26th July 2019

Dear colleagues

Help develop the African Forum for Primary Health Care (AFPHC)

We, as health workers on the frontlines of Primary Care (PC) services in health systems of Africa and supporters of the Primary Health Care (PHC) approach, are committed to achieving universal health coverage (UHC) in Africa. However it is very easy for UHC to be seen as a financial solution without the required reform in primary care service delivery. The centrality of PHC to UHC efforts may become lip service especially when frontline PC worker voices are ignored in Africa. We feel that there is a serious risk of African UHC becoming directed towards super-specialist and hospital services focused on vocal city elites, rather than PC services and PHC approach that serves the often-silent masses, especially in rural communities.

We are very concerned that the draft UHC statement, to be adopted at the High-Level Meeting on Universal Health Coverage in New York in September 2019, does not address human resources for PC services, specifically the need for everyone to have access to well-trained health workers in their first contact with health care.  Overly-simplistic solutions for primary care through vertical disease-based approaches are not sustainable. We welcome the move by WHO towards PC services that are integrated, continuous and people-centred. We know that there is a human resource shortage in Africa and believe strongly in the need for teamwork. This must include family doctors, clinical officers/associates, nurses (including advanced-trained nurses and midwives), public health professionals, community health workers and many others in a PC/PHC team-based approach to well-defined populations that builds accountable care for the people of Africa. We are all committed to innovatively building the capacity of PC/PHC teams at scale in Africa.

We want to bring together leadership of ALL health workers at the coalface in African primary care and ensure that we ALL have a voice in policy on PC/PHC in Africa. We hope to develop an African Forum for Primary Health Care (AFPHC) as the voice of the PC/PHC team and its supporters, sharing and supporting each other in advocating for PHC. The European Forum for Primary Care serves as a useful example and a possible supporting organisation.

In order to build the African Forum for Primary Health Care (AFPHC).

  1. We hope to engage with members of the PHC team, wherever they are across Africa, using the Towards Unity for Health online platform as a communication vehicle without the usual cost.
  2. We hope to have a face-to-face workshop/conference in May-June 2020 in Johannesburg, South Africa to explore the idea of AFPHC further. This may be allied with the APN Conference.
  3. We hope to have a regular AFPHC pre-conference at the WONCA Africa biannual conference, with next one in Abuja, Nigeria in 2021, as a way to build on this PC/PHC teamwork.

Dr. Bongi Sibanda, Convenor of Anglophone Africa Advanced Practice Nurse Coalition (working to develop family nursing practitioners in Africa) has been very enthusiastic about the AFPHC but cannot commit to this as yet on behalf of nursing leadership. She is assisting us to engage with African nursing leaders. Prof Moosa will be meeting Dr Sibanda and engaging with many other PHC disciplines in the 2nd Interprofessional Education and Collaborative Practice for Africa Conference in Nairobi.

We ask all organisations and individuals interested in developing the AFPC to join us here. We will then get you onto the TUFH online platform without charge, sharing ideas for AFPHC including a structure and process to advocate for strong PC/PHC under UHC.

PLEASE share this message with any of your local colleagues and organisations in the PHC team in Africa and ask them to join the discussion, starting here. (https://mailchi.mp/bdadfc45a145/afpc )


Prof. Shabir Moosa, President WONCA Africa

Dr. David Lusale, African Network of Associate Clinicians

Prof Marietjie de Villiers, President AFREHealth

Prof. Godwin Aja, Africa Regional Board Member, (TUFH)


This short list of organisations supporting AFPHC will be updated here.