Latest news with #GithinjiGitahi
Yahoo
14-04-2025
- Health
- Yahoo
Africa needs innovative financing solutions to prevent health systems from collapsing, say experts
African health care leaders said innovative financing solutions will be essential to prevent the collapse of health systems on the continent, with the departure of donor aid funding creating a more important role for startups and public-private investments. The abrupt withdrawal of USAID funding earlier this year, following a trend of cutbacks from other Western nations, has left a nearly $12 billion shortfall in financing critical services such as maternal and child health, HIV treatment, pandemic preparedness, and disease control. Last week the Africa Centres for Disease Control and Prevention (Africa CDC) outlined urgent reforms to secure sustainable funding, focusing on domestic financing, health taxes, and public-private investments to close infrastructure gaps. 'If we do not act now, we risk losing 20 years of progress in health security, with preventable diseases returning in force and overwhelming already fragile systems,' said Jean Kaseya, director-general of Africa CDC. Githinji Gitahi, CEO of Nairobi-based nonprofit Amref Health Africa, told Semafor that Africa faced a health care funding gap of roughly $66 billion a year even before accounting for the USAID cuts. 'Traditional funding sources like foreign aid and out-of-pocket payments simply aren't enough. That's why innovative financing models are essential,' he said. Gitahi pointed to several 'promising approaches' including Rwanda's health insurance program, which covers more than 90% of the population by combining affordable premiums with government subsidies. Another example, he said, is the 'sin taxes' imposed on alcohol, cigarettes, and sugary drinks in South Africa and Botswana, which are generating millions for health care while addressing the growing burden of lifestyle diseases. The urgency of Africa's health financing crisis was highlighted at last month's Africa Health Agenda International Conference in Kigali where experts said governments needed to diversify funding strategies to reduce their reliance on external aid. In a recent briefing, the Center for Global Development also wrote that 'innovative partnerships' with the private sector were a key part of the solution, pointing to pharmaceutical manufacturing as a prominent example. Last year the vaccine alliance GAVI launched the African Vaccine Manufacturing Accelerator, a financing instrument that will make up to $1.2 billion available over 10 years to support local vaccine production. Afreximbank also committed $2 billion to this push toward vaccine sovereignty. Frederik Kristensen, head of the Regionalized Vaccine Manufacturing Collaborative, an initiative set up to help potential manufacturers find funders, said it was a crucial time to help Africa become less reliant on imports after the COVID-19 pandemic exposed stark global vaccine inequalities. 'It's really important in terms of health security,' he told Semafor, 'if there is an outbreak that there are vaccine manufacturers on the continent which can switch to producing vaccines that will be needed.' At present South Africa and Senegal are the only countries with end-to-end vaccine manufacturing capacities in Africa. Around nine priority vaccines have been identified for local production by 2030 including those targeting cholera, measles-rubella, and yellow fever. A key hurdle for the sector is ensuring sustainable and long-term demand for the vaccines. But with 'political will' to drive-through policies and regulations for manufacturers, this can be achieved, Kristensen said. EASE South Africa, an equipment business set up by the African Asset Finance Company, on Monday secured funding from Standard Bank, Africa's largest bank by assets, to expand its pay-per-use model to provide hospitals and clinics with access to high-end diagnostic machines such as MRI scanners. 'What it means is that [health care providers] don't have to make a big upfront capital investment,' said Kanyinsola Oyeyinka, senior vice-president at EASE. Such costs can be a barrier to accessing the latest technology and so the model could 'free up' money for other priorities such as hiring more nurses or increasing hospital beds. 'We will own the equipment, but they will have full access to using it to provide care to the patients.' Standard Bank will invest about $100 million into EASE, which has already applied the model in Ghana and Nigeria, over the next seven years. John van Kan, head of the bank's healthcare sector, told Semafor that the equipment aimed to help more patients in 'outlying areas' access the care they need. A da Vinci surgical robot installed by EASE last year, for instance, at a hospital in the coastal town of Umhlanga will be used to help surgeons perform procedures with reduced recovery time. Another startup that has been leading health innovation in the supply chain space, is Zipline, a US firm that uses autonomous drones to deliver drugs, vaccines, and other medical goods to remote clinics in countries including Cote d'Ivoire, Ghana, Kenya, Nigeria, and Rwanda. A study published last month analyzing health care data from 191 Ghanaian health facilities found a direct link between reliable medical supply availability and improved health system use, leading to a 56% reduction in maternal deaths at facilities served by Zipline compared to those that were not. Long-term strategies to reduce aid dependency are vital for African health care, a global health expert writes in The Conversation.
Boston Globe
09-03-2025
- Health
- Boston Globe
How foreign aid cuts are setting the stage for disease outbreaks
'It's actually in the interest of American people to keep diseases down,' said Dr. Githinji Gitahi, who heads Amref Health Africa, a large nonprofit that relies on the United States for about 25 percent of its funding. Advertisement 'Diseases make their way to the United States even when we have our best people on it, and now we are not putting our best people on it,' he added. In interviews, more than 30 current and former officials of the US Agency for International Development, members of health organizations and experts in infectious diseases described a world made more perilous than it was just a few weeks ago. Many spoke on condition of anonymity for fear of retaliation by the federal government. The timing is dire: Congo is experiencing the deadliest mpox outbreak in history, with cases exploding in a dozen other African countries. The United States is home to a worsening bird flu crisis. Multiple hemorrhagic fever viruses are smoldering: Ebola in Uganda, Marburg in Tanzania, and Lassa in Nigeria and Sierra Leone. In 2023, USAID invested about $900 million to fund labs and emergency-response preparedness in more than 30 countries. The pause on foreign aid froze those programs. Even payments to grantees for work already completed are being sorted out in the courts. Waivers issued by the State Department were intended to allow some work to continue on containing Ebola, Marburg, and mpox, as well as preparedness for bird flu. But Trump administration appointees choked payment systems and created obstacles to implementing the waivers, according to a USAID memo by Nicholas Enrich, who was the agency's acting assistant administrator for global health until Sunday. Advertisement Then last month, the Trump administration canceled about 5,800 contracts, effectively shuttering most USAID-funded initiatives, including many that had received permission to continue. 'It was finally clear that we were not going to be implementing' even programs that had waivers, Enrich recalled in an interview. The decision is likely to result in more than 28,000 new cases of infectious diseases such as Ebola and Marburg, and 200,000 cases of paralytic polio each year, according to one estimate. Secretary of State Marco Rubio 'has been working diligently since being sworn in to review every dollar spent,' the State Department said in an emailed statement. 'We'll be able to say that every program that we are out there operating serves the national interest, because it makes us safer or stronger or more prosperous,'' the statement quoted Rubio as saying. Most USAID staff members were terminated or placed on administrative leave without warning. The agency had more than 50 people dedicated to outbreak responses, the result of a congressional push to beef up pandemic preparedness. Now it has six. Those who were fired included the organization's leading expert in lab diagnostics and the manager of the Ebola response. 'I have no idea how six people are going to run four outbreak responses,' said an official who was let go. Also sent home were hundreds of thousands of community health workers in Africa who were sentinels for diseases. In early January, the Tanzanian government denied there were new cases of Marburg, a hemorrhagic fever. It was a community health worker trained through a US-funded Ebola program who reported the disease a week later. Advertisement The outbreak eventually grew to include 10 cases; it is now under control, the government has said. Even in quieter times, foreign aid helps to prevent, detect and treat diseases that can endanger Americans, including drug-resistant HIV, tuberculosis and malaria, and bacteria that don't respond to available antibiotics. Much of that work has stopped, and other organizations or countries cannot fill the gap. Compounding the loss is America's withdrawal from the World Health Organization, which has instituted cost-cutting measures of its own. 'This is a lose-lose scenario,' said Dr. Keiji Fukuda, who has led pandemic prevention efforts at the WHO and the Centers for Disease Control and Prevention. The slashing of foreign aid deprives the world of American leadership and expertise, but it also locks the United States out of global discussions, Fukuda said: 'For the life of me, I cannot see the justification or the reason for this very calculated, systematic approach to pull down public health.' Some African countries such as Somalia have fragile health systems and persistent security threats, yet minimal capacity for tracking infections that sicken animals and people, said Abdinasir Yusuf Osman, a veterinary epidemiologist and chair of a working group in Somalia's health ministry. Each year, Somalia exports millions of camels, cattle, and other livestock, primarily to the Middle East. The nation has relied heavily on foreign aid to screen the animals for diseases, he said. 'The consequences of this funding shortfall, in my view, will be catastrophic and increase the likelihood of uncontrolled outbreaks,' Osman said. Advertisement In countries with larger economies, foreign aid has helped build relationships. Thailand is a pioneer in infectious diseases, and USAID was funding a modest project on malaria elimination that boosts its surveillance capabilities. The abrupt end to that commitment risks losing goodwill, said Jui Shah, who helped run the program. 'In Asia, relationships are crucial for any type of work, but especially for roles that work with surveillance and patient data,' she said. 'Americans will suffer if other countries hesitate to engage with us about outbreaks.' This article originally appeared in
New York Times
07-03-2025
- Health
- New York Times
How Foreign Aid Cuts Are Setting the Stage for Disease Outbreaks
Dangerous pathogens left unsecured at labs across Africa. Halted inspections for mpox, Ebola and other infections at airports and other checkpoints. Millions of unscreened animals shipped across borders. The Trump administration's pause on foreign aid has hobbled programs that prevent and snuff out outbreaks around the world, scientists say, leaving people everywhere more vulnerable to dangerous pathogens. That includes Americans. Outbreaks that begin overseas can travel quickly: The coronavirus may have first appeared in China, for example, but it soon appeared everywhere, including the United States. When polio or dengue appears in this country, cases are usually linked to international travel. 'It's actually in the interest of American people to keep diseases down,' said Dr. Githinji Gitahi, who heads Amref Health Africa, a large nonprofit that relies on the United States for about 25 percent of its funding. 'Diseases make their way to the U.S. even when we have our best people on it, and now we are not putting our best people on it,' he added. In interviews, more than 30 current and former officials of the United States Agency for International Development, members of health organizations and experts in infectious diseases described a world made more perilous than it was just a few weeks ago. Many spoke on condition of anonymity for fear of retaliation by the federal government. The timing is dire: The Democratic Republic of Congo is experiencing the deadliest mpox outbreak in history, with cases exploding in a dozen other African countries. The United States is home to a worsening bird flu crisis. Multiple hemorrhagic fever viruses are smoldering: Ebola in Uganda, Marburg in Tanzania, and Lassa in Nigeria and Sierra Leone. In 2023, U.S.A.I.D. invested about $900 million to fund labs and emergency-response preparedness in more than 30 countries. The pause on foreign aid froze those programs. Even payments to grantees for work already completed are being sorted out in the courts. Waivers issued by the State Department were intended to allow some work to continue on containing Ebola, Marburg and mpox, as well as preparedness for bird flu. But Trump administration appointees choked payment systems and created obstacles to implementing the waivers, according to a U.S.A.I.D. memo by Nicholas Enrich, who was the agency's acting assistant administrator for global health until Sunday. Then last month, the Trump administration canceled about 5,800 contracts, effectively shuttering most U.S.A.I.D.-funded initiatives, including many that had received permission to continue. 'It was finally clear that we were not going to be implementing' even programs that had waivers, Mr. Enrich recalled in an interview. The decision is likely to result in more than 28,000 new cases of infectious diseases like Ebola and Marburg, and 200,000 cases of paralytic polio each year, according to one estimate. Secretary of State Marco Rubio 'has been working diligently since being sworn in to review every dollar spent,' the State Department said in an emailed statement. 'We'll be able to say that every program that we are out there operating serves the national interest, because it makes us safer or stronger or more prosperous,'' the statement quoted Mr. Rubio as saying. Most U.S.A.I.D. staff members were terminated or placed on administrative leave without warning. The agency had more than 50 people dedicated to outbreak responses, the result of a Congressional push to beef up pandemic preparedness. Now it has six. Those who were fired included the organization's leading expert in lab diagnostics and the manager of the Ebola response. 'I have no idea how six people are going to run four outbreak responses,' said one official who was let go. Also sent home were hundreds of thousands of community health workers in Africa who were sentinels for diseases. In early January, the Tanzanian government denied there were new cases of Marburg, a hemorrhagic fever. It was a community health worker trained through a U.S.-funded Ebola program who reported the disease a week later. The outbreak eventually grew to include 10 cases; it is now under control, the government has said. Even in quieter times, foreign aid helps to prevent, detect and treat diseases that can endanger Americans, including drug-resistant H.I.V., tuberculosis and malaria, and bacteria that don't respond to available antibiotics. Much of that work has stopped, and other organizations or countries cannot fill the gap. Compounding the loss is America's withdrawal from the World Health Organization, which has instituted cost-cutting measures of its own. 'This is a lose-lose scenario,' said Dr. Keiji Fukuda, who has led pandemic prevention efforts at the W.H.O. and the C.D.C. The slashing of foreign aid deprives the world of American leadership and expertise, but it also locks the United States out of global discussions, Dr. Fukuda said: 'For the life of me, I cannot see the justification or the reason for this very calculated, systematic approach to pull down public health.' Trying to Adapt U.S.A.I.D.'s intense focus on global health security is barely a decade old, but it has mostly received bipartisan support. The first Trump administration expanded the program to 50 countries. Much of the aid was intended to help them eventually tackle problems on their own. And to some extent, that was happening. But confronted with a new virus or outbreak, 'there's so many things that one has to do and learn, and many countries can't do that on their own,' said Dr. Lucille Blumberg, an infectious diseases physician and expert on emerging diseases. U.S.A.I.D. and its partners helped countries identify the expertise, training and machinery they needed, brought together officials in various ministries and engaged farmers, businesses and families. 'It actually doesn't cost the U.S. government that much,' said an official with a large development organization. 'But that sort of trust-building, communication, sharing evidence is a real strength that the U.S. brings to health security — and that's gone.' In Africa, some countries have reacted to the disappearance of aid with alarm, others with resignation. 'We're doing our best to adapt to this development,' said Dr. Muhammad Ali Pate, Nigeria's health minister. 'The U.S. government is not responsible, ultimately, for the health and the security of Nigerian people,' he said. 'At the end of the day, the responsibility is ours.' A successful outbreak response requires coordination of myriad elements: investigators to confirm the initial report; workers trained to do testing; access to test kits; transport of samples; a lab with enough workers, running water, electricity and chemical supplies for diagnoses; and experts to interpret and act on the results. In broad strokes, the C.D.C. provided expertise on diseases, U.S.A.I.D. funded logistics and the W.H.O. convened stakeholders, including ministries of health. Before the aid freeze, employees from each organization often talked every day, sharing information and debating strategy. Together, they lowered response time to an outbreak from two weeks in 2014 to five days in 2022 to just 48 hours most recently. But now, C.D.C. experts who have honed their expertise over decades are not even allowed to speak to colleagues at the W.H.O. U.S.A.I.D. funding for sample transport, lab supplies, fuel for generators and phone plans for contact tracers has ended. Much of its investment in simple solutions to seemingly intractable problems has also stopped. In West Africa, for example, rodents that spread Lassa fever invade homes in search of food. One program in U.S.A.I.D.'s Stop Spillover project introduced rodent-proof food containers to limit the problem, but has now shut down. In Congo, where corruption, conflict and endless outbreaks mean that surveillance 'looks like Swiss cheese even at the best of times,' the mpox response slowed because there were no health workers to transport samples, said a U.S.A.I.D. official familiar with the response. More than 400 mpox patients were left stranded after fleeing overwhelmed clinics. Before a waiver restarted some work, the United States identified two new cases of mpox, both in people who had traveled to East Africa. In Kenya, U.S.A.I.D. supported eight labs and community-based surveillance in 12 high-risk counties. Labs in the Marsabit, Mandera and Garissa counties — which border Ethiopia and Somalia — have run out of test kits and reagents for diseases including Rift Valley fever, yellow fever and polio, and have lost nearly half their staff. Kenya also borders Uganda and Tanzania and is close to Congo — all battling dangerous outbreaks — and has lost more than 35,000 workers. 'These stop-work orders would mean that it increases the risk of an index case passing through unnoticed,' Dr. Gitahi said, referring to the first known case in an outbreak. His organization has terminated nearly 400 of its staff of 2,400. Many labs in Africa store samples of pathogens that naturally occur in the environment, including several that can be weaponized. With surveillance programs shut off, the pathogens could be stolen, and a bioterrorism attack might go undetected until it was too late to counter. Some experts worried about bad actors who may release a threat like cholera into the water, or weaponize anthrax or brucellosis, common in African animals. Others said they were concerned that even unskilled handling of these disease threats might be enough to set off a disaster. Funding from the U.S. government helped hire and train lab workers to maintain and dispose of dangerous viruses and bacteria safely. But now, pathogens can be moved in and out of labs with no one the wiser. 'We have lost our ability to understand where pathogens are being held,' said Kaitlin Sandhaus, founder and chief executive of Global Implementation Solutions. Her company helped 17 African labs become accredited in biosafety procedures and supported five countries in drafting laws to ensure compliance. Now the firm is shutting down. In the future, other countries, including China, will know more about where risky pathogens are housed, Ms. Sandhaus said: 'It feels very dangerous to me.' Some African countries like Somalia have fragile health systems and persistent security threats, yet minimal capacity for tracking infections that sicken animals and people, said Abdinasir Yusuf Osman, a veterinary epidemiologist and chair of a working group in Somalia's health ministry. Each year Somalia exports millions of camels, cattle and other livestock, primarily to the Middle East. The nation has relied heavily on foreign aid to screen the animals for diseases, he said. 'The consequences of this funding shortfall, in my view, will be catastrophic and increase the likelihood of uncontrolled outbreaks,' Dr. Osman said. In countries with larger economies, foreign aid has been enormously useful for building relationships. Thailand is a pioneer in infectious diseases, and U.S.A.I.D. was funding a modest project on malaria elimination that boosts its surveillance capabilities. The abrupt end to that commitment risks losing good will, said Jui Shah, who helped run the program. 'In Asia, relationships are crucial for any type of work, but especially for roles that work with surveillance and patient data,' she said. 'Americans will suffer if other countries hesitate to engage with us about outbreaks.'
The Guardian
27-02-2025
- Health
- The Guardian
Africa's medical system risks ‘collapse in next few years', warns health leader
Health services in Africa are at risk of 'collapse in the next few years' due to soaring chronic diseases, a senior public health leader has warned. Foreign aid to Africa has been focused on infectious diseases, leaving conditions such as cancer and diabetes to escalate, said Dr Githinji Gitahi, group CEO of Amref Health Africa. In sub-Saharan Africa, non-communicable diseases (NCDs), including hypertension, diabetes and heart disease accounted for 37% of deaths in 2019, up from 24% in 2000. They are forecast to become the leading cause of death in the region by 2030 – driven by factors such as unhealthy western-style diets, less active lifestyles and air pollution. 'Aid is not charity' and will inevitably follow donor countries' own interests such as stopping infectious diseases that could spread overseas, said Gitahi, who called for Africa's leaders to step up their own work on controlling NCDs. Gitahi spoke to the Guardian at the Global NCD Alliance Forum in Kigali, Rwanda, earlier this month, a gathering of more than 700 delegates from 89 countries. The challenge is vast, according to Gitahi. 'Africa has a big risk of collapse of health systems in the next few years because of NCDs […] 50% of all admissions in a typical African hospital are NCDs, yet 80% of NCD care is out of pocket. And governments don't have money to actually take care of NCDs.' The blame lies with multinational corporations chasing profits, he said, and with governments failing to bring in regulations to put a brake on their activities. 'Politicians think about the next election,' he said. 'This issue is about the next generation.' Gitahi, from Kenya, said global health and foreign aid spending had historically focused on diseases that could affect the donors themselves. Less than 3% of development spending for health goes to NCDs. 'That is why there is so much focus on TB, HIV, because when you keep HIV low in Kenya, you keep it out of your country because people travel, and people carry diseases,' he said. 'But for cancer, for hypertension, for diabetes … that's non-infectious. 'The people who should care about that are their governments because [NCDs] are taking away people from active social and economic participation. Because the governments don't have enough money […] it is likely to continue being a neglected problem.' The forum's delegates were meeting as a result of decisions by the US administration to freeze much of its overseas aid spending and to issue stop work orders to current programmes. Amref's work has been affected, Gitahi said. 'We do about $250m [£197m] of work a year […] about $50m of that is actually US government partnerships,' he said, in areas including maternal and child health, HIV work and laboratory and health system strengthening. Some Amref staff have been placed on unpaid leave, Gitahi said, though he was optimistic that some of the work will restart after the 90-day review period announced by Donald Trump's officials. 'We hope that at the end of it, they will continue with programming, as they say, that's aligned to their foreign policy, but actually protects communities and community lives and protects Americans themselves,' Gitahi said. 'I keep saying aid is not charity. Aid is strategic investment by a country to protect its own internal interests. That's what it has always been.' African governments will need to become more efficient and to tackle corruption, he suggested, and to embrace taxation of unhealthy goods, such as tobacco, alcohol and sugar, with the proceeds earmarked for health programmes. They will also need to work on the prevention of ill health, Gitahi said, suggesting they 'copy and paste' regulations from western countries that ban things such as the advertising of foods high in sugar, salt or fat to children. US funding accounts for half of all development assistance in Africa, he said, or $6.5bn out of $13bn. African governments will not be able to completely replace lost funding, Gitahi said, because their economies are not large enough. It may mean reframing goals to provide universal health care to cover '100% of the poor' rather than the entire population. 'Africa cannot raise enough money from its fiscal space, from its GDP, to actually take care of all social services,' he said. 'Africa needs solidarity.' In the end, the international community should see that solidarity was important for global security, he said. 'When you have a weak health system in any country, it is like having an insecure airspace in any country. That [poses] a risk to the entire world.'
