Sightsavers blog

Five takeaways from the Africa Health Agenda conference

Fred Smith, March 2019
A large crowd of people standing in a conference hall with a banner promoting the Africa Health Agenda International Conference.

This week I attended the Africa Health International Conference (AHIC) in the beautiful city of Kigali, Rwanda, which focused on achieving universal health coverage in Africa by 2030.

The conference brought together more than 1,500 participants from all kinds of sectors, all working on ways of ensuring better health outcomes for everyone.

As I get ready to leave Rwanda, here are my top five reflections on the discussions over the past three days.

1. Human resources for health: a crucial consideration

The lack of human resources for health is a major barrier that needs to be addressed. It is commonly cited that Africa has 24 per cent of the global disease burden and 11 per cent of the global population, but only 3 per cent of the health workforce. Whichever way you look at those figures, it’s clear they result in a major challenge around the availability of health workers. It was promising to see how this was highlighted in almost every session, but it urgently needs to change.

2. Awareness is a weak spot

We need to raise more awareness of what is available. There have been so many great examples this week of work that is taking place in challenging environments to improve health outcomes for the poorest people. But a consistent message has been that often, people aren’t aware of what is available, meaning they don’t access health services designed to help them. Clearly, we need to do more to ensure people understand their right to health and how to access those services.

But we also need to make sure barriers to accessing services are removed. Which leads to my next point…

3. ‘Vulnerable’ is too vague

We need to do a better of job understanding who is left behind. There is always a lot of talk about the ‘last-mile’, ‘under-served’ or ‘vulnerable’ people when we talk about health and development. But we need to do more to break down those umbrella terms. We know from our work on inclusive development that people with disabilities, women, older people, youth, indigenous people and minority groups – among others – often don’t participate in development programmes, and that those factors intersect to create ‘vulnerability’. We need to identify who makes up ‘the last mile’ and genuinely target them first, otherwise it’s just another nice turn of phrase in theory, that won’t help in practice.

4. We need to make progress more quickly

In line with the above, there is a policy and implementation gap. Too often there is a big gap between what’s committed to or written on paper, and what happens in practice. This needs to change – and quickly. A number of speakers referred to ‘2030 Now’, meaning the global Sustainable Development Goals expire in 2030 and there’s a lot of work to be done between now and then. Hopefully this has made an impression, as rapid progress is required if we are to achieve universal health coverage.

5. It’s time for action

Finally – and it has been rightly highlighted again and again here in Kigali – political will needs to translate into political action. A lot of health leaders have spoken eloquently on the great work they are doing to improve health outcomes for their people. And there was a consistent theme to what was said by all the ministers who were presenting success stories: political will on its own is not enough. Action is required.

This last point is crucial, and it’s why all the participants in Kigali are working to influence the UN High-Level Meeting on universal health coverage that is taking place in September this year. This is a massive opportunity for world leaders to take action and ensure the steps to achieving universal health coverage are genuinely put in place, so that all people can access the health care they need.

At Sightsavers, we’re departing Rwanda determined to work with our partners to ensure the High-Level Meeting results in the long term change that is required for the people who need it the most.


Fred Smith.Fred Smith
Fred is Head of Policy at Sightsavers.

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