My World in 25 Years is Scary to Admit

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Over the years, we have seen improvements in life expectancy, advancements with vaccinations, and better management of infectious diseases. Additionally, globalization has surged since two and a half decades ago, fostering greater interconnectedness and interdependence among nations. This interconnectedness has led to the establishment of crucial partnerships, exemplified by initiatives like the current Sustainable Development Goals (SDGs), which have contributed to health advancements in regions like Sub-Saharan Africa (SSA). For the sake of this discussion, I am compelled to contemplate what the future holds for health outcomes in SSA in the next 25 years. This is not only due to my profound connection to the region but also because I envision myself living and working in these areas before that period. 

Africa as a continent is expected to experience significant population growth over the next two decades. Whether this population increase becomes a blessing or a curse will depend on how well we manage it. While we have witnessed progress over the last 25 years, such as increased life expectancy, improvements in child and maternal health, the successful eradication of polio, and increased investment in healthcare, there is still much work to be done in effectively managing our health systems. This is primarily due to limitations in health infrastructure, and a lack of political will. The focus on improving health outcomes through initiatives like the SDGs and the United Nations motto of Universal Health Coverage (UHC) for all, serve as driving forces in addressing health inequities in SSA. Notably, maternal and child health stand to benefit significantly from UHC, as improved access to timely maternal and child health services can mitigate the risks of mortality, a major concern in SSA. UHC will also reduce financial burdens, enabling individuals to retain more resources, resulting in increased productivity, fostering economic growth and prosperity in our society. However, with the projected population increase over the next two decades, questions arise about our preparedness to ensure UHC for all by 2048, with the strength of our current infrastructure.

One significant criticism I hold regarding the SDGs is the reliance on political will to drive progress toward the goals. The conclusion of the Millennium Development Goals (MDGs) revealed that many SSA countries lagged, particularly in health-related goals, largely due to a lack of political will. Given the current trajectory of these trends, I believe that in the next 25 years, we will not achieve UHC, and this will be further exacerbated by our current system's inability to accommodate our expected population growth. The consequence of us not attaining UHC will lead to a major strain on our healthcare system, increasing disease burden and financial hardship because of out-of-pocket payments. As a result, economic growth will be stagnant leading to unemployment and increased poverty. This will also drive highly skilled individuals to look for better economic prospects, causing the problem of brain drain, which will further decrease economic development and weaken our healthcare infrastructure.

In conclusion, the prosperity of my world 25 years from now depends on the political willingness to enhance our infrastructure through increased funding and health systems strengthening to achieve UHC for all. This extends to our anticipated progress in economic growth, reducing inequalities, and addressing planetary health. On the topic of SSA’s planetary health, there is an urgent imperative to address the mounting concerns surrounding how climate change will be amplified by our growing population in 2048. Without the implementation of adaptive climate response measures, landlocked regions in SSA are at risk of enduring climate-related disasters that will lead to physical, social, and economic vulnerability. I began this reflection by highlighting how globalization has improved health outcomes, I strongly believe that SSA can leverage its interdependence within the continent, to foster greater political will.