By GITHINJI GITAHI
It’s Wednesday August 16, 2079. Turning over in bed, Carl, 74, reaches for his phone. He holds it up as the morning update starts.
“Good morning Carl! Your blood pressure is not doing too well. I have noticed a steady rise over the past three days. This could be related to increased salt intake during your recent travel. Did you have a lot of cheese? We recommend that you increase your blood pressure medicine dosage by 50 per cent. Thank you Carl!
“And Carl, please go slow on the whiskey! Yours, Auntie Siri!”
This is no fiction.
In the year 1900, global life expectancy was barely 40 years, largely because of premature death arising from malnutrition, infectious diseases, and violence. Indeed, in Africa, average life expectancy was around 30 years, rising to 40 years by 1960.
In Kenya specifically, one was expected to live about 47 years around 1960. This was the case in many African countries, which led their presidents to declare war on illiteracy, poverty, and disease at the sunrise of their independence.
Over the better part of the 20th century Africa made unprecedented progress in reducing cases of premature death, with corresponding increase in life expectancy peaking at about 50 years—before the scourge of HIV/Aids, first reported in 1981, came to subtract what had been added.
Life expectancy plummeted in many African countries. Kenya’s, which had peaked at about 59 years in 1985, reached rock-bottom, at 51 years by the year 2000.
The gains that had been made were reversed. The health system just stood and watched as families suffered the catastrophic effects of this unknown disease, including impoverishment.
Then the world woke up and by the turn of the millennium in 2000, UN Secretary-General Kofi Annan was addressing himself to the scourge and the solidarity in its response.
Quoting Rudyard Kipling’s poem, Recessional of 1897 – “The tumult and the shouting dies – The captains and the kings depart” – he called for “…the fight for development – which is also the fight against poverty, ignorance and disease, including the world-wide scourge of HIV-Aids”, and the world listened.
Through multilateralism, civil society action, government response, and community solidarity, lives were added back where they had been taken away and life expectancy rose fast to the original figures.
In Kenya, it took close to 25 years to get back to a life expectancy of 59 years – a quarter of a century!
It’s 2019, life expectancy in Africa is about 64 years, and 67 years in Kenya. On average, Africa has added about 1.1 years every three years to life expectancy, and Kenya 1.2 years, accounting for the scourge of the 1980s and 1990s. This is largely as a result of addressing Jomo Kenyatta’s 1963 call to address poverty, ignorance, and disease, which are all bedfellows.
Let’s now walk to the future – to try to run would be to go ahead of ourselves. If I were to do back-of-the-envelope calculations using these rough figures (warning: I am no demographer), I would say the life expectancy of a person born in Africa’s in the year 2079 (the Nation Media Group’s 120th birthday) will be 83 years while that of a person born in Kenya will be 90 years.
In other words, children born in 2079 in Kenya will look forward to living on average 90 years compared to 67 years for those born today.
But as we have seen from the past 60 years, this won’t happen just by chance. It will need to be a deliberate investment in persisting and new threats to the fight against poverty, ignorance, and disease.
In the human capital concept, widely popularised by the World Bank under the leadership of its former president, Jim Yong Kim, poverty is closely related to disease and ignorance (illiteracy), as healthy children learn and healthy adults learn.
To build a prosperous A-class nation, countries in Africa will need to build A-class citizens through investing in health and education, and they cannot do this in the next 60 years the way they have done in the past 60 years.
Currently, African governments are spending a miserable $30 per person per year on health –in fact, low-income countries spend a fraction of that.
Compare this with $4,000 average in high-income countries in Europe. This is not because African governments have refused to invest more in health, though that too is true; the main problem is that Africa’s economy is a mere 3 per cent of the global one, and yet the continent carries 17 per cent of the world’s population and 25 per cent of the global burden of disease. Do the math – it doesn’t add up!
If we were to follow my “back-of-the-envelope” economics again and assume an average 2 per cent annual economic growth, Africa’s GDP would be about $6 trillion. This would mean about $17,000 per capita income, up from the current low of around $1,000.
Even assuming that Africa will have a population of 3.3 billion 60 years from now, and taking into account the effects of inflation, there would still be plenty of money.
These gains are already arriving with a rising burden of lifestyle-related diseases such as hypertension, diabetes, cancer, and mental illness. This is in addition to existing health complications such as HIV/Aids, malaria, tuberculosis, and preventable maternal deaths.
But society is changing and science is growing fast. Digital concepts and solutions that were considered science fiction only a few decades ago are now a reality.
Artificial intelligence, nanotechnology, and universal connectivity will accelerate ownership of health and the focus will shift from the traditional health system to the individual.
Artificial intelligence will replace your doctor and Robodoc will be an app on your phone, not a 2009 science fiction movie. Drug discoveries will be faster and humans of the future may even be composed of both artificial electromechanical and organic parts.
Technology will lead to immense savings in our healthcare delivery models and help us to move away from reactive disease management, where governments are spending money offering kidney dialysis, to proactive prevention and health promotion, thus disrupting the entire health system as we know it and giving a real chance to organic universal health access.
Self-care will empower millions of people – especially women, who won’t have to seek family planning services from healthcare professionals.
Carl – remember the guy at the start? – is only 14 years old today and probably playing games on his phone as his father reads this pullout celebrating the 60th anniversary of the Nation Media Group.
Maybe Carl’s granddaughter will write a similar article in the special e-pullout to celebrate – just maybe!
Dr Githinji Gitahi is the group CEO of Amref Health Africa and co-chairman of UHC2030.