A Professor of Health Economics at the University of Ghana, Justice Nonvignon, has called for an urgent overhaul of the current global donor financing scheme to ensure equitable and sustainable development in Africa.
Prof Nonvignon said while development assistance played a vital role in supporting health delivery, improving health outcomes, and overall development, its current structure jeopardised African economies including Ghana.
“The current architecture of development assistance for health perpetuates inequities and deviates from its supposed role as a global saviour. This is not optimal,” he said.
The first professor of Health Economics at the University of Ghana said this at his inaugural lecture in Accra on the topic: “The Pursuit of Health Amidst Scarcity:
Economics, Health, and the Romance In-Between”.
Referencing the COVID-19 pandemic, he said the early stage of the vaccines, saw high-income countries pre-ordered doses “only to doll them out to lower and middle income countries in tots, and unfortunately, many of them came close to expiry”.
He, therefore, called for a review of the current global donor support system, adding that: “The multilateral financing system too needs an overhaul. It motivates countries to prioritise payments over critical social services like health.”
Prof Nonvignon attributed the reliance of African governments on donor support in health to low prioritisation of health expenditure, high debt and the burden of interest payments.
He said an average of 22 per cent of health expenditure in many African countries were donor-funded, compared with seven percent in South East Asia and two percent in the Americas.
Between 2019 and 2021, developing countries spent some 40.8 per cent of their
public expenditure on health, 41.1 per cent on investment, and 60.4 per cent on interest payment, UN Global Crisis Response Group 2023 data showed.
Again, some 3.3 billion people live in nations where interest payments surpass investments in education and health.
“For instance, in Sudan, 64 percent of all health spending is from donors, and in Zimbabwe, it’s 56 per cent. This heavy reliance on development assistance often results in health priorities that are shaped, rather than our national governments,” the Health Economist said.
“This mounting debt burden jeopardises prosperity for both humanity and the planet,” he said and urged African policymakers and governments to prioritise health investments.
Despite signing the 2001 Abuja Declaration to commit about 15 per cent of its annual budget to health, the observation is that not more than three countries in Africa have achieved that target.
“The average domestic government spending in Sub-Saharan Africa is $74, and in some countries, it is as low as $16. This compares sharply with countries in Latin America and the Caribbean, who are spending $594 on health,” Prof Nonvignon said.
He said that the active working populatior in the productive sector was key to economic growth, and asked, “How can the population work when they are not healthy”?
“Global financing institutions are critical in supporting health delivery in Africa, but they will not solve all of Africa’s health problems. Africa must take more responsibility in driving and financing solutions to its problems,” he stated.