Political commitment is key for good healthcare

With the annual budget negotiations in Parliament going on right now, difficult decisions are being made on which aspects of health budgets should be prioritised for funding.  This gives us an opportunity to contribute to these ongoing national and regional budget discussions.

Let us begin by understanding health financing. It is defined as “the raising, pooling and spending of financial resources with the primary intention of improving health”. 

The sources of health financing are the general tax, donor aid, deficit funding (or borrowing), ear-marked taxes, and social and private health insurance. This should exclude out-of-pocket spending by individuals at the point of receiving health care. 

Today, health financing remains the most intractable challenge for the health and development globally. Indeed, some have argued that Universal Health Coverage (UHC) in poor countries cannot be funded internally.
Yet, the health of the people is central to everything. It is a precondition for well-being and productive lives. 

The second foundation is our innate humanity of feeling for each other so that the pain and suffering of one is felt, shared and addressed collectively and “no one is left behind” to suffer alone. 

On top of these moral arguments is the new evidence that health is no longer perceived as a cost but is an investment with high social and economic returns.  

The health economy on its own contributes to economic growth, employment and Gross Domestic Product (GDP). 

Last but not least, voters value their health and investing in the health and well being of the population has high political returns.

Although Africa made major gains in health indices during the Millennium Development Goals (MDG) period (2000-2015), the continent still lags far behind other regions of the world in health indices. 

The opportunity of SDGs and UHC should be used for Africa to catch up. This is why UHC is a political choice made by governments to provide citizens with the health services that they need without financial barriers. 

Strong government leadership is essential to create the conditions that enable people to live healthy lives.

This includes marshaling actors from all government sectors and the whole of society to deliver integrated people-centred primary health care by enacting enabling laws and regulations, providing access to information, healthy food, clean water, decent housing, quality education and other resources.

A country should not wait to become rich to attain quality universal health care. Studies have shown that poor quality of health care linked to low level health financing causes more deaths than disease itself.  

African political leaders should therefore commit to UHC and embark on this journey resolutely starting now with:
• Enacting health financing laws 
• Reorganise the governance of the health system to provide capabilities to implement the enacted laws effectively and efficiently.
• Agree on a basic package of community-based promotive and curative health services based on the burden of disease and other mutually agreed criteria. 
• Provide services beyond the basic package by introducing a menu of financing mechanisms including ear-marked taxes, community, social and private health insurance schemes. 
• Monitor and review the performance of the health system regularly and make adjustments to grow the size of the basic package over time matched with the economic growth.

Prof Francis Omaswa is the executive director for the African Centre for Global Health and Social Transformation

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