence in this era of a new hope for Africa and how it can be institutionalized and sustained. In our past discussions, we have proposed solutions. Now, let’s ask and answer the question of “How” to close those many gaps and how not merely to pursue but to actually achieve excellence in Africa’s health.
There is a growing buzz, din and action over health workers for Africa and the world. As we ended the year 2012, you may recall our discussions over the multiple meetings on Community Health Workers and thankfully those groups have been brought together under the theme “health workers on the front line”. There are other new independent initiatives on One Million Community Health Workers for Africa and another global campaign on training 1500 midwives in 13 African countries. We already have the USA government funded Medical Education Partnership Initiative (MEPI) and Nurses Education Partnership Initiative (NEPI). At the October 2012 annual Health Ministers WHO Regional Committee for Africa in Angola, an African Health Workforce development Roadmap was adopted. Next week on the fringes of the African Union Heads of State Summit in Addis Ababa, there will be a meeting on “Africa Post 2015 Health Dialogue: Health at the core of Post 2015”
I have been prompted to share my thoughts and stimulate a discussion on this topic by a number of recent events. There is an ongoing online conversation moderated by GHWA on “frontline health workers” that is a spin off from the multiple meetings on community health workers that we discussed in June and July 2012. In Uganda, parliament declined to pass the national budget unless government increased the health budget for recruiting rural health workers. The government accepted this demand and increased the salaries of only doctors in rural health centers by four times, surpassing senior consultants and professors! The African Women Parliamentarians met in Johannesburg in mid- October where ACHEST presented a paper on the tools needed by the parliamentarians to advocate for increasing financing for health especially MDG 4 and 5. It is apparent from all these events that gaining more clarity and a shared vision on how to strengthen health systems by contextualizing interventions based on the way they work for ordinary households as complex adaptive systems, could help us to focus our discussion and efforts for better and sustainable results. This is how I see it in the African context.