Boosting Access, Reducing Harm Pathway To Africa Healthcare

Concerns about access to healthcare and harm reduction practices on the African continent dominate discussions as health experts, civil society and policy makers converge in Ghana for the 2024 edition of Africa Healthcare Summit.

The summit with the theme” Advances in Public Health-Tackling Inequities and Access: A One Health Approach” had participants from about 25 countries including Ghana, Senegal, Nigeria, Morocco, Kenya, US and the United Kingdom.

Mounting challenges:

Different speakers at the summit admitted that healthcare delivery on the African continent is currently beleaguered by challenges of accessibility, weak health system, human resources for health and vaccine development among others.

While stressing the need for improved investment in healthcare, the speakers also make a case for African governments to collaborate in combating health inequity and advance the task of ensuring sound health for all.

In a remark, the representative of World Health Organisation (WHO), Frank Lule noted that the concern is on addressing two pronged issues of one health approach and all hazard approach. He reaffirmed the commitment of WHO to creating a healthier and more equitable Africa for the present and future generations.

For his part, the Director General of West African Institute of Public Health Nigeria, Dr Francis Ohanyido noted that universal health coverage is one of the things that will determine Africa’s tomorrow.

Speaking during one of the sessions, founder of African Women Cancer Foundation, Dr Ify Nwabukwu lamented the lack of access to healthcare delivery for many, especially women and girls, on the continent.

In a virtual presentation, Nigeria’s Dr Aminu Magashi urged the African government to step up investment in healthcare noting that the 15% Abuja declaration has been observed in the breach by virtually all the African countries that signed the treaty.

“Africa must invest massively in the health sector to tackle the pressing healthcare challenges” Magashi who is the founder and coordinator of the Africa Health Budget Network, a regional group that uses budget advocacy to influence adequate health spending and improve transparency and accountability, said.

Prioritising harm reduction:

While access and affordability for healthcare services constitute part of the problems on the continent, one other critical challenge is that of adopting harm reduction practices. This has been plagued by misinformation and misconception.

Good enough, there is a gradual shift as efforts are being intensified to create more awareness on the need for all to imbibe harm reduction practices.

To this extent, a session of the Summit was dedicated to harm reduction with experts who emphasized the need for harm reduction in different areas of health practices, urging governments on the continent to prioritize harm reduction practices.

Leading discussions during the session, a globally respected healthcare leader, Dr. Kgosi Letlape, who focused on Tobacco Harm Reduction, decried a situation where people approached harm reduction from a moral position.

While chronicling how use of alternative tobacco products led to drastic reduction in tobacco related deaths in Sweden, Letlape chided the World Health Organisation (WHO) for banning such alternatives which are less harmful than combustible tobacco.

Letlape who founded the Africa Medical Association lampooned Africa for taking what the WHO says as the gospel truth instead of using its faculty and thinking process.

“If what we were told about covid was completely true, Africa would have been devastated. Despite the absence of vaccines because of vaccine hoarding, we survived”.

He urged African governments to put in place policies that are based on science and evidence, ask critical questions and critically assess situations before making policies.

Letlape noted that harm reduction is always rejected in medicine and cited the fierce objection that trailed the use of condoms other harm reduction practices noting ‘the greatest issue around harm reduction and behaviours that harm people is stigmatization of those people.

He enjoined cigarette smokers to move away from combustible tobacco to risk reduced products like e-cigarettes, smokeless tobacco, heat not ban technology, among others.

On his part, the Executive Director of Harm Reduction Alliance in Ghana, Samuel Kujo noted that there is a growing interest in harm reduction in Ghana owing to the sustained advocacy of civil society organisations and awareness creation by the mass media.

“We have focused on the dangers of drug use and how to effectively mitigate it through sustainable harm reduction practices, even though there were pockets of resistance initially, this was occasioned largely by misconception and misinformation, people are now appreciating the need to adopt the culture of harm reduction in Ghana.

“Of course, the health workers are part of the problem because some of them don’t understand and accept the need for harm reduction because they think that by talking about harm reduction, we are rather promoting drug use. That has been a challenge, especially from mental health professionals. but gradually, the situation is improving as we are having more people who have been exposed to the principles of harm reduction”.

When asked what African governments and policy makers should do as far as harm reduction practices are concerned, Kujo said they need to be bold and take practical measures that will support harm reduction.

“It is not possible to have a vice-free society and since people will always indulge in drug consumption, taking of tobacco and other things that are harmful to their health, policy makers on the continent must make concerted efforts to work out ways of reducing this harm and therein lies the principle of harm reduction whether in relation to drug abuse by youths, tobacco consumption, use of condoms to reduce sexually transmitted diseases or crash helmets to reduce impact of accidents.

“There is a plethora of scientifically proven evidence to show that harm reduction is working, in different parts of the world. Therefore, African governments need to do all it takes to ensure that harm reduction practices reflect public health policies on the continent” he added.

Speaking on the sidelines, Technical Adviser to Nigeria’s Minister of Innovation, Science and Technology, Prof Martins Ike Muonso said for there to be effective harm reduction campaigns, the instrument of the campaigns must be accessible and affordable to those that need them.

“Because these products are not readily available, the impact is not being felt as it should. Generally speaking, regulation has failed a lot of people who are moving in droves into drugs and use of combustible cigarettes. The harm is staring us all in the face and one way of stopping this is to use the reduced risk products like the alternative tobacco products that are available.

“We must admit the fact that people are addicted and the best way is to fashion out how to reduce the harm associated with such addiction. To do this effectively, all the stakeholders have to synergize. Government needs to reduce excise taxes on the alternative products and tax heavily, combustible tobacco. Once that is done, there will be a reduction in the cost of availability and this will be helpful to the system and the overall drive of engendering harm reduction,” he added.