Health Interactive with Dr Aminu Magashi

 

Africa, U.S.A and Health Matters

healthinteractive@hotmail.com

 

It was Kristen Krapf Campbell, Program Director of Africa Center for Health and Human Security at  The George Washington University, USA who sent me the paper presented by Honorable David H. Shinn titled African Health Issues: Challenges for US Policy. The paper was presented at the GWU Africa Centre and US Foreign and Civil Service Leadership Meeting held on April 26, 2006.

 

Ambassador David Shinn, actually requires little introduction, apart from being a member of the Technical Advisory Board of the GWU Africa Centre for Health and Human Security. He also in the past served as the United States Ambassador to Ethiopia and Burkina Faso.

 


        

        For Public Health Commentators, like my humble self, his paper which has received the highest accolade from many quarters provided an insight in to the thinking of the America’s Policy Makers, Development Agencies and their academia as to what the future of Americas’ Health Policy would be for Africa . It has also generated interest to look at some of the proposed ways of that future policy with the aim of making a critique , all in the interest of Africa’s Growth and Development.

        

        

         

        

        

        We are all very much aware that, it is in Africa that we have the highest Maternal Mortality Ratios, Under Five Mortality Rates, and high burden of diseases such as HIV/AIDS, Tuberculosis and Malaria to mention but few. Looking at our Annual Population Growth Rates in various countries and if not properly controlled and with dwindling and scarce resources, health indicators are bound to be worst. We are aware that many countries in Africa, at the rate we are progressing, the attainment of Health Millennium Development Gaols by 2015 shall remain with our imagination only .

        

        

         

        

        

        
        Coming back to the Honorable David’s paper , He 
        mentioned among others that  
        Africa faces a 
        host of controversial health policy issues and decisions on resolving 
        most of them are in the hands of AFRICAN GOVERNMENTS THEMSELVES ( 
        emphasis mine ) . But in some cases, the international donor 
        community has an important role to play. The time has come, for example, 
        to reassess the amount of assistance that is being devoted to HIV/AIDS 
        as compared to all the other pressing health needs facing Africans.
        
        

        

         

        

        In FY 2004, 30 percent of all 
        USAID economic assistance to sub-Sahara Africa went to HIV/AIDS. Another 
        21 percent of all economic assistance was for other health programs, 
        especially Child Survival, Maternal and Reproductive Health. These 
        programs have been frequent candidates for congressional earmarks. 
        Consequently, more than half of the USAID development budget for 
        sub-Sahara Africa went to health. It is hard to argue with this emphasis 
        on health, but it is time to question if this is the most appropriate 
        division of scarce resources within the health sector.

      

      
      
      

 

      

      …………….. But there are other 
      enormous health problems that confront Africa and deserve greater 
      attention.  

      

       

      

      
      I strongly share same feelings with 
      the presenter on the spending on HIV/AIDS, which engulfed 30 % of USAID 
      funding in 2004. We are all aware of the
      15 Billion Dollars Americas’ Africa Initiative 
      to curve the menace of HIV/AIDS through the Presidential HIV/AIDS 
      Emergency Relief Programme (PEPFAR) which already is being implemented in 
      many African States in the area of provision of Anti Retro viral Drugs, 
      working with faith based organisations to curve the menace of HIV/AIDS as 
      well as other preventive measures.

      

       

      

      In another form of good gesture America has made 
      another pledged to fight Malaria in Africa by earmarking One point Two 
      Billion Dollars ($ 1.2 Billion). On 30th June 2005, President 
      Bush made the announcement and reportedly challenged the world to reduce 
      the burden of Malaria dramatically as a major killer of children in 
      sub-Saharan Africa, and pledged to increase funding of Malaria prevention 
      and treatment by more than $1.2 Billion over five years. The goal of this 
      effort is to reduce Malaria deaths by 50 percent in each of the target 
      countries after three years of full implementation.

      

       

      

      I argued in my article that was published last year( 
      2005 )  in Daily Trust Newspaper and posted at Gamji Website titled ‘ 
      U.S.A , Africa and Malaria , that no body would take America serious 
      in the area of fighting Malaria in Africa with the meagre resources being 
      put when compared with what HIV/AIDS Intervention is engulfing .

      

       

      

      
      Malaria, according to W.H.O, 90 
      percent of the 600 million annual Malaria cases worldwide occur in 
      sub-Sahara Africa. Each year, Malaria 
      claims more than 2.3 million African lives, mostly young children. Malaria 
      causes an estimated $12 billion in economic loses annually in sub-Sahara 
      Africa, reducing the GDP of endemic countries by an average of 1.3 
      percent.  In that light, American Policy has to be re-sharpened to 
      accommodate more funding to address Malaria burden.  

      

       

      

      Looking at the Americas’ Strategy 
      to address Malaria in Africa, one is not impress and carried away by them.

      

      The strategies are as follows
      
      

      

       

      

      1.     
      
      Provision of long-lasting Insecticide Treated Bed Nets.
       

      

      2.     
      
      Use of Artemisinin Combination Therapy, which is a herb from Asia 
      from what's called wormwood. It's a plant.  

      

      3.     
      
      Use of a particular drug -- anti-malarial drug -- to pregnant women 
      to reduce the incident of absorption by the newborn child when the child 
      is born.  

      

      4.     
      
      Indoor spraying of insecticides on people's huts and their homes to 
      kill the mosquitoes that are in the house at night

      

       

      

      In all the Four Strategies, none is 
      looking at addressing the Cause, but rather the Effect. The policy is not 
      investing in Environment and all its related problems of ensuring  a good 
      breeding site for mosquito and proliferation of Plasmodium Parasite. 
      African  environment is dirty with a lot of bushes and contaminated water 
      and improper refuse and waste disposal systems  all over and addressing 
      some of these problems will surely see the light of the day in addressing 
      Malaria problem.  

      

       

      

      Another worry about the Americas’ 
      Malaria Strategies is the simple fact that it is another way of Business 
      and Marketing  of Products in Africa, which in the long run, the funding 
      that comes to the continent will go back to its source.

      

       

      

      Coming back to HIV/AIDS, as I 
      mentioned severally in many fora in the past, an effective policy that 
      targets HIV/AIDS has to look at the problem of Sexual and Reproductive 
      Health holistically. HIV/AIDS is more or less an effect of poor approach 
      in addressing Sexual and Reproductive Health Problems (SRH), although it 
      can be contracted through other means.  My recommendation is for the 
      HIV/AIDS funding to be within a holistic budget of SRH, that way other 
      important problems such as our High Maternal Mortality Ratio can begin to 
      appreciably be coming down from its unacceptable figure.

      

       

      
Coming back to what the Honorable David in his paper  said , that resolving most of the controversial health problems are in the hands of African Governments themselves , I totally agree with him and I also firmly believe that the Americas’ Future Health Policy in Africa should not be only about funding but helping African Governments in the area of Good Governance , Transparency and Accountability and lastly to strengthen the activities of Health Civil Societies and Emerging Leaders in Africa to monitor government policies , track records and demand for Good Services and Good Governance . That way , we in 
      
      Africa can be rest assured that such future policy can lead to sustainability and rapid growth and development of our impoverished continent .

      

      
 

      

      
      Dr Aminu Magashi is the Executive Director of Community Health and Research Initiative, Kano , Nigeria and can be reached at healthinteractive@hotmail.com  or  gamagashi@gmail.com