Caribbean Leaders Endorse New South-South Partnership – Next Stop Africa
Inside View 13/08/2024 •
Sharing experiences across continents: A group of community health workers in a remote Guyana community describe their training to a visiting HeDPAC delegation.

The recent CARICOM summit of Caribbean leaders has endorsed a new Afro-Caribbean Health and Development  (HeDPAC) initiative aimed at stimulating South-South collaboration on resilient health systems, health worker capacity building, and local medicines and vaccines manufacture. 

The formal CARICOM Communiqué at the close of the Summit in Grenada invited its 15 member states and five associated states to join the voluntary partnership: 

“The HeDPAC initiative has three main priorities: to mitigate the difficulties faced by the health workforce of the Africa and Caribbean regions, including education, employment, deployment, retention, and performance; to build resilient health systems capable of withstanding emerging threats; and to promote the local manufacturing of medical products, including vaccines,” stated the Communiqué, noting that the overarching aim is “to manage the gaps identified during the COVID-19 pandemic. 

CARICOM leaders at the close of the recent summit, which endorsed a new initiative on Afro-Caribbean health and development cooperation.

“The Partnership could also be leveraged to improve knowledge exchanges between Africa and the Caribbean, to enhance regulatory capacity for medicines, medical supplies and equipment, and to facilitate the free movement of CARICOM nationals within the Community through advancing the digitalization of health information systems,” the Communiqué added. 

“All Member States are invited to partner with HeDPAC to leverage sustainable health development and capacity building through political, technical, and scientific collaboration between the Regions.” 

The communiqué was issued in early August, shortly after the conclusion of the summit in Grenada, which was postponed to the end July, due to Hurricane Beryl.   

It also referred to “health-related issues of the climate crisis” as another potential area of collaboration – in the wake of the devastating effects of Hurricane Beryl on the region’s small island states.  

Next stop, Africa

Following the CARICOM summit, HeDPAC’s advocates are now making a swing through Africa to build support among member states on the continent for stepped-up collaboration.  

In Addis Ababa last week, the African Union’s Technical Committee on Health, Nutrition, Population, and Drug Control (STC-HNPDC-5) heard a presentation on the initiative. 

Member States were invited to engage, beginning with stepped up participation in cross-regional events such as the upcoming Africa CARICOM day, observed on 7 September.

The initiative also may be a topic of discussion on the sidelines of the upcoming WHO African Committee meeting in Brazzaville, set for 26-30 August, sources say.

The media highlight of the AFRO Committee meeting is sure to be the election of a new Regional Director to replace the outgoing Matshidiso Moeti, the AFRO region’s first female RD, elected in 2015. [In this round, all four candidates are men].  

But some two-dozen WHO-led global and regional action plans are also on the agenda, covering critical topics ranging from local manufacturing to vector borne and infectious diseases, as well as health emergencies. 

A declaration Tuesday by Africa CDC of a continental health emergency on a new, and rapidly-expanding strain of mpox, first identified in DR Congo, along with a possible WHO declaration of a global mpox health emergency, will undoubtedly be another focus for discussions. 

Promoting salaried and certified community health workers

A community health worker who has graduated from her training describes her role in managing vaccine cold storage at a Guyana health facility in Lethem, a primarily indigenous community on the border with Brazil.

Most experts agree that a cross cutting requirement to address all of these challenges involves more robust primary health care systems, built around more and better trained health workers.

And one of the first concrete aims of the HeDPAC initiative is precisely that, says Dr Haileysus Getahun, CEO. It aims to harness lessons learned in the Caribbean to foster stronger cadres of African community health workers (CHW), serving on PHC frontlines.   

Caribbean countries can offer some African countries examples of a way forward, in terms of the standardized training of community health workers and their integration into the health workforce as certified and salaried civil servants, he points out. 

In contrast, many African CHW’s may serve primarily as volunteers, or for small stipends.

“We want to promote certified and salaried health workers to be part of the system in Africa. Not only that, but with career development schemes,” Getahun said in an interview with Health Policy Watch.

Conversely, some African countries, like Rwanda, have useful experiences to share with Caribbean partners related to strengthening regulatory and clinical trial capacity, Getahun noted.   

Building a community health care workforce 

A pharmacist assistant in Lethem, who first began her career as a community health worker, takes HeDPAC CEO Haileysus Getahun on a tour of products available in the clinic pharmacy.

On a recent visit to Guyana, Getahun said he had the opportunity to observe the country’s community health workers in action, in both remote indigenous communities such as Lethem, which sits aside the border with Brazil, as well as busy urban settings near the capital of Georgetown. 

“I found Guyana and the region very much developed and mature in terms of its  primary health care systems – and particularly community health care integration into primary health care.” 

 Community health worker (CHW) training is carried out in a hybrid mix of online-and in-person sessions – with a national curriculum and accreditation system ensuring a standard level of competencies.  

“In addition to being trained and salaried, Guyanan CHWs are offered paths for career advancement;  nursing assistant and pharmaceutical training courses keep them motivated and retained,” Getahun noted.   

A Guyana Online Academy of Learning (GOAL), offers a portal for virtual training in healthcare provisions – supported by a government scholarship programme for those that apply and qualify. There is also a programme for high school students to test out various work options in the health care sector. 

As a next step in building the partnership, HeDPAC is working with African and Caribbean  health leaders to organize experience-sharing visits. 

‘Health leaders in both regions are eager to learn from each other, and we are organizing those platforms to do so starting from field and exchange visits,” he said.

Finance remains a challenge

Barbados Prime Minister Mia Mottley laying out her Bridgetown agenda at the UN Climate Conference in Sharm el-Sheikh (COP 27) in 2022.

Along with awareness and political will, a key challenge for many African states remains finance for new community healthworker and primary health care initiatives. 

Much of Guyana’s innovation in the health sector has been financed by government budgets flush with funds from newfound oil and gas reserves. Surging revenues from oil and gas helped catapult the tiny nation from the status of a middle income country to an upper income one in World Bank classifications last year.  

But some other Caribbean countries, as well as many more of their African counterparts, remain hobbled with debt, which impedes their ability to develop their health systems – an issue Barbados Prime Minister Mia Mottley has called out repeatedly, as part of her “Bridgetown” Initiative calling for creative forms of debt relief that would also free up funds for development in health and climate projects in low- and middle-income nations.    

Along with Guyana, Mottley has also been one of the leading champions of the HeDPAC initiative in the CARICOM community. 

Regulatory standardization 

International political leaders at the launch of BioNTech’s new facility in Kigali in 2023.

Incubated by WHO, HeDPAC  was launched as an independent non-profit in December 2023. It aims to leverage lessons learned from the COVID-19 pandemic to promote health development across the Global South, beginning with more African-Caribbean collaboration. It works directly with government leaders and heads of state – minimizing the bureaucracy that intergovernmental organizations often involve. 

And while Africa may have a lot to learn from the Caribbean, Getahun argues that the collaboration is not a one way street. 

In Africa, Rwanda has been a leading African country championing the cross-continental partnership – and it also has lessons to share across the ocean. Rwanda recently became the host to the COVID pharma giant BioNTech’s first modular mRNA manufacturing facility, thanks partly to its conducive regulatory environment.   

“On the regulatory side, Guyana is just now establishing their own food and drug administration, whereas Rwanda has almost reached a WHO Maturity Level 3 in terms of its regulatory system and standards,” he remarked.

“So Guyana may be able to take some of the regulatory experiences from Rwanda,” he observed. 

  • Linda Straker in Grenada also contributed to reporting on this story.

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Note: HeDPAC is also supporting expanded Health Policy Watch reporting on the healthcare workforce, resilient health systems and local manufacturing in Africa as well as the Caribbean.  

Image Credits: Sophie Mautle/HeDPAC , CARICOM/X, Sophie Mautle/HeDPAC, @DPA.

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