Africa is estimated to lose over $1b in medical tourism abroad, according to World Bank statistics (2015).
Prof. Khama Rogo, the lead Health Sector Specialist with the World Bank and Head of the World Bank Group’s Health in Africa Initiative said that much as the continent is heavily resource constrained, a lot of money is spent on treatment abroad which could have instead helped develop capacity on the continent. He was speaking at a recent forum by East African Health Federation Conference in Kampala.
Africa, according to Rogo, is exporting money and sickness to the East, especially India, which has largely contributed to a flourishing private health sector at the expense of Africa’s.
“Indian private sector is enjoying the benefits of sickness from the African continent. Young people in Africa have instead started clinics as conveyor belts for the Indian hospitals,” he said.
Much to the chagrin of the continent, 25% of the passenger loads on major airlines namely; Kenya Airways and Ethiopian Airlines according to Rogo is sickness.
He argues that since most governments cannot absorb all the experts in their countries, it is an opportunity for the private sector to help retain such talent in the region. This will attract clients from other countries and not necessarily seeking care abroad.
In the case of Uganda, according to the executive director of Uganda Healthcare Federation, Grace Ssali Kiwanuka, the amount of money lost in medical tourism abroad can be placed at about $3m.
The figure could be higher since there is largely no central body that co-ordinates who goes out. Health insurance companies that give international benefits make direct payments, there are individual using own savings and then the numerous sponsors such as the Indian Association in Uganda that sponsors a number of people for heart surgeries.
Such countries as India, South Africa, Thailand and Turkey according to Ssali remain major destinations for Ugandans.
Capacity and quality still remain a major undoing for the region and Uganda in particular. For any hospital to build the confidence of clients for major procedures, it must have a history of success. Most referrals abroad are such cases as oncology, cardiovascular and joint or spinal surgeries.
But this will largely depend as Ssali explains on partnerships between government and private healthcare providers since these acting independently have proved inadequate.
The private sector as Ssali expresses is eagerly waiting for the operationalisation of the public private partnership policy (PPP). Though it is in place, no guidelines have been developed yet for the different stakeholders to know how to do business.
“We need guidelines to tell us how we can be contracted by government, the process and the parameters,” she says.
Currently most CT and MRI scans in Uganda are carried out by the private health providers since most public facilities do not have this equipment. But this is left at the expense of the patient. If according to the experts such services are streamlined, more people will be able to access quality health services.
In Tanzania according to Dr Samuel Ogillo, the CEO of The Association of Private Health Facilities in Tanzania (APHFTA), just this year, a total of 145 private facilities had signed agreements to provide free health services to the population with support from their government.
The Federation currently made up of Uganda, Kenya, Tanzania, Rwanda, Ethiopia and South Sudan is proposing an insurance fund for the region that can be accessed by clients from the region.