For the former minister of health of Guinea-Bissau, the €175 billion in funding for the African continent over 20 years, announced this week in Addis Ababa, the capital of Ethiopia and headquarters of the African Union, by Bill Gates, is “very positive news” and we must “be aware that most African countries will continue to need international cooperation to strengthen their health systems”.
However, in the opinion of the president and co-founder of the Institute for Global Health and Development in Guinea-Bissau, “what cannot continue is absolute dependence” on external funding for the continent. According to the doctor, African countries need to have their own plans to finance “most” of their programmes.
“That is why we need to demystify the issue of foreign aid. We will continue to need it, and it is welcome, but it has to be negotiated on different terms,” stressed the former director of Communicable Diseases at the World Health Organisation in Africa.
“It [external aid] has to be negotiated in terms of the priorities of the countries, which have to take the lead in their health systems (…) and must not be afraid to say no when external aid is not necessarily what they need or what meets their priorities,” the public health expert stressed.
For Magda Robalo, there is a global tendency to make a diagnosis that is “very reductive of what health needs are”. The doctor argues that corruption must be ended and services improved and made more efficient, but there are also other factors that need to be developed.
“We forget that, until road infrastructure is developed to give people easier access to healthcare, drinking water, energy and good education” (…) health systems will not develop either,” she explained. In general, Magda Robalo argues that African countries need to grow economically so that state budgets can have room to finance health care.
On the other hand, many African countries are focused on debt payments, which prevents them from “creating fiscal space to invest,” she lamented. “Therefore, at the macro level, at the global level, reforms in the financial system are needed and the terms of loans to African countries must be fairer,” she advised.
In her opinion, there must be “more availability of concessional debt [on more favourable terms and for specific areas] – so that investment can be made in sectors that bring economic growth and so that the surplus can be used to invest in vital sectors such as health and education” – and also more trade within the continent, she added.
Another issue to be improved is the working conditions of professionals, because “people do not have good conditions and hospitals are not well equipped”.
(Photo by SAMBA BALDE / AFP)
The sector needs to be improved to provide “decent care to the public” and, for the infectious disease specialist, women are the backbone of the health sector, as they constitute “the majority of professionals”. However, “unfortunately, women still struggle with lower pay” and are denied leadership positions, she said.
This was one of the reasons for the creation of the Mulheres Lusófonas na Saúde (Portuguese-speaking Women in Health) group in 2023. Magda Robalo advocates the need for female leaders because they make “a huge difference in the management and basic concerns of what the population needs”.
“The group of Portuguese-speaking women exists for this purpose, to work together with society and governments to help develop policies that move away from the practices that have been most widely used until now,” she concluded.
Platform with AFP
