Next Stop: Universal Health Coverage for all Africans

19 September 2019 by Ibrahim Boubacar Keïta, President of the Republic of Mali

One million people worldwide do not have access to basic health care due to a lack of financial resources or proximity of services. Behind this figure, we can only imagine the difficulties faced every day by the most vulnerable people in developing countries – pregnant women, children, older people and those living in rural areas – and their distress.

In February 2019, I had the honor of launching the most ambitious health reform in the history of my country. This reform has made primary care completely free of charge for pregnant women and children under age 5, and deployed and trained tens of thousands of community health workers to work as closely as possible with 18 million Malians, spread throughout our vast territory.

We designed this historic reform with the unwavering support of our partners: the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Bill & Melinda Gates Foundation, the World Bank, GAVI, the Vaccine Alliance, and the nongovernmental organization Muso. It is currently being implemented gradually over a three-year period, supported by US$120 million in annual funding.

The transformation of Mali's health sector is an incredible moment for our country, which has long struggled to contain preventable infectious diseases and has one of the highest maternal and infant mortality rates in the world. The pilot scheme carried out in the Yirimadio district, on the outskirts of Bamako, has shown us that bringing health services closer to the population is a decisive factor in eradicating epidemics.

We trained community health workers to go door-to-door, identifying any symptoms of childhood diseases such as malaria, diarrhea and pneumonia, and redirecting critical cases to clinics. This resulted in a drop in the number of deaths of children under age 5 from 148 per thousand to seven per thousand in seven years. It is crucial that the most vulnerable are protected and our ambition now is to replicate this model nationwide. 

Beyond the immediate results expected, our approach is also intended to be a first step toward establishing universal health coverage for all Malians. Our vision is indeed that of a state that would fully play its part by covering the bulk of health care expenses for its population. It is the responsibility of every nation, regardless of its level of income or development, to invest in health to improve access to quality and affordable essential health care for all. Not only is this right, but it is also in our own interest.

In this mission, partners such as the Global Fund are essential. The Global Fund is the leading multilateral investor in building sustainable systems for health, including removing human rights and gender barriers and ensuring a consistent and reliable supply of health products. In October, we have a unique opportunity to renew our commitment to the Global Fund as it holds its Replenishment Conference to raise new funds and mobilize partners to end diseases and accelerate progress toward universal health coverage.

Investing in health is a clear priority and an essential foundation for the economic development of our country and our continent. Africa's greatest strength lies in its tremendous demographic dynamism: its human capital. Let’s give our young people the means to live, to grow and to succeed.