Tag: Medical Diplomacy

Primary Health Care and Health  Infrastructure Development: Lessons From China

Posted on By Sino Uganda Research Centre

By Salim Abila Asuman

Attention; in the relentless pursuit of progress, a nation teeters on the brink of stagnation when its healthcare infrastructure falters. As the sickly grip tightens, the nation’s capacity to evolve, innovate, and propel itself forward dwindles.

An ailing healthcare system is not merely a burden, it is an indication of systemic decline, casting a dark shadow over the promise of a brighter future.

In the pursuit of progress and economic advancement, nations often overlook a fundamental pilar of development: healthcare infrastructure. However, the consequences of neglecting this vital aspect of society are dire and far-reaching, threatening the prospects of a nation’s growth and prosperity.

As the heartbeat of a nation’s well-being, healthcare infrastructure serves as the backbone upon which the health and productivity of its citizens rely. And, failure to invest in this critical foundation can unleash a torrent of devasting effects, reverberating through every facet of society.

First and foremost, inadequate healthcare infrastructure leads to a stark reality of inaccessibility to essential medical services for a significant portion of the population.

I assure you, without proper facilities, resources, and personnel, individuals are left vulnerable to the ravages of preventable diseases and untreated conditions, and as a result it becomes a heavy toll on both human lives and economic vitality.

The economic burden of poor health outcomes is profound, draining off resources and stifling growth at every turn. Skyrocketing healthcare costs, coupled with the loss of productivity due to illness, place immense strain on household finances and national budgets alike. Scares resources that could fuel progress in education, infrastructure, and innovation are diverted to address health crises, perpetuating a cycle of stagnation and underdevelopment.

The neglect of healthcare infrastructure strikes at the heart of human capital development, the cornerstone of sustainable progress. A populace plagued by poor health is one deprived of its full potential, with reduced life expectancy, compromised cognitive abilities, and diminished educational attainment stifling the aspirations of generations to come.

On the global stage, the repercussions of neglecting healthcare infrastructure echo far beyond national borders. In an interconnected world where investment and talent flow freely, nations with robust healthcare systems emerge as beacons of stability and opportunity. On the contrary, those marred by neglect face dwindling prospects for foreign investment and skilled labor.

For a nation like Uganda, the consequences of a deficient healthcare system reverberate across every aspect of society, profoundly impacting its development trajectory.

Without adequate access to medical care, preventable illnesses become barriers to productivity, leading to increased absenteeism and diminished economic output.

A robust healthcare infrastructure is indispensable for nurturing human capital and enhancing productivity, accessible healthcare services ensure that individuals remain healthy and productive, minimising absenteeism due to preventable illnesses and enabling workforce participation. Healthy individuals, in turn, contribute to higher levels of productivity, driving economic growth and prosperity.

The warning bell tolls loudly for African nations that turn a blind eye to the imperative of healthcare infrastructure. To ignore this call is to gamble with the future of the nation, as we stand at the crossroads of progress let us heed to this warning.

In the archives of healthcare evolution, China’s journey stands out as a fascinating tale of transformation and triumph. And it offers lessons for Uganda and all African countries aspiring to leap into a brighter future.

The completion of iconic projects like the Shanghai Pudong New Area People’s Hospital within a mere two years, underscores the importance of prioritizing infrastructure investment. The lesson to learn here is that by channeling resources into building hospitals and clinics, aiming to enhance accessibility and quality of healthcare services within a defined timeline Uganda can emulate this success.

Embracing healthcare technology by China, including telemedicine and electronic health records (EHRs), has revolutionised healthcare delivery, particularly in remote areas. To replicate this success, Uganda must leverage technology to bridge geographical gaps in healthcare access, and set a target for nationwide coverage at least within two years.

By China collaborating with private entities, such as Alibaba Group’s healthcare initiatives the potential of public-private partnerships has been highlighted in driving healthcare innovation and expansion. Uganda can harness the resources and expertise of private sectors partners to accelerate healthcare projects, aimed to launch joint initiatives within a defined timeframe.

Strengthening primary care infrastructure is a cornerstone of China’s Health policy, by investing in community health centers and promoting primary care services, aimed at providing a comprehensive and preventive healthcare closer to where people live has reduced the burden on tertiary care facilities and improves overall health outcomes.

China acknowledges regional disparities in healthcare infrastructure, highlighting the need for Uganda to implement targeted initiatives to improve rural and remote areas for equitable healthcare access. This is evidenced by China’s support to our health sector with China funded Naguru hospital also known as China-Uganda Frienship Hospital being a key example.

China’s construction of emergency hospitals, such as the Huoshenshan Hospital in Wuhan, in a matter of days demonstrated its ability to rapidly scale up healthcare infrastructure to respond to the crisis, providing critical care to COVID-19 patients while reducing strain on existing facilities. Uganda should learn from China’s example by prioritising proactive and coordinated actions while investing in strong healthcare infrastructure.

A reminder; in the tapestry of international relations, amidst the dynamic currents of global cooperation, one remarkable alliance that emerges is China’s unwavering commitment to Africa’s infrastructure advancement.

It is a symphony of solidarity, a testament to mutual respect, and a beacon of hope for progress.

China’s support in establishment and construction of the Africa Centre for Disease Control and Prevention is a reminder of a reliable partner when it comes to Africa’s efforts in building a strong health system. Today, the centre is playing a leading role in supporting public health initiatives of member states and strengthening capacity of their health institutions to deal with disease threats. The Addis Ababa Fistula Hospital and the China-Angola Friendship Hospital in Luanda are monuments of this unwavering dedication to African’s healthcare advancement, these are tangible testaments to a commitment to fostering progress and prosperity across the continent.

Another paramount reminder is that development hinges on the strength of its human capital. A thriving populace, kept afloat by robust healthcare and wellness initiatives, is the catalyst for transformation growth. China’s remarkable progress stands as a testament to this principle.

Let us embrace this powerful reminder of unity, recognising its potential to reshape landscapes, empower communities, and foster a brighter future for generations to come.

 

Salim Abila Asuman is a reseach fellow at the Sino-Uganda Research Centre.

 

Heart-to-heart Cooperation: Chinese Medical Team Contribution Saving Lives

Posted on By Sino Uganda Research Centre

An old Chinese adage says; “if you want happiness for an hour, take a nap. If you want happiness for a day, go fishing. If you want happiness for a year, inherit a fortune. If you want happiness for a life time, “help somebody.” Like the old English saying; “a friend in need is a friend indeed,” if put in context of China-Uganda relations, this narrative is a perfect match and best describes the relationship between two sides. It pictures a cooperation that supports mutual benefit and brotherhood on both sides.

For the last plus sixty years, the relationship between China and Uganda and generally, China-Africa relations has been growing from strength to strength. From social to economic and political context, China’s contribution in Uganda and generally Africa is spread like an open book and almost all citizens have either benefited individually or their relatives have gained from Chinese contribution which is often done through cooperate social responsibilities.  Also, important to note is that such contribution is also extended to African countries through bilateral relations between the two countries. One of such is China’s medical diplomacy.

In Uganda for example, the Naguru-China Uganda friendship hospital is a face of China-Uganda medical cooperation. The hospital which was constructed by China and gifted to Uganda has been at the center of deepening medical diplomacy between the two countries and arguably, thousands of Ugandans have benefited from Chinese services at the Hospital. Indeed, since 1983, China has been religiously supporting Uganda’s medical sector-annually, sending a team of medical experts in the country to work and share their experiences with their Ugandan counterparts while extending services to a number of Ugandans.

Among other services offered by Chinese medical team include minor and major surgeries. For example, on the January 31st, led by Dr. Zhang Hui, a Chinese surgeon at Naguru-China Uganda friendship hospital with colleagues conducted a successful surgery that lasted over 3 hours to remove an enlarged thyroid gland from a 38-year-old woman who was diagnosed with hyperthyroidism 15 years ago. Of course, there are other hundreds of Ugandans that have benefited from Chinese medical teams in Uganda since they started their medical exportation to Uganda in 1983.

Currently, the team of Chinese medical experts at China-Uganda friendship hospital Naguru is comprised of 22 members offering services among others, gastroenterology, thyroid and breast surgery, otolaryngology, urology, infectious diseases, and traditional Chinese medicine and acupuncture, offering survives daily to over 130 outpatients weekly.

One can argue that almost in the entire global south, almost all countries have benefited from China’s medical diplomacy. From Americas to Middle East and the wider Asia and then to African, people continue to get specialised medical services as a result of Beijing’s good cooperation in medical sector.

As developed countries practiced vaccine nationalism which resulted into hoarding of much needed vaccines at the height of Covid-19 pandemic, China stood taller and shoulder to shoulder working with developing countries especially in Africa to ensure many people got vaccinated against covid-19 by donating billions of Covid-19 vaccine doses to African countries. This was in addition to sharing its technology and jointly producing Covid-19 vaccines with African countries such as Egypt, Algeria and Morocco.

Indeed, at the early stage of the outbreak of the pandemic, Chinese president Xi Jinping warned against vaccine nationalism and proposed that COVID-19 vaccines should be made a global public good and benefit, in particular, developing countries with low or no capacity to produce own vaccines. Consequently, China provided over over 2 billion doses of vaccines to more than 120 countries and international organisations, of which over a billion were provided to Africa.

This is on top of China funding the construction of the new headquarters of the Africa Centre for Disease Control and Prevention (Africa CDC) which Beijing argued will help the continent in response to the Covid-19 pandemic and also help the continent better coordinate its approach to future pandemics. If critically analysed, a conclusion can be made that Beijing’s relations with African capitals is in all ways anchored on concrete and not just high-sounding empty words and hence, a confirmation of President Xi’s vision of building a community of shared future for mankind.

Allawi Ssemanda is a research fellow at the Development Watch Centre.

 

 

 

 

 

 

 

Building A Prosperous Society of People Free From Toil And Want: Lessons From China

Posted on By Sino Uganda Research Centre

The government of the People’s Republic of China began to work for a moderately prosperous society, one they called xiaokang in 1980. This was a fight against poverty with aim of achieving decent life and improvement of human rights in the country. The major aim wasn’t necessarily being rich but so that the people are free from want and toil. The Chinese Communist Party of China (CPC) and the government basically wanted the people to have peace, stability and happiness.  They pushed for growth in all aspects of economic development whilst leaving no individual element like social, economic, cultural etc lacking.

It didn’t come with their hands folded, they had to input a lot which can be as well be emulated by developing countries like Uganda. Interestingly, 770 million people below China’s poverty line have been raised from poverty. Indeed, in February this year, Chinese president, Xi Jinping announced that the country had eradicated extreme poverty one of its main objectives in the last twenty years and stressed that “complete victory” that would “go down in history” had been realized. “According to the current criteria, all 98.99 million poor rural population have been taken out of poverty, and 832 poverty-stricken counties as well as 128,000 villages have been removed from the poverty list,” noted president Xi.

All the above happened 10 years ahead of the projected time of 2030 by the UN. For anyone interested in learning, the first lesson would be the possibility of this seemingly impossible venture with China as the evidence to its feasibility. Most of the problems China had then are the ones many developing countries like Uganda face now. Its therefore more logical for us to implement solutions that have been tested and trusted to work elsewhere other than going about experimenting as this would waste resources and time without guaranteeing outcome.

Foremost, the government has put advancing its people’s rights above everything else. All the people enjoy their human rights, with equal opportunities and the rules affect all the people equally. The people are not favoured nor marginalised on grounds of ethnicity, gender, race, color etc. Also, Beijing fronted rewarding merit (meritocracy) other than kakistocracy. As a result of this, government’s programs are realised as set and the people are unified, patriotic and are willing to work together for the better of the whole country. This is a step several developing African countries can look at and incorporate it into their systems.

According to this month’s official document issued by China’s State Council Information Office entitled; “Moderate Prosperity in All Respects: Another Milestone Achieved in China’s Human Rights,” the government of China offered free compulsory education for its citizens. All primary and secondary schools can access the internet, financial aid has been offered to over 150 million students. There is also a system where those who drop out of school are identified and helped back into school. in developing countries like Uganda, very few and lucky people can afford to pay higher institutions tuition with easiness which has increased on number of those dropping out of higher institutions before completion. Such challenges can be addressed by government waiving tuition or and or textbook fees to reduce burden parents and students face.

China also put-up special teaching posts in villages to ensure that university graduates got to teach in the rural areas. Though such arrangements are in place her – hard to reach areas, strengthening them will see developing countries like Uganda ensuring  that the students in rural areas also acquire a good quality education. Remarkably, China has over 3,000 public libraries where scholars can access reading materials that may not be in their school libraries. Uganda has only of which very few are well stocked.

China has put up places where people can go and do exercises, encouraged the people to do them and has also educated the mases on good nutrition. They have also promoted preventive services like cardiovascular screening and cancer screening. China’s rural areas have access to basic medical insurance. This ensures that the people don’t sell their belongings or die as a result of failing to access medical care. China has also made rehabilitation services generally available for the disabled and mentally ill. During this pandemic, they have pulled numerous resources to build 1000 and 14000 bed health facilities in 10 and 12 days respectively. They have made efforts to vaccinate all the people and on top of offering free treatment for COVID-19 patients. China’s commitment to the health of their citizens has had their life expectancy increasing while most of the world especially in developing countries is decreasing. If Uganda could borrow the whole tree (apparently a leaf might not be enough), we would have reduced mortalities and the unending challenges like strikes of health workers would be history.

China built an agrotechnology system that has greatly improved their productivity. Uganda being an agriculture-based country could benefit umpteen times from such a system. In China, the right to be free from hunger is guaranteed by the nutrition improvement program for children in poor areas and people having access to food through poverty alleviation. China has also ensured safe housing for the poor and put-up programs such as renovation of rural homes. If replicated here, Uganda would as well greatly benefit.

To address the problem of un employment, China has put up 45,800 employment agencies. Though Uganda is trying with programs like skilling youth, extra efforts will help make a big difference.

China has also strengthened the legal protection of human rights and increased the public awareness of the constitution and the law. Consequently, many people understand laws governing them and as they enjoy their much-protected human rights, they also understand what is required of them and hence, many are patriotic and always work to defend interests of their country which is key for development to take place.  Most Ugandans don’t even know their rights or even the constitution. China has as well put-up internet-based government services, the public supreme court has publicized judicial protection of private enterprises. All these have in a way led to the achievement of the desired goals and arguably, all Chinese have peace, stability and happiness which is key for a holistic prosperous society. Perhaps, developing countries like Uganda should embrace such, we shall be on wheels swiftly moving towards a xiaokang too.

Dr. Joseph Nyero is a Ugandan medical doctor and a research fellow at Sino-Uganda Relations Research Centre.

China’s Medical Diplomacy Reflects President Xi’s Philosophy Of Community With Shared Future For Mankind

Posted on By Sino Uganda Research Centre

My favorite Chinese saying is; “if you want happiness for an hour, take a nap. If you want happiness for a day, go fishing. If you want happiness for a year, inherit a fortune. If you want happiness for a life time, HELP SOMEBODY.” This is a saying that they have taken very seriously!

I needn’t say it but for emphasis I will, a sick nation cannot develop! Imagine you had to go to work with fever, difficulty in breathing, sore throat, aches, pain and cough. Currently, the world is faced with the COVID-19 pandemic that has brought the entire world to its knees. We have been taught that prevention is better than cure and we agree but what if we can’t entirely prevent a disease because its airborne and yet we still have to walk around looking for food. The next option would be going for a cure except there isn’t one and that’s why high-income countries with sophisticated medical systems that a country like Uganda can only admire have terribly crushed down. If something befalls the jungle and leaves the lions down, the sheep don’t go running around, they take shelter. It brings us down to the only shelter that we have learnt with time about the noble disease, vaccinating. What this does is to reduce transmissibility and mortality and prevent the severe form of the disease.  All that has to be done is to vaccinate the highest percentage of the population so that even those that haven’t been vaccinated benefit from herd immunity.

Unfortunately for developing countries like Uganda, purchasing covid-19 vaccines has proved to be a very difficult, since developed countries pre-ordered almost all produced vaccines and others opted to hoard them until all their citizens are fully immunized. This has left many countries including Uganda unable to access these vaccines on market on top of the vaccines being super expensive. Even Covax facility which was started to help developing countries vaccinate their citizens experts say it vaccines at their disposal now cannot even vaccinate 20% of population in developing countries. This means developing countries like Uganda cannot fully vaccinate their citizens without support of other developed countries.

This means many developing countries are going to continue struggling in terms of health capacity and hence, the need for support. In sprit of Ubuntu and Chinese president’s philosophy of a community with shared future for mankind, also known as community of common destiny for mankind, China has embraced medical diplomacy by donating 300,000 doses of the vaccine to Uganda. Also earlier donated to support Uganda’s health sector in the wake of Covid-19 pandemic are; 20 tons of cornmeal, mattresses, sanitizers, blankets, masks, gloves. Even Chinese individual citizens such as Jack Ma himself, a successful entrepreneur that has inspired many Ugandans donated medical supplies. All the above extended in times of need is a clear evidence that friends in need are our friends indeed!

These vaccines are going to go a long way in relieving the effects of COVID-19 in Uganda. The cases began as numbers which shortly turned into names of people we know. With no particular selection criteria, rich or poor, families have broken down leaving behind orphaned children. The people are mostly senior citizens like Uganda’s ambassador to Sudan that are not only important to their families as bread winners but also crucial to the development of the country. The people they leave behind commonly drop out of school, can’t find food and its not rare that they become depressed. These are gaps that will never be filled. We have all been depressed because of loosing someone we know. These vaccines are a strong thread of hope to ending this otherwise unending nightmare.

Currently, Uganda is under lockdown. During the recent presidential address, schools will remain closed and the situation reassessed after 60 days. Before this second lockdown, millions of students did not report to school despite the opening of schools meaning that these dropped out. These are children who are highly motivated with dreams that they wanted to see through. Some of them like me, are the only educated people in their families with a strong desire to finish school and break their families free from the chains of poverty. The awareness that some of the young girls are ending up with teenage pregnancies or being married off as early as 14 years breaks me down to the bones. The opening of schools has been coupled to the vaccination of a significant percentage of the teachers and students. These vaccines will give a huge forward push towards opening up of schools.

A high proportion of Ugandans meet their expenses from their daily incomes. Having a lock down therefore means that they will run short of food, rent, name it. It would really be unfortunate for such a person to catch the severe form of the disease which the vaccine prevents. How can someone who is struggling to find the days food afford 5 million Uganda shillings which is the daily bill of a private hospital to manage someone who is critically ill? This is why we are so thankful for the vaccines from China.

They haven’t only began boosting the medical system of Uganda since the pandemic. China has over the past 36 years donated medical equipment worth $8 million. They didn’t just dump the equipment here! They likewise sent 21 teams of over 200 doctors to show us how to use these equipment and work in our hospitals too. China has also been a significant part of the Ebola emergency prevention and control program that has prevented Ebola outbreaks in Uganda or the spread of outbreaks from Congo. China built the center for disease control. This puts Uganda at a better position, a head of local epidemics due to the preventive nature of the facility. The china-Uganda friendship hospital built in 2012 has reduced maternal mortality rate by 99%, operated on over 7,000 patients and delivered 22,000 mothers annually. These are people who walked into the gates of the hospital full of agony, desperation, uncertainty and trying to find something to hold onto. They walked out of the gates as though reborn, with smiles and full of hope ready to pursue their dreams. As a medical student, I haven’t known more joy than that of patients improving because that’s the call and nobility of the medical profession.

Thanks to China, Uganda is now slowly but steadily crawling out of a poor medical system as they are donating very expensive medical equipment, teaching us how to use them and bringing in expertise and practices that made them breakthrough. It won’t be long till we are there. A dream becoming true!

 Joseph Nyero is a fourth-year medical student at Makerere University and a research fellow at Development Watch Centre, a Foreign Policy Think Tank.

Creating a functioning health system for all: Lessons from China.

Posted on By Sino Uganda Research Centre

A heath system comprises all organisations, institutions and resources that produce actions whose purpose is to achieve good health. It’s building blocks include; governance, human resource, health information, health finance, service delivery, medicines, vaccines and appropriate technology.

All these components work together interrelatedly with an intrinsic goal of providing good health. A breach in one of them make lead to the collapse of the whole system. Take for instance, if there is not health finance, the medicine will not be bought and the service delivery will be poor. It is therefore vital to develop the system as a whole and to do a full systems analysis if there is need to fix any problems in a health system.

Several studies have confirmed that having well-functioning health systems is a forward in eliminating unnecessary and controllable deaths.

While it is not like a picnic to build a strong and good health system, we can borrow a leaf from some of developing countries that have succeeded in this aspect.  China for example had its first health system reform in 1996. The effectiveness and efficiency of the reform was questioned after a couple of years because people still had the same problems, they had in the first place.

They still had high out of the pocket expenditure, most of them didn’t have health insurance. A large proportion of the people couldn’t afford the health that they needed. In a closer look, these are almost the same problems faced by the health system in developing countries like Uganda.

People at times have to sell off their assets just to afford medical care which pushes them right to poverty even if they had escaped the poverty line. It is important that we look not only at prescription drugs but also make sure that health care is a major focus.

Following a failure from a top research institute, the former reform of 1996 had failed. China then embarked on planning another reform in 2007 where they consulted and worked with very many of their ministries. In 2009, the central committee of the communist party of china issued a policy. Its major aim was universal health coverage by 2020 through strengthening health care delivery, health security and provision of essential medicines. This policy reform is a long-term endeavor but the returns are worth the investments. Even when it is quite challenging for the African setting, we ought to start on our own reforms. Like the Chinese say, a journey of 1000 miles starts with a single step.

In order to get the job done, the state council set up a state council health systems reform office where the activities of the reform would be coordinated. The following were the policy reforms.

Under social health security, the social health insurance package was extended, medical aid was extended to the eligible poor and those with catastrophic medical expenditure.

The payment system was also reformed. Through this, 95% of the population has been covered by health insurance schemes by the end of 2017 and catastrophic health insurance introduced in all provinces.

Such a system in Uganda would reduce the burden of out of the pocket health expenditure. Often a times I have seen families who just take their patients back home because they can’t afford any more bills.

These people die from cases that could have been well managed if they had some form of insurance. Such a policy in Uganda would thus reduce mortality.

For the essential drugs, the new policy promoted rational use of antibiotics, removing price mark ups of drug and reforming the drug procurement system. This decreased the unnecessary use of anti-biotics and also made the drugs more accessible to the public. One of the issues in Uganda is over use of antibiotics which will eventually lead to resistance.

It bothers me a lot when I see how a wonder drug like ceftriaxone is used in cases where a milder antibiotic would work just fine. Antibiotic resistance is real and a day can come when a drug that did magic can no longer do a thing. A good example is penicillin. When it was discovered in 1928, it greatly improved mortality. Right now, bugs can have it for lunch! Such a policy in Uganda would not only reduce unnecessary bills on antibiotics but also delay the incidence of resistance.

As a doctor, sometimes I have had to walk through the pharmacies in Kampala to determine their prices. This is because I know that’s the first question patients ask upon presenting to them the treatment options. And from the search, the prices are shockingly different. I then send my patients to the cheapest pharmacy for the respective drugs. If we had a policy like the one China put up where the prices are controlled, medical care would be cheaper.

People even opt for traditional medicine that ends up messing their livers and kidneys the more. This is worse if the patient presented with a liver or kidney failure and they add on herbs to the problem. The people actually don’t want the herbs, they just can’t afford the modern medicine.

On the policy for primary health care, the Chinese government increased the capacity for training and created contracting systems for general practitioners. This was able to increase the number of doctors and improve health care. One of the major challenges in the developing countries like ours is few doctors and poor recruitment by governments. Having such a policy would increase the number of training institutes and ensure more doctors while also providing new jobs to the staff in the institutes. Another reason patients avoid government hospitals in Uganda is the long waiting time. This would provide a solution to this as there would be many doctors seeing the patients.

The other policy introduced by the Chinese to strengthen its health system was basic public health package. Here the government provided subsidies and promoted programs that control the main public health concerns. This made the bills cheaper and reduced the occurrence of non-communicable diseases. As indicated earlier, high bills are still a problem for Uganda. Non-communicable diseases are also on the rise in developing countries.

The last policy was about public hospitals. Through this, they encouraged the creation of consortium or alliances of healthcare providers. They also established a tiered health system where every healthcare provider knew exactly what its functions are. They also encouraged the use of clinical guidelines. This created an organized system with a standard of care that is uniform and a regulatory body. We have a clinical guideline in Uganda but it is not yet widely used and every doctor manages patients their way.

This makes some of the patients to get substandard care. In the Ugandan system, health center IVs are supposed to carryout surgeries but there are those which don’t. such a system would make every health center offer healthcare to the best of its abilities thereby helping reduce congestion at reginal and national health facilities where many tend to run even with cases that could be managed at health centers.

Upon emulation of such policies in to our setting, Uganda shall have tremendous health benefits. More people will visit and afford hospitals, poverty levels will drop, patient waiting time will decrease etc. the end result will be a good sustainable health system for all.

The writer is a research fellow at Development Watch Centre, a Foreign Policy Think Tank, and a fourth-year medical student at Makerere University.