The Healthcare Crisis in Sub-Saharan Africa:  

Ray R. Harris

A Call for Global Action 

Sub-Saharan Africa, a region spanning four time zones and 49 nations, has always struggled to provide quality healthcare to its inhabitants.   Many Africans struggle daily with finding enough food to eat.  Accessing healthcare is beyond their reach.  Despite significant strides in economic development and technological advancements, affordable healthcare remains a distant dream for most Africans.   

Africa has 24% of the world’s disease burden yet just 3% of the health workers. Only 5% of Africans have access to safe surgery, and Africa needs nearly 50 times the current number of surgical workers.  Limited access to safe and effective medical care in sub-Saharan Africa is a profound humanitarian crisis demanding urgent global attention and action.   

Historical Context and Current Challenges 

To grasp the scale of the healthcare challenges in sub-Saharan Africa, it is crucial to consider the historical context. Colonialism left a legacy of economic and political instability, which continues to affect the region’s infrastructure and healthcare systems. Post-independence, many countries in sub-Saharan Africa struggled to establish stable governance necessary for the development of healthcare systems and trained local personnel. 

Insufficient Healthcare Infrastructure 

One of the most significant issues facing sub-Saharan Africa is the lack of adequate healthcare infrastructure. Many rural areas lack even basic medical facilities, and where they do exist, they are often poorly equipped and understaffed. According to the World Health Organization (WHO), sub-Saharan Africa has only 1.3 health workers per 1,000 people, far below the minimum threshold of 4.5 recommended by the WHO to deliver essential health services.  The shortage of healthcare professionals is another daunting barrier.  

Burden of Infectious Diseases 

Infectious diseases pose another significant challenge. Sub-Saharan Africa bears a disproportionate burden of conditions such as HIV/AIDS, malaria, and tuberculosis.  

Dr. Jon Fielder, founder and CEO of African Mission Healthcare, who invested two decades of his life providing medical treatment and education to HIV/AIDS victims in sub-Saharan Africa, recently wrote to the US Senate, “Despite PEPFAR’s many successes, far too many newborns in Africa are being born with HIV – one million over the next decade if no changes are made to business as usual.  We know how to bend the curve towards the elimination of maternal-to-child transmission … and need support to do so.” 

According to UNAIDS, sub-Saharan Africa accounted for 59% of all people living with HIV globally in 2020. The region also sees 94% of global malaria cases and deaths, according to the WHO. These diseases place immense strain on healthcare systems that are already under-resourced and underfunded. 

Lack of Access to Essential Medicines 

Access to essential medicines remains a significant hurdle. Many sub-Saharan African countries rely heavily on imported pharmaceuticals, which can be prohibitively expensive. The high cost of drugs and limited availability, means that many people cannot access the treatments they need. These barriers are particularly devastating for those with chronic conditions, such as diabetes or hypertension, who require regular medication to manage their health. 

Counterfeit and substandard medicines also pose a risk. In some parts of sub-Saharan Africa, up to 30% of medicines on the market are counterfeit, according to the WHO. These fake drugs not only fail to treat the illnesses they are intended for but can also cause serious harm or even death. 

And, the recent global pandemic, highlighted that 80% of African health facilities lack access to the most basic and essential of all medicines, oxygen.   

Maternal and Child Health Crisis 

Maternal and child health is another area of concern. Sub-Saharan Africa has the highest maternal mortality rate in the world, with 533 deaths per 100,000 live births, according to the WHO. This rate is far more than double the global average of 211. Factors contributing to high maternal mortality include a lack of skilled birth attendants, inadequate prenatal and postnatal care, and insufficient access to emergency obstetric services. 

Child mortality rates are equally alarming. According to UNICEF, the region accounts for half of all under-five deaths globally. Preventable diseases, such as pneumonia, diarrhea, and malaria, are the leading causes of these deaths. Malnutrition, poor sanitation, and limited access to clean water further exacerbate the situation, making it difficult for children to survive and thrive. 

Financial Barriers to Healthcare 

Financial barriers prevent poor populations from accessing healthcare in sub-Saharan Africa. Out-of-pocket payments for healthcare services are common, placing a heavy financial burden on families. The World Bank reports that more than 40% of healthcare financing in the region comes from out-of-pocket payments. For many households, the cost of healthcare can push them into poverty, creating a vicious cycle of ill health and economic hardship. 

What Needs to Be Done 

Despite these daunting challenges, there are promising initiatives and strategies aimed at improving healthcare in sub-Saharan Africa.  A respected thought-leader and one of the most strategic nonprofit organizations, African Mission Healthcare, recommends the following six critical steps:   

1. Strengthening Healthcare Infrastructure: Investing in healthcare infrastructure is paramount. This not only includes building new facilities, upgrading existing ones, and ensuring they are adequately equipped but also developing strong healthcare systems across the region.  

2. Increasing the Healthcare Workforce: Addressing the shortage of healthcare professionals requires both short-term and long-term strategies. African Mission Healthcare has implemented the Mission Healthcare Teaching Network to develop teaching hospitals from which graduates fan out across the continent to care for and train others.  Additionally, investing in medical education and training programs will ensure a steady supply of qualified healthcare professionals. 

3. Improving Access to Essential Medicines: Governments and international organizations must work together to improve access to affordable, quality medicines. This can be achieved through bulk purchasing agreements, local production of generic medicines, and stringent regulation to combat counterfeit drugs.  African Mission Healthcare works with trusted suppliers to procure medical supplies on behalf of our partners. African Mission Healthcare has taken a leadership role in the installation of oxygen plants and oxygen distribution systems to ensure that the most basic and essential of all medicines is provided to those in need. 

4. Focusing on Preventive Care: Emphasizing preventive care can help reduce the burden of disease. Public health campaigns to promote vaccination, good hygiene practices, and healthy lifestyles can prevent many diseases. The twin epidemics of HIV and tuberculosis continue to ravage communities across sub-Saharan Africa.  African Mission Healthcare provides hands-on clinical training to expand the knowledge of health workers so they can more effectively manage these diseases and medications and so that they can provide preventative information to each patient treated.  Strengthening primary healthcare services, including training family physicians and nurses, will also ensure that diseases are detected and treated early. 

5. Leveraging Technology: Telemedicine and mobile health technologies offer innovative solutions to bridge the gap in healthcare access. These technologies can provide remote consultations, health education, and disease monitoring, particularly in rural and underserved areas.  African Mission Healthcare’s online learning platform for healthcare workers is currently used by over 20,000 healthcare workers to increase the speed and effectiveness of their healthcare education.  

6. International Cooperation: The global community has a crucial role to play in addressing the healthcare crisis in sub-Saharan Africa.  Individuals, foundations, and nations that can gift resources are urgently needed to implement the five health initiatives detailed by African Mission Healthcare.  Donate now to help. 

A Call to Action 

The healthcare crisis in sub-Saharan Africa is a multifaceted issue that requires a comprehensive and collaborative approach. While the challenges are significant, they are not insurmountable. By investing in healthcare infrastructure, increasing the healthcare workforce, improving access to essential medicines, and focusing on preventive care, we can make significant strides toward ensuring that all people in sub-Saharan Africa have access to the healthcare they need for the life they want. 

It is imperative that the international community recognizes the urgency of this crisis and acts decisively. The health and well-being of 1,226,641,550 people are at stake. By working together, we can build a future where access to quality healthcare is a reality for everyone, regardless of where they live. This is not just a moral imperative; it is essential for achieving global health equity and fostering sustainable development. 

In the words of Nelson Mandela, “Health cannot be a question of income; it is a fundamental human right.” Let us honor this principle by committing to action and ensuring that the people of sub-Saharan Africa receive the medical care and support they deserve.