Global Health: Wealthier nations must do more to close equity gaps

by Amref Health Africa

Editor’s note: Dr. Githinji Gitahi is the Group chief executive officer of Amref Health Africa. The article reflects the author’s opinions and not necessarily those of CGTN.

Since the discovery of the first COVID-19 case in December 2019, economies around the world have grappled with the devastating impacts of the pandemic, from the crippling of major industries to widespread job losses and food shortages. Now, well into the third year of the pandemic, efforts to rebuild are well underway and progress is being made, but the prospects for equitable recovery are looking slim for low- and middle-income countries (LMICs).

According to the World Bank, the uneven pace of post-pandemic recovery means the income per capita in about 50 per cent of low-income countries will still be below 2019 levels by the end of this year. Against this backdrop, we must then ask ourselves: Is global health equity truly achievable? If so, how can it be actualized in the face of widening health inequalities exacerbated by rising poverty, re-emergence of diseases such as polio and measles, low vaccination rates in poorer regions, climate-related disasters, and volatility in the prices of essential commodities such as food and fuel?

Developed economies account for more than 40 per cent of the global economy and contribute up to 80 per cent of development assistance to health. Their support for developing nations is crucial. Yet their reactions to the COVID-19 pandemic highlighted the inequalities in the balance of power between these countries and their beneficiaries, which manifested in the form of vaccine nationalism that denied many African countries timely access to vaccines. 

These actions continue to undermine global, equitable economic recovery. According to the International Chamber of Commerce, letting the developing world fall behind could cost the global economy $9.2 trillion. Despite this, recent figures indicate that six times as many booster jabs have been administered in high-income countries compared to first jabs in LMICs, who could take up to 57 years to achieve the same vaccination rates as G7 countries if at all – a testament to the half-spirited attempts at closing vaccination gaps.

But Africa is ready for change. The continent is ripe for a realignment of power that acknowledges the financial, technological and convening muscle of developed countries, while at the same time recognizing the sovereignty of African nations and their position as worthwhile partners rather than recipients of charity. Levelling the balance of power to achieve global health equity means reimagining what this could look like. It means identifying the gaps and working together to plug them for all to win.

Mutually beneficial partnerships between African countries and the rest of the world can help scale up actions to overcome new and existing challenges, including the ever-present threat of future pandemics and climate change.

For example, the G7 is well-placed to lead global efforts in pandemic prevention. The group is home to two-thirds of the world’s pharmaceutical market and is a leader in vaccine research, development and production. On the other hand, African nations are investing in enhancing their pharmaceutical research and development capacities and could stand to gain from knowledge exchange, and infrastructural and financial support. Both have the common goal of improving health outcomes in their respective jurisdictions, and a responsibility to contribute towards efforts to safeguard global health by preventing, detecting and managing disease outbreaks.

WHO Director-General Tedros Adhanom Ghebreyesus visits the Biomedical Research Institute at Stellenbosch University, Cape Town, South Africa, Feb. 11, 2022. /CFP

Waiving Trade-Related Aspects of Intellectual Property Rights (TRIPS) for diseases of international public health concern is one of the most comprehensive ways of facilitating trade in health knowledge. The waiver would allow for technology and knowledge transfer which would, in turn, enable developing countries to produce vaccines, diagnostics, and other countermeasures against COVID-19 and future disease outbreaks, not only for themselves but as part of the global supply chain.

However, in yet another remarkable example of global policy failing to protect the most vulnerable, the TRIPS waiver saga has dragged on for close to two years with no end in sight as European Union (EU) members and other wealthy nations oppose proposals by countries like India and South Africa to extend the provisions of the waiver to diagnostics, therapeutics and other medical tools. Those who oppose it say it could stifle future innovation by allowing others to benefit from the outcomes of years of research and development without investing in the same.

That this could be put forward in the face of a pandemic that has killed millions of people around the world is – frankly – disappointing, but not entirely surprising.

Global health equity cannot be achieved if profit protection mechanisms supersede the common good.

As heads of state and multilateral institutions, government representatives and policymakers from all over the world convene in New York for the 77th session of the United Nations General Assembly (UNGA 77), wealthier nations ought to be put to task over their failure to do more to achieve global health equity, despite many of them have benefited greatly from the colonial pasts that made them wealthy while leaving their colonies impoverished.

They must be reminded that what Africa needs to strengthen its health systems is a partnership, not charity. In consideration of that, their approach to achieving global health equity needs to centre on collaboration with African countries founded on mutual respect for human life and dignity, rather than perpetuate the vicious cycle of dependence that has characterised Africa’s relationship with the wealthy Global North.

This is an opportunity for them to show their support for African-led initiatives such as the Partnerships for African Vaccine Manufacturing (PAVM) and institutions such as the African Union’s Africa Centers for Disease Control and Prevention (Africa CDC), which has called for a New Public Health Order to safeguard the health and economic security of the continent in line with Agenda 2063.

By strengthening our capacity for prevention, preparedness and response to health emergencies, boosting access to primary care and harnessing science and innovation through knowledge exchange and sustainable health financing, we can break down the barriers to achieving global health equity.

But first, those who currently hold the power must be willing to view African countries not as helpless entities with outstretched arms bearing begging bowls, but as equal partners with astute leadership, capable institutions and valuable knowledge that can help pave a shared path to an equitable future.

To paraphrase Rwanda’s President Paul Kagame: We Africans must do things ourselves, but that doesn’t mean we must do them alone.

Article first published on

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