Where is Right to Health in Africa?

o in Africa where the are many heart rending goings on in Darfur, Congo, Sierra Leone, Zimbabwe and many others. One is more likely to hear from Medicines sans Frontiers, or Save the Children Fund or some other.
Last month medical associations from Canada, Thailand, Malaysia, South Africa, Nigeria, Ghana, Zimbabwe, Zambia, Sudan and the British Medical Association met to discuss ‘improving health in the developing world: what can national medical associations do?’ Also present were a number of interest groups.
The UN Rapporteur on ‘right to highest attainable health’, Paul Hunt said every country in the world was a signatory to the international conventions that enshrine ‘health’ as a human right. As a result every country government has obligations to fulfil. The problem is ‘who’ is going to be seeing to it that these are fulfilled? It is the responsibility of citizens. It is the coming together of the demand on governments to fulfil their obligations and civil society to monitor that constitutes the ‘right to health’ movement.
National Medical Associations [NMAs] represent and consist of citizens who are informed and influential. They have a duty to watch the government on behalf of their patients and ensure that it is fulfilling its obligations. They also have a duty to inform the citizens so that people can participate and make informed decisions about the health choices they have.
One of the medical association delegates asked why it is that the leaders of medical associations sometimes become government ministers, and then often do more damage to the health system during their tenure than a non-medical person. The irony was heightened when it was pointed out that medical associations are often set up with lofty aims of doing social good and maintaining standards, but actually when they meet they discuss only forms of personal gain.
Many medical associations cosy up to government thinking they can influence it, but in reality politicians have no respect for the opinion of health professionals with regard to health policy or administration. This is not an African phenomenon only.
There are many diseases in the world that are found among communities that do not represent potential profitable markets for drug companies. The research and development resources for drug multinationals represent hundreds of millions of dollars per drug to reach the market.
This can only be recouped in high cost and large volume markets. More money still is then spent registering the drug in all the countries of the world. This all tends to marginalize drugs that cannot attract large markets at high prices for a long enough patent period. This is a health human rights issue.
However, private public partnerships [PPP] in drug development can and do make potential drugs [or compounds] developed through public finance in universities and other establishments available to companies to develop for the market. However, they need funding support through public funds or by attracting investors.
That some diseases are neglected or that health needs of some communities are marginalized should be on the agenda of the NMAs. They could use their international lobby potential to press for international funding.
Dr Titiola Banjulu, who is director of Africa Recruit, pointed out that from data collected from African professionals in the diaspora including health professionals, over 70% of want to continue to have professional contact with Africa including returning for periods of time, but there are no mechanisms that permit such a relationship to continue.
There is a large gap of unfulfilled need existing in the community, for which health professionals have an ethical responsibility, which the associations are not addressing because they are trying to cosy up to government. The governments are very hard bedfellows. They take but don’t give.
In Zambia all the junior doctors were sacked when they took industrial action to support pay demands. The medical system has never recovered with very few local doctors wanting to stay after qualifying. In Sudan over 50% of the population has no access to a health facility at all. In Ghana 90% of doctors are in Accra and Kumasi regions of the country. However, there is some movement. The health human rights agenda is slowly creeping up the ‘to do list’.
During the first week of November, 12 medical associations from Africa are meeting in South Africa to set up the Africa Region of the World Medical Association [WMA]. The WMAs main arena is medical ethics and health human rights. In May several health human rights associations from Eastern and Southern Africa met in Nairobi. So, maybe, in the future it will be African health professionals championing the health of their people.