Examining The Africa Health Workforce Investment Charter

Published on 8th May 2024

The World is currently negotiating the pandemic agreement in Geneva. Because the health workforce is essential for PPPR, substantive article 7 is dedicated to this pandemic agreement. Therefore, please allow me to read the paragraph 1 of this article 7:

1. Each Party, in line with its respective capacities and national circumstances, shall take the necessary steps to establish, safeguard, protect, invest in and sustain a multi-disciplinary, skilled, trained and diverse workforce to prevent, prepare for and respond to health emergencies closest to where they start, including in humanitarian settings, while maintaining quality essential health services and public health functions to contain outbreaks and prevent the escalation of a small-scale spread to global proportions.

Each African country has a clear responsibility to fulfil this commitment that we are making under the Pandemic Agreement. We will be accountable, and the World will evaluate our performance as a country, region, and continent. Our continent bears a significant portion of the World’s disease burden, yet we operate with one of the most sparse health workforces globally.

The statistics speak volume:

· While Sub-Saharan Africa accounts for approximately 24% of the global disease burden, it is home to only 3% of the World’s health workers. Achieving universal health coverage by 2030 will require an additional 1.8 million health workers in Africa alone. The critical shortage of health workers in Africa is projected to reach about 6.1 million by 2030. This will be made worse by the recurrent public health emergencies that we face daily. In 2023 alone, Africa recorded 166 disease outbreaks, and the trend I see in 2024 is not promising.

AU member states must realize the 2017 AU Assembly Decision that called for rapid recruitment, training and deployment of 2 million institutionalized CHWs by 2030. To accelerate this agenda, we thank our Heads of State who approved during the 2024 AU Assembly the decision tabled by Africa CDC to appoint President Bola Tinubu as Champion for Health Workforce and Community Health Delivery Partnership. I will be in Abuja the third week of May to meet President Bola and discuss how he can help the continent push this agenda.

·Studies show that investments in the health sector yield substantial economic returns, estimating a nine-to-one return on investment. This is one of the pieces of evidence I’m using when talking about changing the narrative in the health area in Africa. Indeed, some of you Ministers here know that sometimes you have difficult conversations with Ministers of Finance because they still believe that the health sector is a liability. The new narrative we are promoting is to transform the health sector from a liability to an asset for the economy of our countries. Then, we will start to have another conversation with our Ministers of Finance. They will be people who will begin to look for Ministers of health.

Indeed, from World Economic Forum data, as a driving force of their economies, the pharma sector was responsible for more than 35% of the GDP of Switzerland and India between 2010 and 2020.

You will understand why I qualify the local manufacturing agenda in Africa as the second independence of our continent every day: It will bring health security, job creation, economic growth, peace, and stability.

I was upset about an article from the UK newspaper. This article states that local manufacturing in Africa is a dead dream. It advises that Africa has to accept that India is the Pharmacy of the World and strengthen its ties with this country to import needed vaccines and medicines. To support their conclusion, they are outlining three challenges:

(1) Low human capacity, (2) Low ability to develop antigens for the vaccine, and (3) Inability to procure vaccines made based on the economic scale

· The first challenge is why we are here today. While we have made massive progress in Africa, this gathering will send a strong message about our commitment to addressing the health workforce by becoming innovative.

· The second challenge is why we are fighting under the pandemic agreement to have more technology transfer. Please let us also recognize the effort we made, and we are now capturing more resources for R&D and clinical trials in Africa.

· The third reason is why Africa CDC submitted to heads of State, who approved the creation of the continental pooled procurement mechanism during the February 2024 AU Assembly. What kind of economy of scale are they talking about when you have a market of 1.4 billion people that is still growing to become the first biggest market in a few years?

To make our action more concrete, in March 2024, Africa CDC signed an MoU with UNICEF that transfers its capacity and capability on pooled procurement mechanism and supply chain management to our continental organization. In short, in the next 2-3 years, Africa CDC will take over and play the role that the UNICEF Supply Division in Copenhagen is playing by procuring and supplying African countries with essential commodities with a preference for products made in Africa.

I was in Washington for the WG-IMF Spring meeting. Among gatherings, I had an impressive meeting with the Ministers of Finance from Egypt, Tanzania and CAR, who agreed with me to work together and change the narrative. Thanks to the experience of innovative financing that he managed to put in place in Egypt and to generate around 2 billion USD for the health sector, I have appointed the Minister of Egypt as the lead of the African high-level panel on innovative financing in the health area. Other members will be three other Ministers of Finance, 3 Ministers of health, some partners and personalities. Very soon, you will have details about this initiative.

To bridge the gap between Finance and health, I also initiated a continental platform to exchange health financing. Every year, during the Spring meeting in April in Washington, our Ministers of Finance, Planning, Budget, and Health will be supported by some Heads of State, mostly our champions in different areas.

Since I announced this initiative, I have seen significant interest from various partners, such as the World Bank, IMF, US Treasury, Gavi, GFATM, the Private sector, and many others, who request involvement. We are working on that, and you will be updated soon.

As demonstrated, we will go nowhere if we don’t have an appropriate health workforce.

At the continental level, our countries have adopted the AU Agenda 2063, “the Africa we want.” To achieve this ambitious agenda, we have a milestone: the Sustainable Development Goal in 2030, primarily for SDG 3. Achieving SDG3 means achieving Universal Health Coverage (UHC) by 2030. How can we accomplish that if we still face a severe shortage of health workers in Africa, undermining access to quality health services for our populations?

Although some strides have been made towards establishing a resilient and robust healthcare system in some African countries, substantial progress still needs to be made to ensure an adequate and fair distribution of healthcare workers regionally and nationally.

The Public health workforce shortage in Africa stems from several factors, including underfunding of health system by Member States, inadequate training capacity, poor remuneration of health workers, rapid population growth, international uncheck labour migration, weak governance of the health workforce, lack of career path as well as poor retention of health personnel.

Today, this Forum brings us together to discuss and act. Over the next few days, we will delve into a series of crucial topics like:

1. Innovative Financing Models: How can we creatively fund the scale-up of health education and workforce training?

2. Policy and Planning: What frameworks can be established or enhanced to support sustainable health workforce growth?

3. Retention Strategies: How do we keep talent within our borders and ensure our investments are long-lasting?

4. Technological Advancements: How can we leverage technology to train, support, and expand the reach of our health workers?

5. Involvement of the private sector: What incentives should we give to the private sector to contribute to this agenda?

These discussions are not academic; they are urgent and essential. Our collective effort is needed to translate our plans into tangible outcomes.

As we set our sights on these ambitious goals, let us remember the power of partnerships.

In conclusion, As we progress with our sessions, please let us challenge ourselves to think beyond the conventional. Let us commit to action that is bold and to strategies that are inclusive. Let us harness our collective energies to build health systems that are not only equipped to meet current demands but are resilient enough to adapt to future challenges.

Therefore, Africa CDC is proud to be part of the launch of the Africa Health Workforce Investment Charter. I hope that this will mobilize and sustain political and financial commitment and foster inclusiveness and collaboration across sectors as part of investment in the development, performance, and retention of the health workforce in AU Member States. Thank you, once again, for your dedication to this cause. Let us make history together by building a healthier, stronger Africa.

By H.E. Dr. Jean Kaseya

Director-General of Africa-CDC,


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