Africa: a petition demanding investment in

Gilles Yabi, last week you launched a petition calling for the improvement of health systems in West Africa and you also organized on Wednesday 15 March a virtual roundtable discussion on how health structures work. Why this focus on health right now?

For us, there is no specific opportunity to raise the issue of health, another to talk about education and another to discuss peace, security, political institutions or economic diversification. We must feed the public debate on all these topics at once. We have no choice given the scale of the challenges.

It is true that the pandemic has created an unprecedented interest in global health issues. As we recall in the petition, by making medical evacuations of ruling elites and their families to the most reputable foreign hospitals almost impossible, the Covid-19 crisis should have reminded top African politicians that everyone can pay with their lives for the chronic underinvestment of to improve health systems.

With or without Covid, before and after Covid, our message is the same: it is important to strengthen all the pillars of health systems. The petition we have launched aims to involve citizens in a collective mobilization to ask West African leaders to make specific commitments and to respect them, I dare not add, this time.

In addition to the call for a clear increase in the proportion of national budgets allocated to the health sector, you also call for measures to be taken to: significantly improve the daily functioning of public health facilities. This was also the subject of debate at your virtual round table on 15 March.

Absolutely. We had invited three health professionals from three different countries in the region, Dr Assa Traoré Touré, an endocrinologist who practices at a large health center in Bamako, Mali, Leslie Agbo, a midwife in Benin and Professor Ibrahima Seck, head of preventive medicine and public health services and former Chief of Staff to the Minister of Health of Senegal.

In addition to their rich efforts, we also gave the floor to several participants from various other countries, who testified about their own experiences. There has been a lot of talk about non-existent or unpleasant reception of users, the first point of contact is often security guards without training for a proper reception. We talked about poor hygiene, regular water disruptions in health structures, the spread of mosquitoes and other unfriendly beasts sometimes in the largest hospitals. I must say that it evoked some personal memories for me.

Other failures with sometimes dramatic consequences, the quality of the technical platforms, painstaking maintenance of medical devices in the absence of qualified technicians. A fundamental issue, too, is that of professional behavior, ethics and empathy for healthcare professionals, which must be placed at the center of the training of all healthcare professionals.

But the point of this type of discussion is not just to make a long list of shortcomings, you say.

Absolutely. It is about pushing for concrete improvements by facing reality, breaking down and prioritizing problems. In connection with a breakdown in trust between populations and political leaders, it is through strong and visible signals of change in a sector such as the health sector that we can move away from a reassuring discourse on good governance and state reconstruction.

If we can not organize and run a reception and orientation service properly, if we can not install signs to guide patients in a hospital, if we can not ensure that working hours are respected by healthcare professionals, even those assigned to emergencies, I understand not really how we could find solutions to much more complex problems in all other areas of public service.

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