Tag: WHO

300 Remote Health Care Facilities to Benefit from Gavi backed Solar Electrification Project
Quick look;
- 300 remote health care facilities across Ethiopia will be powered with solar energy, benefiting an estimated 6.7 million people
- Backed by Gavi funding, this new initiative aims to build climate-resilient health systems, while also boosting vaccine storage capacity
- The programme – which supports the Ethiopia Ministry of Health’s goal to solar power over 1,000 health care facilities and enhance maternal, infant and post-natal care in underserved areas – will be implemented by the Ministry of Health, UNICEF and WHO.
In response to the urgent demand for reliable energy in health care facilities, the Ethiopia Ministry of Health, Gavi, the Vaccine Alliance (Gavi), UNICEF and WHO Friday officially launched the Health Facility Solar Electrification (HFSE) initiative.

This new initiative, which is part of a broader US$ 35 million programme funded by Gavi, aims to significantly reduce greenhouse gas emissions, increase access to immunization, and broaden primary health care services.

Three hundred health care facilities have been prioritized for solar expansion across all regions in Ethiopia, focusing on facilities that are distant from the main power grid.

The deployment of solar energy will significantly improve health care outcomes for the estimated 6.7 million people living in the catchment areas of the health facilities by increasing the range of services offered at primary health care facilities, including expanded access to immunization services and availability of clean water at health facilities. It also aims to strengthen health care services by providing decentralized solar energy, contributing to climate-resilient health facilities while simultaneously reducing carbon emissions.

This jointly led effort falls under the Ministry of Health’s plan to equip over 1,000 health care facilities with solar energy and will be implemented by December 2025.

“Today, we are powering health and hope across Ethiopia. With solar electrification, our health facilities will deliver reliable care, even in the most remote communities, bringing us closer to a healthier andbrighter future for all,” said H.E Dr. Dereje Duguma, State Minister of Health.

“Climate change is increasing the burden of diseases in the most vulnerable communities, and access to electricity is a core determinant of a country’s ability and readiness to provide quality health services,” said Thabani Maphosa, chief country delivery officer, Gavi, the Vaccine Alliance. “Establishing and scaling health facility solar electrification, as we are doing here today, represents an unprecedented opportunity to strengthen primary health care systems, contribute to a greener planet, and drive improved health outcomes.”

“This initiative marks a significant step forward in sustainable health care and climate resilience, benefiting millions in underserved communities,” highlights Dr. Aboubacar Kampo, UNICEF Representative in Ethiopia. “By enhancing immunization for children and strengthening health services for mothers and infants, we are promoting safer deliveries and improving post-natal and infant care.”

“The connection between energy and health is clear in both homes and health care facilities in Ethiopia. Access to clean and reliable energy in health care facilities is crucial for providing quality essential services for disease prevention and treatment, particularly for mothers and children in hard-to-reach areas of the country,” highlights Dr. Owen Laws Kaluwa, WHO Representative to Ethiopia. “Access to electricity in health care facilities can be a matter of life and death.”

Recognizing the critical role of cold chain equipment in health care delivery, the HFSE initiative will leverage Gavi’s Cold Chain Equipment Optimisation Platform (CCEOP) mechanism to deploy solar photovoltaic packages at 1,000 primary health care facilities across Ethiopia, Pakistan, Uganda and Zambia.

With a funding commitment of US$ 35 million from Gavi, the project will enhance the ability of health care facilities to power essential cold chain equipment and other vital medical devices in those countries.
October 12, 2024
Reducing Malaria Could Add $126.9 Billion to Africa’s Economy

A new report by Malaria No More UK revealed that achieving the World Health Organization’s (WHO) target of reducing malaria by 90% by 2030 could add $126.9 billion to Africa’s Gross Domestic Product (GDP).

The report was shared by Gavi, the Vaccine Alliance, on its website.

Titled “The Malaria Dividend,” the report utilized data and analytics from Oxford Economics Africa, noting that the potential economic benefits of reducing malaria cases are substantial.

It stated that Nigeria’s economy could gain $35 billion and international trade $80.7 billion by 2030.

“This economic uplift would add $35 billion to Nigeria’s economy – already one of the largest on the continent – and could increase international trade by $80.7 billion by 2030,” the report noted.

According to the report, the world is unlikely to meet the WHO’s 2030 target of reducing malaria cases and deaths by 90 percent. It stated that malaria kills 600,000 people annually, with 95% of deaths occurring in Africa, mainly among children under five.

The disease also affects working-age adults, leading to lost income and increased healthcare costs, resulting in a significant economic burden.

The report highlights that the fight against malaria has been hindered by factors such as climate change, conflicts, drug and insecticide resistance, and the COVID-19 pandemic, creating a “perfect storm” that has slowed progress in reducing malaria cases and deaths.

“While great progress was made in the first two decades of the century– the global mortality rate for malaria halved between 2000 and 2015, and case incidence fell by 26% – the fight is far from over,” the report noted.

It further suggested that achieving the 90% reduction in malaria by 2030 is still possible with collective efforts and the introduction of new tools, such as advanced vaccines and other groundbreaking innovations that could turn the tide in the fight against malaria.

Lowering the economic burden of malaria would enable countries to enhance their overall healthcare systems, including upgrading diagnostic capabilities and the healthcare workforce, leading to improved health and economic security.

The report emphasized that continuous support from organizations like Gavi and the Global Fund is essential to combat malaria and other diseases, facilitating a stronger link between health and economic stability globally. “In the near term of the next 18 months, the necessity of adequately funding both the Global Fund and Gavi at their upcoming replenishments cannot be overstated,” it noted.

It highlighted that the connection between health and economic security is far-reaching, with investments in healthcare yielding significant economic benefits.

Citing a report by the World Economic Forum and McKinsey Health Institute, it noted that addressing the women’s health gap could add $1 trillion to the global economy by 2040, preventing 24 million years lost due to disability and providing a $400 billion economic uplift.

Malaria transmission within the country is high and even higher in rural communities situated by the banks of major rivers and water bodies. The disease is caused by tiny parasites called plasmodium, often found in mosquitoes.

The National Malaria Elimination Programme (NMEP) reports that malaria accounts for 60% of outpatient visits to health facilities across the country and 30% of childhood deaths.

Globally, there are an estimated 249 million malaria cases and 608,000 malaria deaths among 85 countries.

The African region carries a disproportionately high share of the global malaria burden.

July 3, 2024
WHO Excited by Historic $160m Funding to Expand Roll-out of First-ever Malaria Vaccine in Africa

The World Health Organization (WHO) welcomes the launch by Gavi, the Vaccine Alliance, of the landmark opportunity for countries to apply for funding to introduce, or further roll-out, the RTS,S/AS01 (RTS,S) malaria vaccine.

This international support of nearly US$160 million from 2022-2025 will facilitate increased vaccine access to children at high risk of illness and death from malaria, starting with Ghana, Kenya and Malawi, the three African countries that began pilot introduction of the vaccine in 2019, and then expanding to other eligible endemic countries.

Malaria remains a primary cause of childhood illness and death in sub-Saharan Africa. In 2020, nearly half a million African children died from malaria – or 1 child died of malaria every minute.

Since the world’s first malaria vaccine was introduced in 2019, it has been well accepted in African communities after a relatively short period of time.

Demand is high even in the context of COVID-19: vaccination performance for the first dose is reaching between 73% to over 90% coverage, depending on the country, with no major disruptions during the pandemic. To date, about 1.3 million children have benefitted from the vaccine in the three African pilot countries.

“Gavi’s new funding opportunity brings us one step closer to reaching millions more children across Africa with the lifesaving RTS,S malaria vaccine,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Throughout the pandemic, when routine health services faced myriad challenges, parents and caregivers diligently brought their children to clinics and health posts to get the malaria vaccine. They know all too well that lives are being lost to malaria every day and are eager to protect their children from this deadly disease.”

Following WHO’s recommendation in October 2021 for widespread use of the RTS,S malaria vaccine among children in regions with moderate to high Plasmodium falciparum malaria transmission, a number of malaria-endemic countries have expressed interest in adopting the vaccine and are expected to apply for Gavi support to introduce the vaccine. The RTS,S vaccine works specifically against Plasmodium falciparum, which is the deadliest malaria parasite and the most prevalent on the African continent. Where the vaccine has been introduced, there has been a substantial drop in children being hospitalized with severe malaria and a drop in child deaths in the age group that is eligible for the vaccine.

Gavi has indicated that the first application deadline in September 2022 is reserved for countries currently piloting the vaccine and for which continuity of the vaccine programme is a priority. A second window open to other eligible malaria-endemic countries will close in January 2023. Countries can already submit expressions of interest during the first funding window for inclusion in this round.

“Malaria has devastated communities for far too long in Africa. We know that initially, supply, will not meet demand, nevertheless, we look forward to working with countries and our partners to introduce and scale this new tool in our fight against malaria, which could save the lives of thousands of children across the continent,” said Thabani Maphosa, Managing Director of Country Programmes at Gavi. “Gavi is proud to support this vaccine, and we hope this is just the beginning of a broader rollout that will see populations across the continent increasingly protected against this deadly disease.”

Like with many new vaccines, the supply of the malaria vaccine is limited as vaccine production ramps up.

“The long-awaited malaria vaccine for children is a breakthrough for science, child health and malaria control. It is projected that – at scale – using this vaccine could save tens of thousands of young lives each year, but we will need an increased supply of the vaccine so Africa can reap the benefits of this additional tool for malaria prevention,” said Professor Rose Leke, a malaria disease expert from the University of Yaounde in Cameroon, and co-chair of the expert group that advised WHO on a framework to allocate the currently limited malaria vaccine supply.

Over the next few years, the supply of the RTS,S malaria vaccine will be insufficient to meet the needs of over 25 million children born each year in areas where the vaccine is recommended, according to a WHO-commissioned global market study.

Should a second malaria vaccine complete clinical development successfully and be approved for use, the period of constrained supply could be shorter. The demand is estimated to range from 80 to 100 million doses annually.

In response to the supply situation, WHO has developed, with expert advice, a framework to guide vaccine allocation decisions at global and country levels that ensures children at highest risk across endemic countries are prioritized to receive the vaccine.

The framework also aims to ensure that childhood vaccination services started in the three pilot countries continue without disruption, until supply fully meets demand.

“Now is the time for African countries and communities to call out their interest – to donors, health leaders and manufacturers – in early access to this vaccine. Lives are at stake, every day,” added Dr Moeti. “This situation underlines once again why expanded local production of vaccines is essential for meeting health needs in Africa. We’ve seen encouraging first steps in that direction in recent months, and we are committed to supporting further efforts to expand vaccine production in Africa.”

WHO, Gavi and partners are working to accelerate RTS,S supply by exploring approaches to increase manufacturing capacity, market-shaping and facilitating the development of other first-generation and next-generation malaria vaccines.

Dr Moeti spoke during a virtual press conference today. She was joined by Mr Maphosa and Professor Leke.

Also on hand from WHO Regional Office for Africa to respond to questions were: Dr Akpaka Kalu, Team Lead, Strategic planning and Policy, Communicable and Noncommunicable diseases Cluster, Dr Opeayo Ogundiran, Epidemiology Pillar Lead for the Regional COVID-19 Response; Dr Phionah Atuhebwe, Medical Officer, New Vaccines and Dr Solomon Woldetsadik, Emergency Response Officer.

July 22, 2022
Gavi, WHO and UNICEF: 12 African Countries to Receive 18 million Doses of Malaria Vaccine by 2025
- In response to high demand for the first-ever malaria vaccine, 12 countries in Africa will be allocated a total of 18 million doses of RTS,S/AS01 for the 2023–2025 period
- Malaria Vaccine Implementation Programme countries Ghana, Kenya and Malawi will receive doses to continue vaccinations in pilot areas
- Allocations were also made for new introductions in Benin, Burkina Faso, Burundi, Cameroon, Democratic Republic of the Congo, Liberia, Niger, Sierra Leone and Uganda
Twelve countries across different regions in Africa are set to receive 18 million doses of the first-ever malaria vaccine over the next two years. The roll out is a critical step forward in the fight against one of the leading causes of death in the continent.

The allocations have been determined through the application of the principles outlined in the Framework for allocation of limited malaria vaccine supply that prioritizes those doses to areas of highest need, where the risk of malaria illness and death among children are highest.

Since 2019, Ghana, Kenya and Malawi have been delivering the malaria vaccine through the Malaria Vaccine Implementation Programme (MVIP), coordinated by WHO and funded by Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid.

The RTS,S/AS01 vaccine has been administered to more than 1.7 million children in Ghana, Kenya and Malawi since 2019 and has been shown to be safe and effective, resulting in a substantial reduction in severe malaria and a fall in child deaths. At least 28 African countries have expressed interest in receiving the malaria vaccine.

In addition to Ghana, Kenya and Malawi, the initial 18 million dose allocation will enable nine more countries, including Benin, Burkina Faso, Burundi, Cameroon, the Democratic Republic of the Congo, Liberia, Niger, Sierra Leone and Uganda, to introduce the vaccine into their routine immunisation programmes for the first time.

This allocation round makes use of the supply of vaccine doses available to Gavi, Vaccine Alliance via UNICEF. The first doses of the vaccine are expected to arrive in countries during the last quarter of 2023, with countries starting to roll them out by early 2024.

“This vaccine has the potential to be very impactful in the fight against malaria, and when broadly deployed alongside other interventions, it can prevent tens of thousands of future deaths every year,”
said Thabani Maphosa, Managing Director of Country Programmes Delivery at Gavi, the Vaccine Alliance.

“While we work with manufacturers to help ramp up supply, we need to make sure the doses that we do have are used as effectively as possible, which means applying all the learnings from our pilot programmes as we broaden out to a new total of 12 countries.”

Malaria remains one of Africa’s deadliest diseases, killing nearly half a million children each year under the age of 5, and accounting for approximately 95% of global malaria cases and 96% of deaths in 2021.

“Nearly every minute, a child under 5 years old dies of malaria,”
said UNICEF Associate Director of Immunization Ephrem T Lemango.

“For a long time, these deaths have been preventable and treatable; but the roll-out of this vaccine will give children, especially in Africa, an even better chance at surviving. As supply increases, we hope even more children can benefit from this life-saving advancement.”

“The malaria vaccine is a breakthrough to improve child health and child survival; and families and communities, rightly, want this vaccine for their children. This first allocation of malaria vaccine doses is prioritised for children at highest risk of dying of malaria,” said
Dr Kate O’Brien, WHO Director of Immunization, Vaccines and Biologicals.

“The high demand for the vaccine and the strong reach of childhood immunisation will increase equity in access to malaria prevention and save many young lives. We will work tirelessly to increase supply until all children at risk have access.”

Given the limited supply in the first years of the roll-out of this new vaccine, in 2022 WHO convened expert advisors, primarily from Africa – where the burden of malaria is greatest – to support the development of a Framework for allocation of limited malaria vaccine supply, to guide where initial limited doses would be allocated. The Framework is based on ethical principles on a foundation of solidarity; and it proposes that vaccine allocation begin in areas of greatest need.

The Framework implementation group that applied the framework principles included representatives of the Africa Centres for Disease Control and Prevention (Africa CDC), UNICEF, WHO and the Gavi Secretariat, as well as representatives of civil society and independent advisors. The group’s recommendations were reviewed and endorsed by the Senior Leadership Endorsement Group of Gavi, WHO and UNICEF (for more, see First malaria vaccine supply allocations: explanation of process and outcomes).

Annual global demand for malaria vaccines is estimated at 40–60 million doses by 2026 alone, growing to 80–100 million doses each year by 2030. In addition to the RTS,S/AS01 vaccine, developed and produced by GSK, and in the future supplied by Bharat Biotech, it is expected that a second vaccine, R21/Matrix-M, developed by Oxford University and manufactured by Serum Institute of India (SII), could also be prequalified by WHO soon. Gavi has recently outlined its roadmap to support increasing supply to meet demand.
July 8, 2023
Enhancing Cross-Border Payments in Africa

Cross-border payments in Africa have long been plagued by challenges such as currency incompatibility, limited interoperability, and high costs.

In reality, cross-border transactions can be a convoluted and time-consuming process, and can also be halted at any point – causing friction, delays, and a suboptimal experience for all those involved.

But the International Fund for Agricultural Development noted that “migrant workers sent over US$95 billion to and within Africa in 2021, benefiting over 200 million family members, majority of whom live in rural areas.

However, recent developments and strategic partnerships are poised to transform this landscape.

The Nigerian Exchange Limited (NGX) and the Pan-African Payment Settlement System (PAPSS) have joined forces to facilitate seamless cross-border transactions across the continent’s capital markets.

Additionally, Ecobank Group and PAPSS, Thursday, signed a memorandum of understanding (MoU) to enable settlement of cross-border transactions, while a white paper by BankservAfrica sheds light on the potential of mutual digital infrastructure to revolutionize payments in the region.

These initiatives are poised to enhance trade, foster financial integration, and promote economic development across Africa.

Temi Popoola, Chief Executive Officer, NGX Limited said one challenge that all of these mechanisms face is the lack of compatibility of local currencies across African countries and, by extension on African exchanges. “It is important to efficiently settle transactions in local currencies, and this is where the collaboration between NGX and PAPSS comes in.”

Streamlining Cross-Border Capital Market Investments

Interestingly, the partnership between NGX and PAPSS addresses a significant challenge in African capital markets: the lack of compatibility of local currencies. By efficiently settling transactions in local currencies, this collaboration aims to facilitate cross-border capital market investments.

This move is crucial for unlocking local capital, which plays a vital role in driving deep, stable, and less volatile capital markets.

By reducing frictions, increasing market access, and deepening the flow of local capital, African exchanges can witness substantial growth and contribute to the continent’s economic prosperity.

PAPSS: A Catalyst for Intra-African Trade

PAPSS, developed by the Africa Export-Import Bank, is a continental payment system that aims to foster trade and investment across Africa. The recent partnership with NGX and other financial institutions is expected to extend its reach and impact significantly.

“We cannot promote investment and growth on our continent without integrating our capital markets and our securities market. The role of PAPSS is critical in helping to achieve this,” Prof. Benedict Oramah, President of Afreximbank.

With the involvement of nine central banks and over 50 commercial banks, PAPSS is already facilitating cross-border transactions.

As more central banks and financial institutions join this network, PAPSS will enhance inter-Africa trade, promote financial inclusion, and contribute to the objectives of the African Continental Free Trade Agreement.

Addressing Fragmentation and Cash Culture

Cross-border payments in Africa face the challenge of a pervasive cash culture, where the majority of transactions are still conducted with physical currency. Furthermore, the payment landscape is fragmented, with numerous mobile wallets, banks, and card networks operating across the continent.

World Bank report stated, “moving funds through the current corridors requires transferal through the relevant domestic payment systems, which often have different operating hours and are located in different time zones.

“For certain corridors, the funds must be routed through several banks and intermediaries before they reach their destination, leading to higher fees and slower payment settlement.”

This fragmentation hinders smooth transactions and increases costs for merchants and remittance service providers. However, the push for broad-based and all-to-all interoperability, combined with innovative digital solutions, can help overcome these barriers and encourage the shift from cash to digital payments.

Unlocking the Potential of Digital Solutions

To address the complexities associated with cross-border payments, the focus is increasingly shifting towards digital solutions.

The partnership between Ecobank Group and PAPSS exemplifies this trend, leveraging the power of a regional payment solution to enable efficient and instant payments across African currencies.

Additionally, the white paper by BankservAfrica and Cenfri highlights the value of a mutual digital infrastructure in driving formalized, accessible, and inclusive payments in the Southern African Development Community (SADC) region.

These digital solutions hold the potential to revolutionize cross-border payments, improve transparency, reduce costs, and enhance the overall payment experience.

Conclusion

The recent partnerships and initiatives in cross-border payments across Africa are poised to transform the way trade is conducted and financial transactions are processed.

By addressing currency incompatibility, promoting interoperability, and embracing digital solutions, these efforts have the potential to unlock the vast trade potential in Africa, foster financial inclusion, and contribute to the continent’s economic growth.

As collaboration and innovation continue to drive progress in this space, Africa is set to establish itself as a hub for seamless cross-border transactions, furthering regional integration and prosperity

June 23, 2023
WHO, EU Collaborate to Launch Digital Health Certificate for Global Benefit

The World Health Organization (WHO) and European Commission have joined forces to establish a significant partnership in digital health, aimed at providing quality healthcare services to people worldwide.

This collaboration marks the foundation of the WHO Global Digital Health Certification Network (GDHCN).

WHO’s Global Digital Health Certification Network is an open-source platform, built on robust & transparent standards that establishes the first building block of digital public health infrastructure for developing a wide range of digital products for strengthening pandemic preparedness and to deliver better health for all.

The partnership, which aligns with the EU Global Health Strategy’s digital action plan, was highlighted as a crucial milestone by Stella Kyriakides, the Commissioner for Health and Food Safety.

Kyriakides emphasized the importance of utilizing European best practices to contribute to global digital health standards and interoperability, ultimately benefiting those in need. The collaboration between the EU and WHO serves as an example of how joint efforts can deliver better health outcomes globally.

Under this partnership, close collaboration will take place in the development, management, and implementation of the WHO GDHCN system, leveraging the European Commission’s technical expertise in this domain.

The initial focus will be on ensuring the effective functioning of the current EU digital certificates.

In June 2023, the WHO will adopt the EU system of digital COVID-19 certification to establish a universal system that enables international mobility and safeguards individuals from ongoing and future health threats, including pandemics.

Dr. Tedros Ghebreyesus, WHO Director-General, highlighted that the aim of developing new digital health products is to ensure prompt and efficient access to quality healthcare services worldwide.

The WHO intends to provide all Member States with access to an open-source digital health tool, guided by principles of equity, innovation, transparency, and data protection.

This collaboration is based on the EU and WHO Global Health Strategy on digital health, following an agreement reached on November 30, 2022.

The two organizations are committed to strengthening their strategic cooperation on global health matters, reinforcing a robust multilateral system with the WHO at its core, supported by a strong EU.

Thierry Breton, Commissioner for Internal Market, emphasized the global impact of the EU Digital COVID-19 Certificate, which has been recognized by 80 countries and territories.

Breton expressed satisfaction that the WHO will build upon the privacy-preserving principles and cutting-edge technology of the EU certificate to create a global tool against future pandemics.

The statement emphasized that the EU Digital COVID-19 Certificate has played a pivotal role in the EU’s efforts to combat the pandemic and facilitate international travel and tourism.

By using open-source technologies and standards, the EU DCC has become the most widely adopted solution worldwide, allowing for the integration of non-EU countries issuing certificates according to its specifications.

June 6, 2023
Healthy Life Expectancy in Africa Rises by Almost Ten Years, according to WHO Report

Healthy life expectancy in the African region has increased on average ten years per person between 2000 and 2019, a World Health Organization (WHO) assessment reports.

This rise is greater than in any other region of the world during the same period. The report also notes that the disruptive impact of the COVID-19 pandemic could threaten these huge gains.

Nursing mothers at a healthcare centre – PHOTO Source: Tracking Universal Health Coverage in the WHO African Region, 2022

The Tracking Universal Health Coverage in the WHO African Region 2022 report shows that healthy life expectancy—or the number of years an individual is in a good state of health—increased to 56 years in 2019, compared to 46 in 2000. While still well below the global average of 64, over the same period global healthy life expectancy increased by only five years.

Improvements in the provision of essential health services, gains in reproductive, maternal, newborn and child health, as well as progress in the fight against infectious diseases due to the rapid scale-up of HIV, tuberculosis, and malaria control measures from 2005, helped to extend healthy life expectancy.

On average, essential health service coverage improved to 46% in 2019, compared to 24% in 2000.

The most significant achievements were in preventing and treating infectious diseases, but this was offset by the dramatic rise in hypertension, diabetes and other noncommunicable diseases and the lack of health services targeting these diseases.

“The sharp rise in healthy life expectancy during the past two decades is a testament to the region’s drive for improved health and well-being of the population. At its core, it means that more people are living healthier, longer lives, with fewer threats of infectious diseases and with better access to care and disease prevention services,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “But the progress must not stall. Unless countries enhance measures against the threat of cancer and other noncommunicable diseases, the health gains could be jeopardized.”

Progress in healthy life expectancy could also be undermined by the impact of the COVID-19 pandemic unless robust catch-up plans are instituted.

On average, African countries reported greater disruptions across essential services compared with other regions.

PHOTO Source: Tracking Universal Health Coverage in the WHO African Region, 2022

More than 90% of the 36 countries responding to a 2021 WHO survey reported one or more disruption to essential health services, with immunization, neglected tropical diseases and nutrition services suffering higher disruptions.

Efforts have been made to restore essential services affected by the pandemic. However, to enhance health services and ensure they are adequate, of good quality and accessible to all, it is crucial for governments to step up public health financing.

Most governments in Africa fund less than 50% of their national health budgets, resulting in large funding gaps. 

Only Algeria, Botswana, Cabo Verde, Eswatini, Gabon, Seychelles and South Africa fund more than 50% of their national health budgets.

“COVID-19 has shown how investing in health is critical to a country’s security. The better Africa can cope with pandemics and other health threats, the more our people and economies thrive. I urge governments to invest in health and be ready to tackle head on the next pathogen to come bearing down on us,” said Dr Moeti.    

One of the key measures to improve access to health services is for governments to reduce catastrophic out-of-pocket expenditure by households. Health expenditure is considered as not catastrophic when families spend less than 10% of their income on health expenditure, irrespective of their poverty level.

Over the past 20 years, out-of-pocket expenditure has stagnated or increased in 15 countries.

The WHO report also analysed healthy life expectancy and health service coverage differences along country income level and geographic location. High and upper middle-income countries tend to have better health service coverage and higher healthy life expectancy at birth than lower-income countries, with around 10 additional years of healthy life expectancy.

Average percentage point change in the incidence of catastrophic health spending as tracked by SDG indicators

The report recommends countries to accelerate efforts to improve financial risk protection, rethink and repivot health service delivery with a focus on incorporating noncommunicable health services as part of essential health services, involving communities and engaging the private sector. It also recommends putting in place sub-national system monitoring systems so that countries are better able to capture early warning signs for health threats and system failures.

August 7, 2022
Reducing Smoking Prevalence Through Prevention

The Royal College of Nursing in the UK is currently running a campaign tagged “Prevention is better than cure”. This is a phrase that is learned early in life the world over: wisdom passed down by our forebears.

We often save ourselves the harmful effects of any action by avoiding such actions in the first place, rather than waiting to remedy the resulting consequences. This philosophy applies to all areas of life, and to the maintenance of assets.

Prevention is a principle in modern primary healthcare systems and a major factor in the increasing global popularity of wellness programmes.

In healthcare, where the concept is most popular, the logic is quite straightforward: go upstream to tackle the causes of ill-health rather than waiting downstream to cure the resulting illnesses.

As global health concerns mount over the health impact of smoking, all scientifically verified measures that can drive down the prevalence of smoking should be encouraged and pursued. In recent months, different civil society organisations (CSO) have increased the call for implementation of graphic health warnings alongside text on cigarette packs.

The clamour must be applauded for considering the potential harm of tobacco smoke exposure to smokers and non-smokers who are in proximity to them.

Tobacco Harm Reduction (THR) is a pragmatic approach to reducing the harm from combustible tobacco based on the scientific and empirical evidence that the risk of harm to smokers is from the toxic effluents that result when tobacco is burned, which the smokers in turn inhale, and not from the nicotine that they crave.

https://techeconomy.ng/2022/04/why-tobacco-harm-reduction-will-reduce-the-prevalence-of-smoking/

Therefore, by providing alternative products that deliver nicotine or the sensation of smoking but without the combustion of tobacco, THR prevents nicotine consumers from exposure to harmful tobacco smoke, which they would otherwise get from combustible tobacco.

As a public health strategy, THR advises and encourages smokers to switch from combustible tobacco to these alternative products, which are known as reduced risk products (RRP).

RRPs include e-cigarettes; heated tobacco products (HTP, which heat tobacco without burning them), nicotine pouches; nicotine gums and others.

Whereas, proponents of THR recognise that abstinence remains the best way to prevent tobacco harm, experience has shown over time that abstinence is not always feasible. For those users who are either unable or unwilling to quit, RRPs are targeted at smokers who choose to continue to enjoy nicotine, while appreciating the harm from tobacco smoke.

Prevention of smoking at any stage remains a more effective health and wellness strategy than stopping, hence more proactive initiatives that translate to earlier interventions tend to yield better outcomes.

This is perhaps among the reasons that countries, which were early adopters of graphic health warnings on cigarette packs, have not only accepted the empirical evidence of the effectiveness of THR but are also implementing science-backed regulations that provide guidance on the use of reduced risk products.

In an evidence brief published by the World Health Organisation (WHO) in 2014, WHO reported that citizens of such countries like Canada and the UK indicated that pictorial health warnings on cigarette packs provided more motivation to quit than text only warnings.

However, in more recent times, the government of Canada through Health Canada has issued science-backed statements such as “Completely replacing cigarette smoking with vaping will reduce your exposure to harmful chemicals” and “Vaping products and e-cigarettes deliver nicotine in a less harmful way than smoking cigarettes” among several messages to adult smokers to move them away from combustible tobacco products.

With graphic health warnings mostly limited to cigarette packs, smokers tend to encounter them following a decision to not only smoke but also to proceed to purchasing cigarettes. At that point, a decision has already been made to smoke and the graphic images at the point of sale or on cigarettes packs might be less effective as a deterrent.

On the other hand, THR messages continuously and steadily enjoin smokers to turn away from combustible cigarettes and switch to alternative products that prevent exposure to toxic tobacco smoke. This messaging does not depend on a smoker’s contact with cigarette packs.

Beyond providing earlier warnings, THR also provides less risky alternatives on the understanding that smokers really crave nicotine, which is not toxic, and not the toxic smoke from tobacco combustion.

The National Institute for Health and Care Excellence (NICE) of the UK has published a guidance on THR (or alternative tobacco products) and its efficacy in driving down smoking rates.

The guidance recognizes that quitting smoking is always the best option for smokers, but it supports the use of licensed nicotine containing products (NCPs) to help smokers, who are currently unable to quit, to switch to a less harmful option.

A study by William G Shadel, Steven C Martino, Claude M Setodji, Michael Dunbarin, et al., to assess the efficacy of graphic health warnings in deterring tobacco smokers was published by Oxford Academic in June 2019.

The result showed that graphic health warning labels reduced the chances of cigarette purchases for smokers with lower nicotine dependence but had no effect on smokers with higher dependence.

This study is a pointer for many African countries that have implemented graphic health warnings only, to further adopt THR as a scientifically established strategy with empirical evidence of success in reducing smoking rates and preventing death and illness.

*Olufisayo Adeoti sent this piece from Lagos

May 16, 2022

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