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.
“Africa rising” was the heading of an article in the Economist Magazine in December 2011. In May 2000, the same magazine had discussed Africa under the title “Hopeless Africa”. I have been in several international meetings during the last two months and in all of them we have been talking about Hopeful Africa. Strong economic growth, improving development indices, peaceful transitions in leadership, discoveries of viable deposits of oil, gas and minerals all support the era of a new hope that some of us have been talking about for some time. There have been a few negatives during this time such as the miners’ deaths in South Africa the festering conflict in the Eastern DRC and the dreaded Ebola virus outbreak in Uganda and the DRC.
A vision for transformative ownership and capacity building for Africa’s health
The previous discussion topic on creating synergies and building capacity for Africa’s health has generated a vibrant debate which resulted positive actions which continue up to now. So let us carry on. Genuine dialogue is taking place over the four meetings on health workers and MDG 4 and 5 and led to a coordination meeting in Nairobi convened by GHWA and the APHRH. A synthesis document on the collective outcome of the four meetings was circulated in Tunis last week at the conference of African Health and Finance Ministers. What a fantastic achievement! Congratulations are due to Ashgovnet members and Development partners for demonstrating our ability to be synergistic.
During the month of September, 2011, I was a guest speaker at the annual meeting of the Norwegian Medical Association (NMA) which was celebrating 125 years of existence. This was also the 6th Conference on Global Health and Vaccination Research in Norway. There were some 250 participants from all parts of Norway and representing a variety of institutions who are active participants in the work of the NMA. I met many delegates from African countries such as Malawi, Tanzania, Sudan, Ghana, and Uganda representing Professionals Associations and other institutions in their respective countries.
During our previous discussion on reclaiming the "can do" attitude among African techno-professionals, we were reminded of the era of great expectations when African economies were performing well and social services were provided without the need for visible donor support. Then followed the era of decline when African economies collapsed and went into debt; becomingheavily donor dependent and earning the shameful classification of Highly Indebted Poor Countries (HPIC). I wish they had coined a more euphemistic title!