Improving the healthcare services in low income countries by tackling the treatment of the population, rather than the individual, offers a highly effective, low-cost path out of the cycle of poverty and disease.
So says Tope Lawani, Co-Founder and Managing Partner of Helios Investment Partners, a private equity firm operating in Africa with offices in Kenya, Nigeria and the UK.
Mr Lawani, who also serves on the Board of Directors of the END Fund – an organization that seeks to control and eliminate neglected tropical diseases (NTDs) – believes that having a systematic focus on Africa’s high infectious disease burden can help free the continent’s people from poverty.
He says this kind of initiative can help them fully pursue their own prosperity.
Mr Lawani speaks of Nigeria’s floating slum city of Makoko, which is separated from the high-rises of mainland Lagos by a 12-kilometre overpass.
“Typical of the many marginal spaces on the peripheries of large cities, the streets of Makoko are disproportionately crammed with the surplus populations that result from uneven development,” explains Lawani.
He describes such areas as “collateral communities borne of poor health” with too many people either “crippled by disease or disheartened by joblessness.”
According to the Helios Investment Partners chief, good health boosts a community’s ability to develop human capital, pursue economic activities, and attract investments.
He believes that equally, lowering the cost of doing business allows investors the freedom to put their money to work in communities where capital can offer a bridge to improved livelihoods.
“A labour force prone to sickness turns into higher health care costs to employers, eating away at potential returns, and ultimately deterring investment,” Lawani elaborates.
Over 1.5 billion people in the world’s poorest countries need treatment for NTDs, with Africa accounting for over 40% of the global NTD burden.
This high burden of disease and costs to quality of life have resulted in a two-decade gap in life expectancy between the richest and poorest countries, as well as sharp losses in productivity and school attendance among young children.
A study by Erasmus University in the Netherlands shows that meeting the World Health Organisation’s (WHO’s) 2020 goals for the five most common NTDs in Africa would save the continent $52 billion by 2030 and avert 100 million years lost to ill-health, disability, or early death.
An approach that prioritises primary health, targeting NTDs through the mass distribution of medicines, especially to rural areas, at a cost reduced by the generosity of pharmaceutical companies that donate the needed medicines, presents a real opportunity to build that bridge out of poverty and disease to a better life, states Lawani.
This approach also involves collaboration between governments, health organizations and philanthropic partners with a common understanding of the link between poverty and disease.
For instance, in Rwanda an NTD control program driven by the health ministry, with initial investment from the Legatum Foundation, saw the prevalence levels of intestinal worms, a major cause of infectious disease, decrease by over a third from 65.8% in 2008 down to 45.2% in 2014.
The Rwandan program was rooted in the principle of good epidemiology and a willingness to partner with private donors. It began with a year-long, country-wide NTD screening by the health ministry to gain a systematic understanding of the disease profile.
This was followed by a mass roll out of drug distribution, paired with the upgrading of health equipment, information systems as well as training of health workers and outlay of education programs aimed at households and customised to meet their specific disease challenges.
Between 2010 and 2015, Rwanda has successfully reduced total health expenditure as a percentage of GDP by about 2%. Nigeria, in comparison, has seen health expenditure remain at the same levels over the same period, meaning national budgets and those of households could not be freed for spending on schools, roads, and housing.
Organisations like the END Fund are working to strengthen local health systems, deepen knowledge about NTDs, and integrate with local efforts to scale up community health worker programs. They leverage private philanthropic capital, with the knowledge that every dollar invested in NTD control produces between $27 and $42 worth of economic benefit.
“For business leaders and corporations, investing in ending NTDs is probably the highest and most measurable return you can make on the charitable or corporate social responsibility dollar. Not only high, but quite visible and measurable,” says Lawani.