Dear All,

I would like to share with you this new publication from Lancet Commission: The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

Summary
Sub-Saharan Africa’s health challenges are numerous and wide-ranging. Most sub-Saharan countries face a double burden of traditional, persisting health challenges, such as infectious diseases, malnutrition, and child and maternal mortality, and emerging challenges from an increasing prevalence of chronic conditions, mental health disorders, injuries, and health problems related to climate change and environmental degradation. Although there has been real progress on many health indicators, life expectancy and most population health indicators remain behind most low-income and middle-income countries in other parts of the world.

This Commission highlights 12 strategic options that all sub-Saharan countries should consider in their policies and plans. These options are connected to the health related SDGs and integrate commitments made by regional African bodies. The strategic options are as much about promotion of health and prevention of disease as they are about expansion of access to treatment. Building health systems commensurate to the challenges of 21st century Africa requires action in the critical areas of:

  • people-centred health systems, universal health coverage (UHC), the social determinants of health, and health outcomes.
  • leadership, stewardship, civil society engagement, and accountability at all levels.
  • financing for health.
  • commodity security (eg, medicines, technologies, essential equipment, tools, and supplies).
  • public health systems.
  • health workforce development.
  • research and higher education.
  • innovation in products, service delivery, and governance.

These eight interconnected areas are covered in separate sections of this Commission. We describe the different areas where changes are needed and make recommendations for the way forward, recognising the great diversity within the region. This Commission’s vision and aspiration is that by 2030 Africans should have the same opportunities for long and healthy lives that new technologies, well-functioning health systems, and good governance offer people living on other continents. The Commission concludes with an agenda for action based on the following key messages.

A framework shift is needed to deliver better health outcomes through people-centred health systems and UHC. Frameworks that rely on hospitals and individual care are unlikely to lead to the achievement of greatly improved health for all Africans. A rapid expansion of new, African-bred approaches to people-centred health systems, focused on prevention, primary care, and public health, and supported by clinical referral systems and quality tertiary care is required to move to the next stage of better health. UHC should be designed with local values, sustainability, and equity in mind from the onset.

All my best regards.

Isabelle Wachsmuth
World Health Organization
Health System and Innovation
Service Delivery and Safety
20 Avenue Appia. 1211 Geneva
Tel:+41227913175
Email: hugueti@who.int

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)31509-X.pdf

CITATION: The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa
The Lancet, Published online: 13 September 2017
Irene Akua Agyepong, Nelson Sewankambo, Agnes Binagwaho, Awa Marie Coll-Seck, Tumani Corrah, Alex Ezeh, Abebaw Fekadu, Nduku Kilonzo,
Peter Lamptey, Felix Masiye, Bongani Mayosi, Souleymane Mboup, Jean-Jacques Muyembe, Muhammad Pate, Myriam Sidibe, Bright Simons,
Sheila Tlou, Adrian Gheorghe, Helena Legido-Quigley, Joanne McManus, Edmond Ng, Maureen O’Leary, Jamie Enoch, Nicholas Kassebaum, Peter Piot
http://dx.doi.org/10.1016/S0140-6736(17)31509-X

SUMMARY
‘Sub-Saharan Africa’s health challenges are numerous and wide-ranging. Most sub-Saharan countries face a double burden of traditional, persisting health challenges, such as infectious diseases, malnutrition, and child and maternal mortality, and emerging challenges from an increasing prevalence of chronic conditions, mental health disorders, injuries, and health problems related to climate change and environmental degradation. Although there has been real progress on many health indicators, life expectancy and most population health indicators remain behind most low-income and middle-income countries in other parts of the world…’

SELECTED EXTRACTS
Local generation and use of innovation will accelerate better health outcomes, reduce inequities, and have huge scope for prevention and care by harnessing the rapid growth in information and mobile technology in the African continent.

Capitalising on innovation is key to the future of health in sub-Saharan Africa and can support leapfrogging health improvements, by adopting more advanced technologies rather than following slow, classic paths. Innovative, low-cost vaccines, diagnostics, therapies, and information technology applications have huge scope for prevention and care. Innovations in health professional education, health service delivery, and governance are also urgently needed, particularly those using information and communication technologies.

Information and communications technologies and social media have been and will continue to be important enablers of Africa’s transformation. African countries are experiencing an unprecedented increase in mobile phone subscriptions, internet connections, and mobile phone financial transactions, and a decline in the price of devices and services. There are an estimated three mobile phones for every four people in sub-Saharan Africa, with variations across regions (figure 8). Mobile phone-based money transfer services such as M-pesa (launched in Kenya in 2007) and others are revolutionising business and power relations. Information and communications technologies can transform the work environment, introducing flexibilities that encourage positive lifestyles. Mobile phones and wearable devices can help people exercise and make other healthy behaviour choices, and thus affect the burden of chronic conditions. But information and communications technologies can also lead to sedentary behaviour in young children, adolescents, and adults, and thus precipitate exactly the opposite outcome.

Best wishes, Neil

Coordinator, mHIFA Project (Mobile Healthcare Information For All)
http://www.hifa.org/projects/mobile-hifa-mhifa