Rather than investing in predatory for-profit healthcare companies, development finance institutions should use their funds to help improve universal public services across the continent.

Recently, a good friend of mine took his perfectly healthy daughter to a private hospital in West Africa for a routine check-up. The paediatrician thought she was a bit thin for her age and advised that she undergo a surgical procedure, which is known to trigger weight gain in children. Despite the family’s misgivings, the operation went ahead.

She died on the operating table. It was a terrible loss. So many people I know in Africa have stories like this.

Public investment in essential public services has been in decline, creating a vacuum in healthcare provision that those seeking to make a profit are increasingly exploiting. But mixing profit maximisation with healthcare too often comes at an unacceptable cost.

Today, many private hospitals are abusing and violating the rights of patients and their relatives and impoverishing them. I see the devastating results every day in Africa – people faced with no choice but to watch their loved ones die, or forced to sell everything or take loans to pay the exorbitant medical bills.

However, the private sector continues to gain huge support as “the solution” to Africa’s development challenges.

Last month, I attended the Summit on the New Global Financial Pact in Paris on behalf of Oxfam. African leaders spoke passionately there about the issues affecting their citizens and, in particular, the need for public finance and public solutions. South Africa’s President Cyril Ramaphosa highlighted the profiteering by Big Pharma during the pandemic, and we kept saying, “What is more important, life or profits by your big pharmaceutical companies?”

But the World Bank and the rich countries instead again offered the private sector as the answer.

The new World Bank president, Ajay Banga, talked about how “for years, the World Bank Group, governments, and other multilateral institutions have tried – and fallen short – to mobilise meaningful private investment in emerging markets” and that “we must try a new approach … to catalyse private capital more effectively”.

In my view, the private sector knows quite well how to look after itself. It does not require taxpayers’ funding.

Sadly, and without asking us, governments in rich countries have contributed to this misery by underwriting and investing in these predatory private healthcare companies, feeding them to grow in our countries and become ever more powerful.

Oxfam recently released two shocking reports, based on complex and detailed investigative research in a number of countries.

We show how development institutions belonging to the governments of France, Germany, and the United Kingdom, as well as the European Union and the World Bank, are investing billions of dollars in Majority World countries into for-profit private hospital chains that block or bankrupt patients, deny them emergency medical care, with some even imprisoning patients and retaining corpses for non-payment of fees.

They are making huge profits for their already rich owners. All this, in the name of advancing universal health coverage and fighting poverty.

Ironically, the same rich countries provide healthcare and education funded by taxation and free of charge to their own citizens.

In Kenya, Oxfam unearthed dozens of cases of alleged or confirmed human rights violations by the Nairobi Women’s Hospital since 2017, including a newborn baby detained for three months, a schoolboy for 11 months, and a single mother of two for 226 days during which time her bill escalated by more than 2,000 percent.

The body of Francisca’s mother was locked in the hospital’s morgue for two years, she said. “I feel very sad seeing her … It is not easy for me because her body has changed … It does not look like a body any more, it’s more like a stone … We pleaded with the hospital to give us the body. We will never be able to pay the money, no matter how long they keep it.”

What upsets me most is that this hospital’s policy of detaining patients was already public knowledge before the rich countries chose to invest.

In Nigeria, nine out of 10 of the poorest women give birth with no medical care, yet childbirth at Development Finance Institution (DFI)-funded Evercare Hospital would cost those women their 12 years’ income.

Across all the hospitals getting these development funds, the average starting price for a childbirth procedure is more than a year’s income for an average earner in the poorest 40 percent.

During the COVID-19 pandemic, when people in my region of the world searched in desperation for scarce oxygen and life-saving care, exploitation escalated within some of these DFI-funded hospitals.

In Uganda, one of Africa’s poorest countries and hardest hit by the virus, private hospitals funded by European governments and the World Bank charged patient “clients” up to $2,300 per day for treatment and care. The Maputo Private Hospital reportedly charged COVID-19 patients an upfront deposit of more than $6,000 for oxygen and more than $10,000 for a ventilator.

In my view, the evidence is clear that the private sector is not the answer for the delivery of the public good. We know what the solution entails.

Instead of promoting the growth of expensive, out-of-reach hospitals for the elite, countries should support quality universal public services – funded by taxes and aid – and delivered free of charge at the point of use.

For example, look at the incredible improvements in healthcare delivered by thousands of new health workers in Ethiopia, pioneered by then minister of health, Dr Tedros Adhanom Ghebreyesus, before his time leading the World Health Organization.

European governments and the World Bank should stop funding for-profit private hospitals and evaluate the effect that their decades of investment in them have had on healthcare in Africa.

Fati N’zi Hassane – Oxfam in Africa Director – Aljazeera

L’article Investments in private healthcare are not helping Africans est apparu en premier sur World Opinion | Alternative Média.

Private hospitals in India and Kenya accused of refusing people on low incomes vital healthcare, or holding them hostage until bills have been paid, benefit from UK government investment funds, according to a report by Oxfam.

Investments worth hundreds of millions of pounds by government-backed agencies are used to facilitate the “impoverishment and even the imprisonment of the very people [the private hospitals] are supposed to be helping”, said the development charity.

A succession of incidents that in some cases have left patients with large debts shows the policy of investing in private healthcare is flawed and should be halted by the UK government, the charity said.

Oxfam’s Sick Development report is a critique of the millions of pounds taken from the UK aid budget and invested into foreign businesses and programmes in poor countries via British International Investment (BII), which is owned and managed by the Foreign, Commonwealth and Development Office.

The report found that the UK government was one of several, including those of France and Germany, and international groups like the World Bank that backed investments by wholly or part state-owned agencies into private healthcare groups, themselves often owned by large US private equity groups.

Development charity says patients denied treatment or held hostage until fees paid in private facilities in India and Kenya

Oxfam said investments by these agencies – known as development finance institutions (DFIs) – into private healthcare providers in low and middle-income countries should be redirected into strengthening public health systems “to help those living in poverty to access healthcare”. It said many of the countries receiving development money for healthcare had become “go-to destinations for health tourists”.

The report found “dozens of cases”, from a BII-funded hospital chain in Kenya, of patients being imprisoned until they paid medical fees.

This included a secondary school student who was held hostage in hospital for 11 months. “There have also been several cases of the hospital refusing to release dead bodies until fees are paid, in at least one case for over two years,” the report said.

In India, private hospitals funded by BII were accused of denying people treatment, “even though they had government health insurance cards entitling them to free care”.

Much of the report focuses on the activities of BII, which is the UK’s DFI. It has a mission to invest in private sector organisations in developing countries to boost growth and achieve the United Nations development goals.

The agency said all its activities are directed towards achieving these goals and supporting private healthcare businesses to “strengthen the quality and accessibility of healthcare in ways which improve the lives of millions”.

A spokesperson said: “Every healthcare system in the world – be they public or private – have isolated incidences of shortfalls in care.

“We take the Oxfam allegations extremely seriously. We investigate all such incidents whenever they come to light and have an established complaints mechanism for anyone to raise matters of concern.

“We continue to encourage Oxfam to share any evidence they hold of these alleged cases so that we can accelerate our investigations.”

The World Bank’s DFI, the International Finance Corporation, said it was always concerned by “improper healthcare delivery” in hospitals where it invested, but “private sector-led innovations such as digital health solutions can allow providers to help augment health systems’ capacity and capabilities and reach people who are vulnerable, poor or living in hard-to-reach rural areas”.

Oxfam said the evidence from its research in India, Kenya and Nigeria was that private hospitals failed to honour promises to accept accident and emergency cases and the profit-motive meant cases of financial or medical abuse were covered up.

The charity’s senior health policy adviser, Anna Marriott, who investigated many of the claims made against individual hospitals, said more than 90% of BII’s health investments were “out-of-sight and unaccountable, made via fee-charging and profit-hungry private equity funds mostly domiciled in tax havens”.

An inquiry by the all-party international development committee into the UK’s use of DFIs is due to be published next month.

“This is far more than just a case of a few bad apples. Wherever we looked we found cases of exclusion or exploitation and some appalling human rights violations,” said Marriott.

Oxfam’s local representatives spoke to people who were pushed into poverty by health fees of up to $36,000 (£29,000), the report said. “There were also cases of emergency patients, including a stab victim, not being treated until relatives turned up with cash.”

The report said BII-funded private hospitals were found charging “astronomical fees for maternity care”. In one hospital in Nigeria, the fee for an “uncomplicated birth” was the equivalent of 12 years’ wages for the poorest 10% of the population. A caesarean section cost the equivalent of 24 years’ wages, the report said.

Marriott said: “Every second, 60 more people are pushed into poverty by catastrophic health costs, and instead of helping to tackle the problem this way of spending UK aid is fuelling it.

“At a time of spiralling need and decimated aid budgets, it’s more crucial than ever that any development funding for health is spent as effectively as possible to reach those without access to healthcare.”

World Opinions –Theguardian.com

L’article UK aid should not fund private hospitals in developing countries, says Oxfam est apparu en premier sur World Opinion | Alternative Média.

About 27 million people already suffer hunger, a number that could rise to 23 by June unless urgent action is taken.

About 27 million people in West Africa are suffering from hunger marking the region’s worst food crisis in a decade, international aid groups have said.

In a damning statement published on Tuesday, 11 major international organizations including Oxfam, ALIMA and Save the Children, warned that the figure could even rise to 38 million this June.

Unless urgent action is taken, they said, the increase would mark “a new historic level” and an increase by more than a third during last year.

The alert comes a day before a virtual conference on the food and nutrition crisis in the Sahel and Lake Chad.

Since 2015, the number of people in need of emergency food assistance in the region – which includes Burkina Faso, Niger, Chad, Mali, and Nigeria – has nearly quadrupled, jumping from seven to 27 million.

Assalama Dawalack Sidi, Oxfam’s regional director for West and Central Africa said the situation had been worsened by “drought, floods, conflict, and the economic impacts of COVID-19”, which has displaced millions and is “pushing them to the brink”.

“There is not enough food, let alone food that is nutritious enough for children. We must help them urgently because their health, their future and even their lives are at risk,” stressed Philippe Adapoe, Save the Children’s director for West and Central Africa.

The United Nations has estimated that 6.3 million children aged 6-59 months will be acutely malnourished this year, an increase of almost 30 percent from 2021.

“I had almost no milk left so I gave my baby other food. He often refused to take it and lost weight. In addition, he had diarrhoea, which worsened his condition,” said Safiatou, a mother who had to flee her village because of the violence in Burkina Faso.

With food increasingly scarce, families’ food sources, especially in the central Sahel, and families increasingly being forced to sell their assets, further jeopardising their productive capacity and the future of their children.

As often happens during crisis, girls are dropping out of school or being forced into early marriage.

“The rains were scarce. There is no more food. With the lack of grazing, the sheep are getting thinner and this forces us to sell them at a loss. I used to have 12 sheep, but now I only have one left”, explained Ramata Sanfo, a herder from Burkina Faso. “I would like to have my cattle back so that I have enough money and my children can go back to school.”

To add to the already dire situation, experts have predicted that Russia’s invasion of Ukraine could push food prices up to 20 percent worldwide – “an unbearable increase for an already fragile population”.

The conflict will likely significantly reduce the availability of wheat in the six West African countries, which import at least a third or even as much as half of their consumption volumes from the conflicting countries.

And while the crisis has shown no sign of abating during the past decade, international donations are drastically reducing. Last year, the humanitarian response plan for West Africa failed to reach half of its scope.

“The Sahel crisis is one of the worst humanitarian crises on a global scale and, at the same time, one of the least funded,” said Mamadou Diop, the regional representative of Action Against Hunger. “We fear that by redirecting humanitarian budgets to the Ukrainian crisis, we risk dangerously aggravating one crisis to respond to another.”

According to the statement, Denmark has announced that it will postpone about half of its entire bilateral development assistance to Burkina Faso and Mali this year, in order to fund the reception of people displaced from Ukraine.

SOURCE: AL JAZEERA

L’article Oxfam, others: West Africa facing worst food crisis in a decade est apparu en premier sur World Opinion | Alternative Média.