Sub-Saharan Africa: Defects in the Healthcare System
Many provinces of Sub-Saharan Africa face the alarming reality that adequate healthcare is a privilege, not a right. Healthcare is still an afterthought in parts of Africa that continue to battle diseases that have been eradicated or reduced in much of the Western world. There are substantial flaws in the African healthcare system that are often overlooked.
What defects occur in the African healthcare system today?
Questionable Healthcare Practices
Sub-Saharan Africa heavily utilizes both the public and private sectors when it comes to healthcare. The International Finance Corporation states, “In Ethiopia, Kenya, Nigeria, and Uganda, more than 40 percent of people in the lowest economic quintile receive health care from private, for-profit providers. The private sector also has a broad geographic reach among rural populations. Based on self-reported usage, over 50 percent of the rural populations of Nigeria and Uganda and use for-profit private providers.” Although ample individuals working in the private sector of the medical industry have pure intentions, many have the freedom to up-sell services, under-service, practice without a license, bill inaccurately, raise prices and use outdated equipment to unsuspecting patients. Public healthcare facilities are often spread thin and their resources are limited.
The rural populations that generate less income are often subjected to poor medical care while wealthier populations have access to higher quality care.
The Brain Drain
The flaws in the Sub-Saharan African healthcare system extend farther than corruption within the private sector. Furthermore, there’s an unequal distribution of healthcare professionals to patients, specifically in South Africa. The Organisation for Economic Co-operation and Development states, “In 2012, South Africa had only 0.7 physicians per 1000 population, well below the OECD average of 3.2. There were also only 1.1 nurses per 1000 population in South Africa in 2012, compared with an OECD average of 8.8.” This is partially due to insufficient healthcare funding; medical professionals are seeking professions outside of Sub-Saharan Africa causing what is commonly known as a “Brain Drain.”
Mishandling of Pharmaceuticals
Individuals working in the healthcare industry who have access to pharmaceuticals can generate profits by selling them into the black-market drug trade. Whoonga, a drug closely associated with the South African province of KwaZulu-Natal, is a mix of Antiretroviral (ARV) medication for HIV in addition to other drugs such as heroin, cocaine, marijuana, and even rat poison. In some cases, drug cartels are obtaining these medications from the medical staff or buying medications from patients directly. National Public Radio released an article titled, “Dangers of ‘Whoonga’: Abuse Of AIDS Drugs Stokes Resistance,” that emphasizes the side effects of using ARV medication for recreational use. It says, “People with HIV who smoke so-called whoonga — can develop mutant strains of the virus resistant to the medication. So when they need treatment, it doesn’t work. Or people can become infected with a strain of HIV that came from someone who used whoonga.” This results in unsuccessful attempts to help patients struggling to survive in one of the highest HIV impacted continents.
Integration of Counterfeit Drugs into Society
In addition to whoonga’s negative impact on the effectiveness of ARV drugs, counterfeit drugs have also leaked into Africa’s pharmaceutical market. The International Finance Corporation concludes, “The region is also plagued by substandard drugs and counterfeit drugs. Drugs with inadequate levels of active ingredient are all too common, and some have none at all. For example, in a study of 27 drugs on the WHO essential drug list from pharmacies in Lagos and Abuja, 48 percent of samples did not comply with pharmacopeia standards for active ingredient content.” When counterfeit drugs are integrated into the healthcare system it causes a deficiency in patient treatment along with the difficulty to distinguish authentic drugs from replicated ones.
Is there hope for the future?
In 2015, The United Nations adopted The Sustainable Development Goals (SDGs) which consists of 17 goals to essentially improve the world. These goals address world health, economic, environmental, and general well-being issues. Unfortunately, these efforts to reform the healthcare system continue to fall by the wayside for people living in poor communities of Africa. Sub-Saharan Africa still holds the highest HIV infection rates in the world in addition to carrying roughly 24 percent of the global disease burden in human and financial cost according to the IFC.
In order to improve health conditions in Sub-Saharan Africa, both the private and public health sector should be utilized in such a way where is it regulated and staffed appropriately. Proper financing and unity between countries is key in resolving Africa’s healthcare crises.
Strides have been made to unify Africa’s healthcare system; however, these defects will remain prevalent throughout Africa until properly addressed.