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AFREHealth focuses on decolonization & disparities

September / October 2022 | Volume 21 Number 5

Francis Omaswa, holding a microphone and wearing a dark suit, red tie, and mask, speaks at the 2022 AFREHealth Symposium. Photo courtesy of AFREHealthFogarty grantee, Francis Omaswa, gave a talk entitled “Human Resources challenges and service delivery. How do we reorganize post pandemic?” at the 5th Annual AFREHealth Symposium.

The fifth annual AFREHealth Symposium, held in Harare, Zimbabwe, this past August, offered in-person attendance and presentations for the first time in two years. While the official theme was “COVID-19 pandemic and post-pandemic issues for health education, research, and service delivery," the topic of decolonization ran through many of the sessions, especially in view of the ongoing disparities brought into sharper focus by the pandemic.

Established through a Fogarty grant in 2018, the African Forum for Research and Education in Health (AFREHealth) is an interdisciplinary health professional society that seeks to work with Ministries of Health, training institutions, and other stakeholders to improve the quality of health care in Africa through research, education, and capacity building.

Three Fogarty grantees gave plenary talks, Dr. Francis Omaswa, chancellor of Soroti University, Dr. Damalie Nakanjako, professor of medicine at Makerere University, and Dr. Catherine Kyobutungi, executive director of the African Population and Health Research Center. Dr. Ndola Prata of the University of California Global Health Institute, a consortium in Fogarty's Global Fellows and Scholars/LAUNCH program, also presented.

“COVID should become an opportunity” to prioritize the health care workforce in Africa, said Omaswa during his talk on human resource challenges post pandemic. “Health care HR on the continent has been too focused on administrative tasks and managers don't understand the skills of their staff," he added. Omaswa stressed that the COVID-19 pandemic exacerbated health worker shortages in all countries, but especially in low- and middle-income ones as higher-income countries could recruit workers from abroad to deal with the influx of patients. He referenced the ;WHO Global Code of Practice on the International Recruitment of Health Personnel , which discourages “active recruitment of health personnel from developing countries facing critical shortages of health workers." But the pandemic brought more migration from African countries.

“If Africa doesn't employ our own healthcare workers they will be 'taken' by the Global North," Omaswa warned. His recommendations included African nations investing in their health workforce; development and support of national health resource plans; coordination between government, academia, and the private sector; and standardizing competencies for health care workers to bring about clinical excellence.

In her talk, Kyobutungi focused on reframing global health from a paradigm that sees part of the world (usually the Global South) as having problems and the other part (the Global North) as having solutions to one in which both problems and solutions are defined collaboratively. This was echoed by Ndola Prata's talk who championed transitioning from “capacity-building" to “capacity-bridging"–acknowledging the capacity that exists within Africa and pooling it with capacity from outside the continent to improve public health.

Roger Glass, Wearing a dark blue suite and light blue shirt, stands at a podium speaking into a microphone at the 2022 AFREHealth Symposium.Photo courtesy of AFREHealthFogarty Director, Roger Glass, recognized the loss of James Hakim and David Olaleye during his speech. “My hope is that their work will inspire a new generation to dedicate themselves to improving health care and advancing biomedical research on the continent.”

Since most global health institutions are located in high-income countries, Kyobutungi suggested that reforming research practices can be an entry point into decolonization. By asking clarifying questions—who is doing the research, who will it benefit, and who gets attribution when results are published—researchers and funders can focus more on bringing about change in health outcomes and less on publishing papers in the pursuit of more funding. She also suggested that new frameworks for knowledge systems outside of legacy colonial academic structures be developed, ones that consider the knowledge and capabilities ;existing within Africa.

The conference also saw the establishment of four AFREHealth regional chapters and the election of a new executive committee, which includes former Fogarty grantee Alfred Mteta as Vice President.

This was also the first in-person conference since the loss of two AFREHealth leaders—Dr. James Hakim and Dr. David Olaleye. Both died from COVID-19 in 2021. Hakim was a member of the AFREHealth governing council and Olaleye oversaw AFREHealth's symposium in 2019. Both were involved in the PEPFAR- and Fogarty-funded Medical Education Partnership Initiative (MEPI) program, one of the progenitors of AFREHealth. Fogarty Director Roger I. Glass paid tribute to both men in his remarks during the opening plenary session: “James and David were both acclaimed researchers and professors, and profoundly important leaders in advancing medical research and education in Africa. They were also important to AFREHealth from its inception. My hope is that their work will inspire a new generation to dedicate themselves to improving health care and advancing biomedical research on the continent.”

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Updated September 27, 2022

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