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Dr. Tedros: “Universal Health Care is not a ‘one size fits all’ journey”

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Dr. Tedros Adhanom addressed a high level meeting on Universal Health Coverage in Africa which was held at the margins of the 6th Tokyo International Conference on African Development (TICAD VI) in Nairobi on Friday (August 26,2016).

Describing the meeting on Universal Health Care in Africa as a significant event, Dr. Tedros pointed out the fact that the issue of Universal Health Coverage has been constantly gaining traction in international health forums, particularly at a time of the current post MDG era. Even further, the Minister said, "I firmly believe the topic for discussion is undeniably important, as the Ebola crisis has shown beyond a shadow of a doubt that universal health access is a vital health agenda for Africa."

In his speech, Dr. Tedros stressed on four major themes: the progress Africa has made over the last decade and a half, the challenges that still bite the continent, the achievements, challenges and prospects in Ethiopia, and finally what remains to be done and the way forward.

Touching upon the progress that Africa has made over the past 15 years, Dr. Tedros said the continent has shown meaningful changes in its macroeconomics. Taking note of the estimates of the Economist magazine, Dr. Tedros noted trade between Africa and the rest of the world has increased by 200 percent since the year 2000 and over the last decade, six of the world's 10 fastest-growing countries were African. He said, "In eight of the last 10 years, Africa's lion states have grown faster than the Asian tigers. The fastest-growing economy in the world in 2011 (at 13%) was Ghana. My own country Ethiopia, has been registering double-digit growth rate in the past 12 years." The Minister also mentioned the 2016 report of the African Development Bank's 2016 report, in which he said the number of middle-class Africans will grow to 1.1 billion (42% of the predicted population) by 2060, and Africans living below the poverty line will be in the minority (33%)t in the same projected year. He added, "The ADB bank describes the trajectory in macroeconomic growth in Africa as 'unstoppable'."

Dr. Tedros, however, noted the road ahead is marred with huge challenges as considerable segments of the African community are still finding it hard to make ends meet. He said, "Despite this rosy figure in economic growth, many of our citizens in Africa are still stuck in a quagmire of poverty and deprivation. It has become evident that macroeconomic averages hide the vast regional and in-country disparities in terms of the chance of improved wellbeing in a person's lifetime."

Even worse, Dr. Tedros mentioned the UN Millennium Development Goal report, which claimed that more than 40 % of Africans still live in extreme poverty,adding that a woman in sub-Sahara Africa has a 1 in 16 chance of dying during pregnancy or childbirth, a figure which stood in a stark contrast to the 1 in 4,000 risk in more developed countries. According to Dr. Tedros, the cost of getting treatment is substantially unaffordable that a considerable portion of African citizens die in their homes without ever seeing a health facility.

Reflecting on the achievements, challenges and prospects in Ethiopia in such regards, Dr. Tedros said, "In Ethiopia we have made the initial steps towards achieving UHC. We have created community based insurance schemes (CBHI) in four regions of our country that covers about 12 percent of the population. Membership to a CBHI is voluntary and the national average for premiums is about 200 ETB (roughly 10 USD). In addition, government subsidies are used to pay for the cost of health services for the poorest of citizens."
Dr, Tedros however said the country has faced several challenges, which among others include lack of a strong institutional set up for managing prepaid health services. To which he added there was a need to raise more public funding for UHC and work towards ensuring enhanced donor support.

On the way forward, Dr. Tedros underscored the fact that universal health care remains to be a fundamental step towards inclusiveness. To such end, the Minister said, "it is imperative that donors and international organization support African countries efforts through financial and technical support. Africa needs to be supported to make health accessible to its people through partnerships built on country ownership.

In all these, Dr. Tedros assured the gathering that his country remains committed to intensify its partnership with governments and international organizations to achieve Universal Health Coverage as outlined in the SDG's.

In his concluding remarks, Dr Tedros said, "UHC is not a "one size fits all" journey. This, of course, does not mean, "anything goes" when it comes to implementing UHC."

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