Coffee with Ada – African Health, Policy & Development Insights
By Ada Ezeokoli
At the 2025 Africa Health Conference at the Harvard Chan School of Public Health, I sat down with Dr. Yele Aluko, a globally respected cardiologist, former health system executive, and one of the sharpest voices on the future of African healthcare. His keynote pushed the audience to confront uncomfortable truths: Africa cannot continue depending on foreign aid to finance its health systems. Not if we want resilient, independent, and equitable health outcomes.
Our conversation dug deep into governance, strategy, private-sector investment, and the ever-present challenge of brain drain. What emerged was a blueprint for what must come next—and how advocates, policymakers, and the diaspora can play a role in building sustainable health systems on the continent.
1. Africa’s Aid Dependency: “Shift from dependency to partnership”
Dr. Aluko acknowledges that foreign aid has helped Africa in many ways—vaccines, medicines, training, and global expertise. But he argues that dependency limits sustainability. True progress requires African nations to move toward equitable partnerships, not one-sided aid relationships.
“This is not like flipping off a light switch. It’s a multi-decade process. But it starts with intent—and a strategy.”
What does that strategy require?
- Clear, long-term planning
- An accountability matrix
- Government commitment that survives political transitions
- Development of in-country competencies in healthcare delivery, financing, and manufacturing
This is where many countries falter—not in strategy creation, but in execution.
2. Where Progress Is Happening
Africa is not a monolith. Some countries are moving faster than others.
According to Dr. Aluko, nations like:
- South Africa
- Egypt
- Kenya
- Rwanda
- Nigeria (under its recent health leadership)
are demonstrating intentional efforts toward system strengthening.
But political turnover often resets priorities, interrupting progress. For healthcare systems to mature, governments must insulate health strategy from politics so technocrats can execute long-term plans.
3. Why Private Investment Hesitates—And How Governments Can Fix It
One of the major questions investors ask is: “Is healthcare in Africa profitable?”
Dr. Aluko’s response: Yes—but only with the right environment.
Private sector investors need:
- Stable policies
- Predictable regulations
- Incentives like tax exemptions and tariffs
- Assurance that their long-term investments won’t be uprooted by new governments
“If the rules keep changing, private organizations won’t come. Healthcare is profitable where the ecosystem—government, private sector, regulators—moves together.”
Healthcare is a long game. A pharmaceutical plant or hospital could require 20 years of investment before yielding returns. Policy instability is simply not compatible with that.
4. The Missing Piece: Governance and Execution
Africa does not necessarily suffer from a lack of good strategy. Ministries of Health often write excellent plans.
The problem? Execution gaps.
- Poor funding
- Indiscipline in implementation
- Corruption
- Uneven resource distribution
- Weak infrastructure
- Underinvestment in human capital
Healthcare financing also needs clearer models. Governments must define the basics they will guarantee—like primary care and preventive services—while enabling the private sector and academic medical centers to provide tertiary care.
5. Primary Healthcare: The True Starting Point
When I asked where advocates should begin, Dr. Aluko was clear: “The priority is primary healthcare.”
Why?
- It reduces the downstream burden of complex diseases.
- It improves early diagnosis.
- It is the most cost-effective intervention for population health.
- It builds community resilience and economic productivity.
But to advocate effectively, we must articulate:
- The business case
- The return on investment
- The economic value of healthy communities
Advocacy must move from emotion to evidence: “Here’s why investing in primary care benefits the nation.”
6. Brain Drain and the Untapped Power of the Diaspora
No African health conversation is complete without discussing brain drain. For decades, African governments subsidized medical education, only to watch graduates leave for better infrastructure, stability, and working conditions abroad.
“People leave because the value proposition at home is weak. If the opportunities were there, the massive exodus would not happen.”
But Dr. Aluko offers a reframing:
Brain drain can become brain gain.
Many diaspora physicians want to give back—but find it difficult due to:
- Outdated regulations
- Poor infrastructure
- Lack of incentives
- Jealousy or resentment toward the diaspora
Governments must create enabling environments and structured partnerships that welcome diaspora expertise, whether temporarily or permanently.
7. The Future of Medical Education: Teaching the Business of Medicine
Dr. Aluko shared that he had no exposure to health systems, financing, or administration as a medical student in Nigeria. It wasn’t until he attended business school in the U.S. that he understood how healthcare truly functions as an industry.
He argues that medical education in Africa must evolve:
Doctors need training in:
- Healthcare finance
- Strategic leadership
- Systems thinking
- Cost management
- Resource optimization
Why?
“A doctor’s pen is powerful. Every test, every prescription, every admission has financial implications. Physicians must understand they are custodians of the health system’s resources.”
8. The Underfunding of Women’s Health
A shocking statistic:
Less than 5% of global health funding goes to women’s health solutions.
Why?
- Cultural biases
- Male-dominated decision-making bodies
- Lack of data awareness
- Weak advocacy grounded in evidence
Advocacy must shift from emotional appeals to data-driven, business-case messaging.
And importantly:
Advocating for women is not a women-only responsibility.
9. A Final Word: Integrity, Empathy, and the Privilege of Healing
When I asked Dr. Aluko about his legacy, he said he doesn’t think of legacy in traditional terms. Instead, he focuses on how he lives daily.
What guides him?
- Integrity
- Empathy
- Fairness
- A deep respect for the privilege of caring for human life
“Every day a healthcare worker goes to work, they make people feel better and live longer. There is no greater societal value.”
He believes the next generation must carry this humility and responsibility into their work—whether in clinical practice, policy, or health systems leadership.
Closing Thoughts
This conversation with Dr. Yele Aluko reaffirmed something many of us already sense: Africa’s health transformation is possible—but only with intentional strategy, stable governance, and investment in people.
We need:
- Governments committed to long-term plans
- A private sector empowered to innovate
- A diaspora welcomed back meaningfully
- A medical workforce trained not just to heal but to lead
- Advocacy that is strategic, data-driven, and focused on economic value
- Policies that put primary healthcare at the center
Africa’s future health systems will be built by Africans—those at home and those abroad—working together to drive sustainable change.
This is the kind of conversation that inspires the heart of Coffee with Ada: African voices shaping African futures.
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