Ensuring access to clean water and sanitation, battling ongoing communicable diseases and stemming the tide of preventable deaths still dominate the healthcare agenda in many countries.

However, the incidence of chronic disease is rising fast and with the advent of the Covid pandemic, has highlighted the need to create a new matrix of Africa’s healthcare workers, policy makers and donors.

A growing urban middle class is willing to pay for better treatment. This has opened the door to the private sector, which is starting to play a new role, often working in partnership with donors and governments to provide better healthcare facilities and increased access to medicine at an affordable price.

For the vast majority of Africans still unable to pay for health provision, new models of care are being designed as governments begin to acknowledge the importance of preventive methods over curative action. This, in turn, is empowering communities to make their own healthcare decisions. At the same time, some countries are experimenting with different forms of universal health provision.

Africa’s healthcare systems are at a turning point. The reforms that governments undertake over the next decade will be crucial to cutting mortality rates and improving health outcomes on the continent.

Implementation of these reforms could strongly influence the future shape of healthcare in Africa.

The Economist Intelligence Unit has identified the following five extreme scenarios to show how the health system might develop over the next decade:

  1. Health systems shift to focus on preventive rather than curative care.
  2. Governments transfer healthcare decision-making to the local level.
  3. Telemedicine and related mobile-phone technology become the dominant means of delivering healthcare advice and treatment.
  4. Universal coverage becomes a reality, giving all Africans access to a basic package of benefits.
  5. Continued global instability forces many international donors to pull out of Africa or drastically cut support levels, leaving governments to fill the gaps.

Thanks and acknowledgement are given to South African Research Council for some of the information contained in the article.

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