Lack of resources and finances are hampering the continent, but Afreximbank has plans for African Centres of Excellence, Oluranti Doherty, Director Export Development, tells Infrastructure Correspondent Barry Francis
Africa has a unique set of challenges when it comes to healthcare. West Africa in particular suffers from a severe shortage of healthcare facilities and, coupled with further issues unleashed by COVID-19, a new way of thinking is taking shape.
For Oluranti Doherty, Export Director at Afreximbank, the underlying reasons are clear. “Healthcare is predominantly within the domain of governments who are responsible for funding healthcare infrastructure projects, but if you look at state reallocation of healthcare across Africa, you see that has been low compared to global standards,” she says.
“Lack of investment and lack of opportunity in the private sector drives healthcare professionals overseas to pursue their careers,” she adds. “Along with the lack of political will to invest in healthcare and support its businesses and systems, not to mention challenges in international financing, there is a huge hurdle to overcome.”
Changing the mindset
Currently, most West African hospitals are underfunded, underequipped and inaccessible to most patients in non-urban areas. Only 4 of 14 West African countries assessed have more than one doctor per 10,000 people. Nigeria currently has the highest ratio at 4 doctors per 10,000 persons.
The acute shortage of healthcare workers and an even greater deficit in skilled specialist personnel feeds and has led to a massive brain-drain in the sector. Much of this is due to inadequate investment in capacity development, and failure to comply with the 2001 Abuja Declaration where African countries committed 15 per cent of their budget to healthcare.
In addition, West African countries are characterised by a disproportionately large contribution of private spending to total health expenditure and this directly impairs the accessibility and quality of healthcare services within the region. Healthcare across specialist areas are mostly supplied at the tertiary care centres, and sometimes at secondary level, while referral systems are generally poor.
Changing lifestyles have led to an increased incidence of NCDs, with cardiovascular ailments, cancer and haematological disorders representing 81 per cent of NCD mortality. The result of all these factors is often medical tourism to such countries as India, the USA and the UK in search of specialist solutions.
The African Medical Centre of Excellence
In response to the critical state of healthcare in the region, Afreximbank has commenced plans to set up a 500-bed, world class African Medical Centre of Excellence (AMCE) in Abuja, Nigeria. The Bank itself was established in Abuja in October 1993 by African governments, African private and institutional investors as well as non-African financial institutions and private investors for the purpose of financing, promoting and expanding intra-African and extra-African trade.
Headquartered in Cairo, Afreximbank also has operations Cote D’Ivoire, Zimbabwe and Uganda with a mandate to stimulate African trade and operate as a first class, profit-oriented, socially responsible financial institution.
And nowhere is this more applicable than in the healthcare sector. “We commissioned King’s College Hospital London to undertake a study for us in 2015,” Oluranti says. “One of their proposals was to change the trend of things by looking at regional centres of excellence as a way of addressing the infrastructure gap and creating an ecosystem that would speak to medical personnel on the continent. At the same time the staff would receive adequate training and address the problem of outbound medical services.”
In 2017 the Bank selected Nigeria for the pilot. “The Nigerian government was very cooperative. They gave us two acres of land in Abuja and committed to provide non-physical incentives to support the project to ensure it will be sustainable.
“We’ve been very fortunate that King’s London have done this before in places like Dubai, Abu Dhabi and China. So they come with a wealth of experience to do these kind of projects in environments that are not as perfect as the West. They have been able to bring onboard their skill set to support us in working on this project and they are now a major partner for us.”
“Many healthcare professionals know the right people but they struggle to access the finance for their schemes. We are willing to look at their projects and to provide the funding where appropriate” – Oluranti Doherty, Director Export Development, Afreximbank
The 500 bed centre will offer a full spectrum of medical services in oncology, cardiology and haematology along with world-class research, education and development capabilities to ensure it remains at the leading edge of delivering clinical services. The services will be offered to both low and high-income patient groups while demonstrating a viable method for quality healthcare that can be replicated across Africa.
Afreximbank are taking a significant portion of equity – 50 per cent – and attracting private investor financing to supplement it. “We are looking at working with like-minded institutions as you can’t have a marriage of strange bedfellows,” says Oluranti. “We’ve seen keen interest from GE Healthcare not just in supplying the equipment, but also providing some form of equity and other forms of financing to ensure that this project is sustainable.”
They are inviting partners for the second phase following the proof of concept with the first phase, which is due to be completed within three years. It will have differentiating facilities, including PET and CT imaging which are not currently available in Africa and will provide patients with the continuity of care required to achieve superior health outcomes compared to other centres in the region.
Service delivery will be led by King’s College Hospital at a level similar to its operations at King’s College Hospital Dubai and King’s College Hospital India. Medical staff will be sourced from KCH’s network along with exceptional Nigerian medical professionals currently practising in Europe, Middle East and America.
World class development partners (project managers, development and design consultants) with experience in executing similar projects in Nigeria have already been engaged to facilitate the project development.
Positive impacts
The project is strongly aligned with the United Nation’s 2030 Sustainable Development Goal (SDG) to ensure healthy lives and promote well-being for all at all ages. The provision of quality healthcare to more than 5000 patients annually includes free or discounted medical services to the poor and uninsured patient groups. Much of Nigeria’s healthcare expenditure is out of pocket, with no social insurance in place for the less well-off.
“The government is trying to scale up insurance schemes,” says Oluranti. “Some states such as Lagos have moved quickly while others haven’t. There is also aid in place to fly severe cases abroad for medical treatment, so we’re looking at a combination of processes to provide for those unable to pay.”
She’s also keen to utilise the returning medical expertise to improve the healthcare provision on the continent. “Many healthcare professionals know the right people but they struggle to access the finance for their schemes,” she says. “We are willing to look at their projects and to provide the funding where appropriate. We have also supported public sector projects including a $1m facility to support the manufacture of medical equipment and consumables on the continent.”
Afreximbank recently collaborated on the Africa COVID-19 financing initiative by providing a $2bn guarantee facility for the acquisition of doses of the Johnson & Johnson vaccine to support the country’s acquisition of vaccines in a timely manner to reduce the burden on African states.
“Afreximbank has always been an institution that rises up to challenges – it’s part of our responsibility to catalyse sectors,” Oluranti says. “When we’ve been able to attract private sector stakeholders into the sector, our objectives will have been achieved and we will be able to show that such a project is possible.”
Contact:
odoherty@afreximbank.com
+20 122 299 9066