NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, August 8, 2013

Editor’s Note: In advance of the many health-related discussions to take place in September at the Clinton Global Initiative, the Social Good Summit, UN week and other such events, the Skoll World Forum asked some of the world’s leading voices in global health to paint a comprehensive picture of key trends, challenges and opportunities to realizing healthcare access and treatment around the world. A new piece will be posted everyday through Friday, and you can view the entire series here.

Alex Chika Ezeh, PhD, MSc, is executive director of the African Population & Health Research Center in Nairobi, Kenya, and honorary professor of public health at the University of the Witwatersrand, South Africa.Rahim Kanani: As the Executive Director of the African Population & Health Research Center in Nairobi, Kenya, what are the top 3 trends you’re seeing from a public health perspective across Africa?

Alex Ezeh: The top three health trends that I see are: growing inequities in access to health services and health outcomes, the shifting burden of disease from infectious to noncommunicable diseases (NCDs), and a greater push for country ownership of health programming and funding.

There are many dimensions to the health inequities across African countries, cities, and regions, but the most pervasive are typically among groups defined by their economic status, geography, age, and gender. People living in remote and marginalized rural areas and urban slums, older individuals, and young children often bear a disproportionate share of the disease burden while simultaneously having limited access to care. Apart from sexual and reproductive health services, there are few interventions aimed at improving adolescent health, which is a precursor to adult health. Addressing the social and structural determinants of these inequities remains a challenge for global health programming.

Unfortunately, with growing urbanization, changing lifestyles, and poor governance, the incidence of NCDs is increasing rapidly in sub-Saharan Africa even while the region still bears a huge burden from infectious diseases like HIV, tuberculosis, malaria, diarrhea, and other neglected tropical diseases. Injuries, especially among young adult males, are also on the rise. These trends will further stretch already weak health systems and could result in a reversal of recent improvements in health.

Lastly, as rich countries struggle with the current economic crisis and as poorer countries achieve higher levels of economic growth, the push for country ownership of strategies and funding for health and other development programs will continue to grow. The rate of this transition in funding arrangements and the positioning of health among other development priorities within countries will have huge implications for health programming in Africa. These factors also will have implications for the mix of country-level expertise to support health programs.