Africa has 16% of the world’s population and accounts for 23% of the global disease burden, but its spending on health is 1% that of total global health expenditure.
Covid-19 caused a significant twofold shock on the African continent, with a dramatic impact on both economic and health systems. The pandemic demonstrated to the world and to the region the deep inequities in access to health services and life-saving medicines – illustrated most graphically by inequitable access to vaccines – and reflects the power imbalances in global health that need to be urgently addressed.
Equally worrying, in 90% of 105 countries surveyed by the WHO, the pandemic severely disrupted access to many essential health services that were not directly related to Covid-19, particularly sexual and reproductive health services such as skilled birth attended deliveries and uptake of contraceptives. This disruption was worse among low-income countries, compared to middle- and upper-income countries.
On average, R1,200 is spent per person per annum on health across the region. In South Africa this figure is much higher, on average R9,300 per person. But this average hides a major inequity. Half of the total health spending in South Africa only benefits the 17% of the population that can afford private health insurance and services.
If every woman and girl had access to quality and comprehensive sexual and reproductive health services, most of these deaths would be prevented. That is why we need to ensure primary healthcare systems deliver an essential package of sexual and reproductive health services close to where people live. Well-trained and incentivised health workers, including community health workers, are required in sufficient numbers.
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