Insight/Opinion

Will the Recession affect Health Care in Africa?

By Derek Kirbow

The world is in recession. Governments are worried about finding solutions to their economic woes. This has led to an overlooked big question; what will happen to health care in Africa?

Just as many nations were beginning to make strides in the fight against disease, mortality in pregnancy, and malnutrition there comes a global slowdown. Many fear this slowdown will limit the amount of aid coming from foreign lenders, governments, and even non-governmental organizations (NGO's). This article looks at the aid that has been coming into Africa for use in the health care industry and the projected effect the global slowdown will have on this aid.

While millions of individuals in the West watched their stock portfolios decline by precipitous amounts, there were millions of others in Africa that had no idea the world was in an economic flux. This might have been fine if it were not for the fact that much of the aid coming into Africa arrives from Western states, especially those who are members of the G-8: The United States, Russia, Germany, France, Britain, Italy, Canada, and Japan. As the world began to experience a deepening recession, government bailouts counted in the billions of dollars, and concern over domestic job loss, there was the beginning murmur of concern about foreign aid.

The International Monetary Fund (IMF) states that over the last four decades there has been upwards of US$500 billion given in aid across the continent of Africa and of this some 30% goes to health care costs. The Kenyan Business Daily reports that governments can save some costs by using this aid to provide health care publicly instead of using private enterprise, but the costs still overwhelmingly come from aid allocations. Whether this is HIV/AIDS prevention and treatment, care for malaria, or simply clinic visits, the amount spent per person is low, with only $30 reaching the average person. Before the global slowdown this was a constant topic at the meetings of the G-8, and it did produce some results. There was an agreement to help meet the United Nation's Millennium Goals by increasing aid to Africa by $25 billion, but now this has come into question.

So what of the promised aid? There are several problems that are commingled and can be confusing when it comes to aid allocations, and it is this web of externalities that makes a positive determination of aid allocations difficult to predict. The first of these is Gross Domestic Product (GDP). Many countries included in the G-8, especially those in Europe, calculate aid to Africa based on a percentage of their GDP. As the recession begins to take its toll the GDP of these states will drop and, by default, so will the amounts allocated to aid. A second problem is that many of the organizations giving aid do so from donations they have been given by governments, through grants, and by private individuals. As the markets dry up there will be less giving and this will put serious strains on an already strained NGO sector. Third, Africans across the globe who are living in a diaspora send money home to relatives who in turn use this for food, health care, and so forth. The loss of jobs across the developed world will seriously curtail these payments and as a result there will be an impact at the family level when it comes to acquiring health services. Finally, there is the question of what governments will actually do. There are promises, and some action, in the developed world for ensuring that aid payments to Africa remain at the promised levels. It would be good news if this turns out to be the way these nations react in the face of this recession, but it must be remembered that even if levels remain the same there are still serious shortfalls. Many of the donor states, including France and Italy, are extremely behind in their agreed upon aid payments. Hoping that they will catch up on undelivered payments while continuing to make the new ones may be more hope than reality.

In addition to the possible reduction in funds there are also the problems of high food prices coupled with the largest growth the continent has seen in decades. Population growth in areas where there are few jobs and minimal resources to begin with will bring about the growing trend of street children, families that cannot supply the basic needs for their children, and will eventually cause the health industry to provide less care per person as the number of patients grows. At the same time, the price of food has remained high even as it has receded from its peak. The price of foodstuffs is still higher than it was two years ago, and as aid allocations come in they cannot purchase the same amount of goods as recently as 2007. This exacerbates the problem of malnutrition which conversely affects health care. Higher populations, smaller budgets, and a diminished purchasing power in foodstuffs make the global recession that much worse for Africa as a whole.

No one knows the length or intensity of the current economic problems facing the developed world. While the G-8 nations scramble to find solutions to their economic woes the thought of Africa may well get pushed to the side. It is the hope of many that these states will stand by their promises of aid and that the current levels of health care on the continent will remain where they are. This is certainly not a solution, and the long term care of each individual must be improved upon, but at this juncture there is the very real fear that the minimal health care being provided may be cut. The final judgment may be that while there are very real problems in G-8 states there are also many that realize the plight of the majority of Africans. These individuals know that cutting aid is not going to help them out of their situation and they will therefore continue to provide the aid they have been giving. This will not alleviate the problems Africa is facing in its health care industry, but it does give a brief respite to those dependent on what little medical attention they are currently receiving, and it gives everyone the moment to pause, take a deep breath, and prepare for the future of the African health care system.

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 About the author: Derek Kirbow is a faculty member at Indiana Wesleyan University in the United States. He earned his B.S. in history and political science from Indiana Wesleyan University, his M.A. in International Relations and Comparative Politics from Purdue University, and is currently completing his Ph.D. in International Development from the University of Southern Mississippi. He can be reached at thekirbows@yahoo.com.

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