Policy Brief No. 04 of 2022-2023 on Strengthening Primary Health Care for Equitable Access to Vaccinations in Africa

Abstract

Primary Health Care (PHC) is a whole of society approach to health that aims at ensuring the highest possible level of health and well-being and equitable distribution by focusing on people’s needs and, as early as possible, along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care and as close as possible to people’s everyday environment (WHO and UNICEF, 2018). The COVID-19 pandemic revealed PHC as the weakest link in the national and community response globally despite its importance as a defence to “flatten the curve” and prevent hospital saturation (World Bank, 2021). PHC facilitates timely vaccination in a functional health system and, therefore, it is vital for coping with the effects of the pandemic. Lessons learned from the pandemic present an opportunity for policy makers to strengthen and reform health systems by establishing sustainable structures that can withstand future crises and persist during non-crisis periods. Investing in PHC is necessary for a healthy population as it optimizes the use of healthcare resources and provides for timely and appropriate care that is responsive to the needs of individuals and communities. However, health systems in most African countries do not emphasize PHC, with many countries in sub-Saharan Africa having inadequately funded PHC initiatives. Existing literature suggests that political, institutional, financial, and ideological barriers have hindered PHC progress in developing countries (World Health Organization, 2018). In many countries, secondary and tertiary curative care receive high budgetary allocations at the expense of PHC (World Health Organization, 2018). In 2020, the 75th anniversary of the establishment of the UN, member states agreed that countries are increasingly facing challenges that are interconnected and transnational, which can be addressed through reinvigorated multilateralism, with the UN playing a central role. As a result, there are deliberate efforts to engage member states and various multi-level actors to focus and work together on identifying how current and future sustainable development challenges can be addressed. In the UN’s our common agenda (OCA) report, the estimated loss to the global economy due to the COVID-19 pandemic is over US$ 9.2 trillion in 2021 alone, in part because developing countries have not had equitable access to COVID-19 vaccines (International Chamber of Commerce, 2021). The OCA report anticipates a breakthrough for a safer and better future of sustainable recovery through vaccine sharing that is broader in scope and more equitable. It envisages enhanced global capacity to produce vaccines for future pandemics within 100 days and start global distribution within one year from the emergence of a pandemic. Realising this goal requires an increased emphasis on PHC to build efficient health systems that can ensure service continuity during and after a pandemic. However, countries in Africa may not achieve COVID-19 vaccination targets if strategic efforts are not made by governments to prioritize primary healthcare. The lack of equitable access to vaccines increases the risk of the emergence of different variants of COVID-19, which will prolong the pandemic and delay economic recovery. Therefore, this policy brief will explore mechanisms through which PHC can be strengthened to enable the equitable delivery of vaccines and offer solutions to the challenges encountered in delivering vaccines through the PHC system.