Dr. Palesa Sekhejane, Research Specialist in the Africa Institute of South Africa, Sustainable Development Programme, Human Sciences Research Council. Research interests: health biosciences, health technology, systems and innovation.
Many health policy commitments have come and gone like the Alma Ata Declaration of 1978, Health for all in the 21st century, the Abuja and Ouagadougou Declarations. Another epoch of post-2000, known as the Millennium Development Goals (MDGs) has passed; and the post-2015 has dawned upon us whereby we have to renew and rename our developmental goal’s vows. The vows of the current era, as we have come to know them, are referred to as the Sustainable Development Goals (SDGs) and Post-2015 developmental agenda. The 2000 United Nations (UN) MDG declaration was agreed on by 189 heads of state to achieve eight set goals by the year 2015. Given the progress made in the developed nations such as North America and Europe, Africa still lags behind in achieving envisaged developmental goals, particularly health related developmental goals.
Africa’s healthcare status
Let’s reduce the focus to Africa’s health care status, since the majority of data suggests that the continent is failing to rise to the occasion. In Africa important developmental matters have been marginalised for material wealth. Human life and health have become an ideal notion, rather than a practical reality. Instead of prioritizing meaningful sustainable quality of life, Africa is romantically imagining what could potentially be, and not what ought to be. Of course the distasteful interventions and physical destructions of the West continue to linger and cause hangover across the continent. However, it is time that Africa’s renewal of the developmental agenda recognises health as a subterranean state-building path. Health is classified as a human right, but it is appalling how the majority of people in the African continent do not have the privilege to enjoy this “scarce commodity”. Healthcare in many of the African countries is a service provided by the state and thus is supposed to be a priority in the national budgets. The hurdle is that many African states are, to a certain extent, unable to provide this social service precisely because this would have to source funding from the government revenue. Therefore, if it is a matter of solely pressurising the finance part of things, then it is important to find means to curb the implications in order to reach the envisaged “sustainable development”. In the current economic models states are not supposed to compete in the economic activities, however, it has to play an interventionist role (1). The states generally accrues the revenue from taxation and the fiscus. This accumulation of the state’s revenue is heavily reliant on the public servants, which places burden on them. This inevitably results in the frustration of the general population if the fiscus is not utilised equitably, prosperously and reasonably; as essentially is a betrayal of human rights. If the economic models are to continue in the current form, health will remain the bottleneck of the state, while the private sector is siphoning billions which could be channelled to the achievement of this social value.
As we learn that sustainable development ties together economic, environmental and social development, it is critically vital to understand for who and by whom is the development undertaken. The question of development in Africa has been lingering and daunting for decades. However, reality is that development or a developmental agenda that marginalizes people should not be recognized at any cost, because healthy human beings are central to development. Uroh (2) and Osia (3) in their seminal works eloquently provided a distinction between development and economic growth:
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