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The Power of the Rising Development Generation Africa
The Power of the Rising Development Generation Africa
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IFC and Partners to Mobilize Up to $1 Billion to Strengthen Private Health Care
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A new report from IFC, a member of the World Bank Group, says spending on health in Sub-Saharan Africa is expected to double over the next 10 years. Investments of $25-30 billion will be needed to meet the demand, with the private sector playing a key role. Entitled The Business of Health in Africa: Partnering with the Private Sector to Improve People’s Lives, the report says the private sector already plays a significant role in delivering and financing health care for the region’s people. On average, the private sector delivers 50 percent of health care goods and services. The report, partly financed by the Bill & Melinda Gates Foundation, has prompted IFC and its partners to announce a new strategy for addressing Africa ’s health challenges, a major aspect of the region’s poverty. This involves mobilizing up to $1 billion over the next five years in investment and advisory services to boost socially responsible health care.



“This is a chance to increase access to health care for millions of Africans,” said Lars Thunell, IFC Executive Vice President and CEO. “If we can get all the critical players – governments, donors, investors, and providers – to leverage the private health sector and integrate it effectively with public systems, we can also greatly improve the quality of care.” Thunell added, “The private sector already provides about half of health care goods and services in the region. And a poor woman in Africa today is as likely to take her sick child to a private hospital or clinic as to a public facility.” “I am delighted to see IFC moving forward with this new investment strategy, which is a promising way to improve access to important health services,” said Tadataka Yamada, M.D., President of the Bill & Melinda Gates Foundation’s Global Health Program. “IFC’s report underscores the significant role the private sector in Sub-Saharan Africa plays in delivering health interventions, including critical services to the poor. It also makes a compelling investment case for private capital seeking financial and social returns on investment.”



The report had input from a wide range of stakeholders, including governments, investors, and civil society. It makes clear that the private sector – for-profit as well as not-for-profit institutions – is only part of the solution and that it must work with the public sector to develop viable, sustainable, and equitable health care systems. But it says t he private sector is sometimes the only option for people living in remote rural areas and urban slums. By 2016, Africa ’s health care expenditure is likely to reach $35 billion, up from $17 billion in 2005. The report points out that people in Sub-Saharan Africa have the worst health on average in the world. It suggests that donors and governments consider using private providers and risk-pooling programs to reach the poor.



IFC will partner with donors, development finance institutions, and other entities to mobilize up to $850 million for development of a socially responsible private health sector in Africa over the next five years. IFC and its partners will also mobilize up to $150 million for a number of initiatives to improve the operating environment for private health care organizations. (See attached Fact Sheet for more information.) IFC’s efforts form a key part of the World Bank Group’s larger health, nutrition, and population strategy, and they reflect a commitment to helping African countries reach the Millennium Development Goals by 2015. “The report from IFC is the most comprehensive analysis to date of the private health sector in Sub-Saharan Africa,” noted Prof. Eyitayo Lambo, a leading international health economist and former Minister of Health for Nigeria , who served on the project’s steering committee. “IFC’s new strategy reflects important first steps to act on the report’s findings. It suggests new ways for health care organizations to access capital and world-class advisory services while working to strengthen the business climate. I am optimistic that it will create an environment for change, offer practical solutions, and facilitate sustainable investment.”



Guy Ellena, IFC Director, Health and Education, concluded, “IFC is committed to supporting private health care in Sub-Saharan Africa to improve people’s health and reduce poverty, and joining forces with our partners will help us understand what works and what doesn’t. I am very happy to note that the African Development Bank was one of the first development finance institutions that supported the initiative and agreed to collaborate with us in establishing the equity investment vehicle, a key component of our strategy.” Going forward, IFC and partners will continue to engage with stakeholders. A series of health and investment forums in Cameroon , Kenya , Nigeria , Senegal, and South Africa and civil society meetings in Europe are planned for the first quarter of 2008.



About IFC

IFC, a member of the World Bank Group, fosters sustainable economic growth in developing countries by financing private sector investment, mobilizing private capital in local and international financial markets, and providing advisory and risk mitigation services to businesses and governments. IFC’s vision is that poor people have the opportunity to escape poverty and improve their lives. In FY07, IFC committed $8.2 billion and mobilized an additional $3.9 billion through loan participations and structured finance for 299 investments in 69 developing countries. IFC also provided advisory services in 97 countries. For more information, visit www.ifc.org

December 23, 2007 | 10:45 AM Comments  0 comments
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Abuses Against Women Obstruct HIV Treatment
Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

The Zambian government is failing to address the life-threatening obstacles facing Zambian women living with HIV who experience domestic and gender-based violence, Human Rights Watch said in a report released today. Gender-based violence and insecure property rights are preventing Zambian women from accessing life-saving antiretroviral treatment. While acknowledging the significant overall progress made by the Zambian government in scaling up HIV treatment generally, the 96-page report, "Hidden in the Mealie Meal: Gender-Based Abuses and Women's HIV Treatment in Zambia," documents how the government has fallen short of its international legal obligations to combat violence and discrimination against women. The report details abuses that obstruct women's ability to start and adhere to HIV treatment regimens, including violence against women and insecure property rights that often force women into poverty and dependent, abusive relationships. "Addressing domestic violence, property grabbing, and unequal distribution of property upon divorce is critical to ensuring that women in Zambia have equal access to antiretroviral medicine" said Nada Ali, researcher in the Women's Rights Division of Human Rights Watch and author of the report. "Ignoring these abuses will mean that the Zambian government's goal of universal access to HIV treatment by 2010 will fail."



The report is based on interviews in Zambia's Lusaka and Copperbelt provinces with dozens of women living with HIV, HIV counselors and other healthcare providers, government officials, donors, and the police. The report documents how domestic violence and fear of violence thwarted women's ability to seek HIV information and testing, discouraged them from disclosing their HIV status to partners, delayed their pursuit of treatment, and caused them to miss clinic appointments and doses of medication. "I fear to tell my husband [about my HIV status] because I fear that he can shout [at me] and divorce me," Maria T. (not her real name), 45, told Human Rights Watch. "I hide the medicine, I put it on a plate, add mealie meal, so when he takes the lid off he [does not find the medication]. [When] I take the medicine I have to make sure that he is outside. That is why I forgot to take medicine four times since I started treatment [seven months ago]. Last year he hit me around the back with his fist."



The report documents how unequal distribution of property upon divorce and property grabbing by in-laws on the death of a spouse impede women's HIV treatment. Under the customary laws of many ethnic groups in Zambia, women have lesser property rights than men, and are often left with nothing when widowed or divorced. Fear of losing homes, land, and other property binds some women in abusive marriages. Women who lost property told Human Rights Watch that they struggled to pay for transport to clinics for HIV treatment and counseling and to afford the food they need for treatment to succeed. In Zambia, 17 percent of the adult population is living with HIV/AIDS, 57 percent of whom are women. Girls and women between ages 14 and 25 are four times more likely to be infected with HIV than their male counterparts. More than half of ever-married women respondents to the 2001-2002 Zambia Demographic and Health Survey (ZDHS) reported having been beaten or abused by their husbands. In November 2006, the Zambia chapter of the Young Women's Christian Association reported that their shelter recorded 10 cases of rape of adult women in Lusaka every week. The ZDHS also found that a large majority of women (85 percent) and men (69 percent) believed that a husband is justified in beating his wife for at least one reason. "Unless the Zambian government introduces legal and health system reform and removes the barriers to HIV treatment that women face, gender-based abuses will continue to shatter the lives of countless Zambian women in acute need of antiretroviral treatments and contribute to avoidable losses of health and lives," said Ali.



Despite the potentially deadly effect of gender-based abuses on women's HIV treatment, Zambia lacks specific legislation on violence against women. The only two shelters available for female survivors of gender-based violence are civil-society operated, and the Lusaka shelter is filled to capacity. Existing inheritance law is poorly enforced. Zambia has made great strides in providing free antiretroviral medicine to more than half of those who need it. But the country's healthcare system is ill-equipped to respond to gender-based violence. Healthcare facilities providing HIV treatment have no systems to detect or respond to abuses such as domestic violence, and there are currently no government protocols on how to address violence in HIV treatment programs. HIV treatment counselors rarely ask about violence in the home, though many said they would do so with proper training and support. "Healthcare facilities can play a key role in responding to violence and other abuses against women," said Ali. "Doing so not only helps women access and adhere to HIV treatment, it could also help end the abuse if it were part of a wider strategy to end violence and inequality between women and men. Unfortunately, this is not happening in Zambia."



Human Rights Watch called on the Zambian government to act urgently to enact and enforce legislation on sexual and gender-based violence and to ensure that the new constitution fully protects women's rights to equality. The Zambian government should also establish systems to enable healthcare providers, including HIV treatment providers, to respond to gender-based abuses. At a minimum, the government should ensure that healthcare providers in the HIV sector receive adequate training, clear guidelines, and support to detect and respond to gender-based abuses. Donor agencies should support these reforms as a key component of effective treatment for women with HIV.