In August, I was privileged to be in Beijing with Chinese state leaders and African Ministers of Health at a watershed moment in global solidarity for health. At the Ministerial Forum of China-Africa Health Development, we witnessed the beginning of a new era of cooperation between China
and Africa, carrying with it the potential to save and improve millions of lives.
The outcome of the forum was the Beijing Declaration—a bold new commitment by Ministers of Health from China and Africa, joined by international organizations, who have pledged to work together to achieve “sustainable, long-term health solutions.”
The partnership between China and Africa is one of the most important geopolitical and economic relationships of the 21st century. Through bilateral trade and cooperation, millions of people have been lifted out of poverty. The Beijing Declaration elevates the relationship to the next level, pressing for increased investment in health from national budgets to promote sustainable health development. It also challenges the international community to actively support African countries tackle the unfinished business of achieving their health-related Millennium Development Goals (MDGs) by 2015 and critically urges governments to give prominence to health beyond 2015.
Invaluable public goods
It is clear that the old approaches to global health have become obsolete. We no longer live in a world of rich benefactor countries and poor aid recipients. Today, the focus is on shared responsibility, global solidarity and national ownership. The China-Africa relationship reflects this new paradigm of cooperation that can lead to breakthrough progress—especially in global health.
Trade between China and Africa is projected to reach $385 billion a year by 2015, putting both countries in a unique position to leverage their unique business and trade relationship to transform health care. That is why China’s state-owned enterprises are being encouraged to invest in and promote health care in Africa—home to seven of the world’s ten fastest growing economies. Chinese investments in the health care sector in the continent can produce substantial financial gains as well as generate invaluable public goods.
China’s response to the AIDS epidemic is a good example of how solid leadership and strategic mobilization of resources can have a game-changing impact. With firm support of its state leaders, China reigned-in what many were predicting would be an out-of-control AIDS epidemic.
Similarly, African leaders have acted decisively over the past decade to halt, and even reverse, the spread of AIDS by making HIV prevention and treatment more easily accessible to people. Leaders both in China and Africa have used scientific and advanced methods to tackle the disease and have enhanced their commitment to respect the dignity of the people living with HIV.
China, for example, has introduced harm-reduction programs for people who inject drugs, effectively halting the spread of HIV among drug users. And African countries have made it easier for people to access antiretroviral medicines despite the challenges facing their health care systems. Today, more than 7.5 million people living with HIV are on lifesaving antiretroviral medicines in Africa, and about 3.5 million lives have been saved.
Platform for sharing science and promoting innovation
The majority of the active pharmaceutical ingredients (APIs) in Africa’s HIV medicines are produced in China. As Africa is building its own capacity to sustainably produce essential medicines and diagnostics. By entering a new partnership with leading pharmaceutical companies and African leaders, China can promote the development of the African pharmaceutical industry based on entrepreneurship, competitiveness and production of affordable, quality medicines—including traditional medicines, in which China has unique expertise.
China’s advanced research and development industry can support Africa to develop the next generation of radically simplified tools and instruments for low-cost laboratory diagnostics and medical equipment. Breakthroughs in this area would not only enable Africa meet its own growing needs for laboratory diagnostics and medical equipment, but also establish the China-Africa platform for medical research and development that could generate low-cost, easy-to-use health solutions for the world.
Primary care revolution
The post-2015 agenda for sustainable global health is not just a matter of delivering more pills to sick people. On the contrary, it is about creating demand for and delivering better health to all. It is about a revolution in primary care.
It was not a coincidence that the Beijing Declaration came about on the 50th anniversary of the first China Medical Team arriving in the People’s Democratic Republic of Algeria in 1963. This transfer launched decades of medical cooperation focused on improving health systems and raising the standards and scope of community-based health care. It is China’s “barefoot doctor” model that African countries are learning from, as they increasingly embrace task-shifting as a key strategy to increase universal coverage of healthcare. By sharing China’s rich expertise in health systems strengthening, Africa has the opportunity to achieve the goal of establishing one million community health workers to reach poor people and rural areas who live beyond the margins of traditional health care systems.
The shift away from high-cost health services provided by doctors and hospitals to more sustainable, efficient models provided by communities and non-traditional care teams has implications for the global AIDS response as well. We are well on our way to redesigning an approach that reflects new paradigms for post-2015 and achieve an AIDS-free generation. This means expanding the focus beyond access to HIV treatment and coverage of services to improving quality of life and assuring dignity for everyone living with or affected by HIV. It means working toward sustainable models of health care delivery that can support people living with HIV throughout their lifetime. And it means enlarging the emphasis on AIDS literacy to embrace health literacy at large, so that systems can address the co-morbidities facing people living with and at risk of HIV: aging, chronic disease, inequity, poverty, drug use and domestic and sexual violence. The AIDS response has continuously served as a pathfinder for human-centered development. This paradigm shift also has the potential to revolutionize global health post-2015.
UN Secretary-General Ban Ki-moon has a presented his vision of “a life of dignity for all.” The Chinese and African leadership are exercising much needed global leadership in recognizing that good health is critical to realizing the Secretary-General’s aspiration. As such, it is encouraging that the Beijing Declaration addresses the importance of quality of life head on by stating: “We acknowledge the important role of health in social development. Health is the foundation for comprehensive development of humanity, and should be placed at the center of global social development.”
China and Africa are positioned to lead and inspire the rest of the world with a powerful example: a partnership that puts people—not politics, profit or ideology—first. GHD