Primary Health Care and Health  Infrastructure Development: Lessons From China

By Salim Abila Asuman

Attention; in the relentless pursuit of progress, a nation teeters on the brink of stagnation when its healthcare infrastructure falters. As the sickly grip tightens, the nation’s capacity to evolve, innovate, and propel itself forward dwindles.

An ailing healthcare system is not merely a burden, it is an indication of systemic decline, casting a dark shadow over the promise of a brighter future.

In the pursuit of progress and economic advancement, nations often overlook a fundamental pilar of development: healthcare infrastructure. However, the consequences of neglecting this vital aspect of society are dire and far-reaching, threatening the prospects of a nation’s growth and prosperity.

As the heartbeat of a nation’s well-being, healthcare infrastructure serves as the backbone upon which the health and productivity of its citizens rely. And, failure to invest in this critical foundation can unleash a torrent of devastating effects, reverberating through every facet of society.

First and foremost, inadequate healthcare infrastructure leads to a stark reality of inaccessibility to essential medical services for a significant portion of the population.

I assure you, without proper facilities, resources, and personnel, individuals are left vulnerable to the ravages of preventable diseases and untreated conditions, and as a result it becomes a heavy toll on both human lives and economic vitality.

The economic burden of poor health outcomes is profound, draining off resources and stifling growth at every turn. Skyrocketing healthcare costs, coupled with the loss of productivity due to illness, place immense strain on household finances and national budgets alike. Scares resources that could fuel progress in education, infrastructure, and innovation are diverted to address health crises, perpetuating a cycle of stagnation and underdevelopment.

The neglect of healthcare infrastructure strikes at the heart of human capital development, the cornerstone of sustainable progress. A populace plagued by poor health is one deprived of its full potential, with reduced life expectancy, compromised cognitive abilities, and diminished educational attainment stifling the aspirations of generations to come.

On the global stage, the repercussions of neglecting healthcare infrastructure echo far beyond national borders. In an interconnected world where investment and talent flow freely, nations with robust healthcare systems emerge as beacons of stability and opportunity. On the contrary, those marred by neglect face dwindling prospects for foreign investment and skilled labor.

For a nation like Uganda, the consequences of a deficient healthcare system reverberate across every aspect of society, profoundly impacting its development trajectory.

Without adequate access to medical care, preventable illnesses become barriers to productivity, leading to increased absenteeism and diminished economic output.

A robust healthcare infrastructure is indispensable for nurturing human capital and enhancing productivity, accessible healthcare services ensure that individuals remain healthy and productive, minimising absenteeism due to preventable illnesses and enabling workforce participation. Healthy individuals, in turn, contribute to higher levels of productivity, driving economic growth and prosperity.

The warning bell tolls loudly for African nations that turn a blind eye to the imperative of healthcare infrastructure. To ignore this call is to gamble with the future of the nation, as we stand at the crossroads of progress let us heed to this warning.

In the archives of healthcare evolution, China’s journey stands out as a fascinating tale of transformation and triumph. And it offers lessons for Uganda and all African countries aspiring to leap into a brighter future.

The completion of iconic projects like the Shanghai Pudong New Area People’s Hospital within a mere two years, underscores the importance of prioritising infrastructure investment. The lesson to learn here is that by channeling resources into building hospitals and clinics, aiming to enhance accessibility and quality of healthcare services within a defined timeline Uganda can emulate this success.

Embracing healthcare technology by China, including telemedicine and electronic health records (EHRs), has revolutionised healthcare delivery, particularly in remote areas. To replicate this success, Uganda must leverage technology to bridge geographical gaps in healthcare access, and set a target for nationwide coverage at least within two years.

By China collaborating with private entities, such as Alibaba Group’s healthcare initiatives the potential of public-private partnerships has been highlighted in driving healthcare innovation and expansion. Uganda can harness the resources and expertise of private sectors partners to accelerate healthcare projects, aimed to launch joint initiatives within a defined timeframe.

Strengthening primary care infrastructure is a cornerstone of China’s Health policy, by investing in community health centers and promoting primary care services, aimed at providing a comprehensive and preventive healthcare closer to where people live has reduced the burden on tertiary care facilities and improves overall health outcomes.

China acknowledges regional disparities in healthcare infrastructure, highlighting the need for Uganda to implement targeted initiatives to improve rural and remote areas for equitable healthcare access. This is evidenced by China’s support to our health sector with China funded Naguru hospital also known as China-Uganda Frienship Hospital being a key example.

China’s construction of emergency hospitals, such as the Huoshenshan Hospital in Wuhan, in a matter of days demonstrated its ability to rapidly scale up healthcare infrastructure to respond to the crisis, providing critical care to COVID-19 patients while reducing strain on existing facilities. Uganda should learn from China’s example by prioritising proactive and coordinated actions while investing in strong healthcare infrastructure.

A reminder; in the tapestry of international relations, amidst the dynamic currents of global cooperation, one remarkable alliance that emerges is China’s unwavering commitment to Africa’s infrastructure advancement.

It is a symphony of solidarity, a testament to mutual respect, and a beacon of hope for progress.

China’s support in establishment and construction of the Africa Centre for Disease Control and Prevention is a reminder of a reliable partner when it comes to Africa’s efforts in building a strong health system. Today, the centre is playing a leading role in supporting public health initiatives of member states and strengthening capacity of their health institutions to deal with disease threats. The Addis Ababa Fistula Hospital and the China-Angola Friendship Hospital in Luanda are monuments of this unwavering dedication to African’s healthcare advancement, these are tangible testaments to a commitment to fostering progress and prosperity across the continent.

Another paramount reminder is that development hinges on the strength of its human capital. A thriving populace, kept afloat by robust healthcare and wellness initiatives, is the catalyst for transformation growth. China’s remarkable progress stands as a testament to this principle.

Let us embrace this powerful reminder of unity, recognising its potential to reshape landscapes, empower communities, and foster a brighter future for generations to come.

Salim Abila Asuman is a research fellow at the Sino-Uganda Research Centre.


Revolutionizing Cancer Diagnostics with Urine and Blood: China’s Story

By Dr. Ham Wasswa M.

The world of cancer diagnosis has witnessed a paradigm shift in the way cancer is detected and diagnosed. Traditional methods such as biopsy of tissue and costly imaging have dominated the medical world for a longtime.

However, the emergence of innovative techniques and the integration of cutting-edge technology have redefined the field. One such game changer is Targene Biotech Company in Huangpu district, Guangzhou, China which I and a team of the Development Watch Centre researchers visited during a seminar on Chinese Modernization and China-Africa Joint Development which was organized by China-Africa Institute (CAI). Targene Biotech, a pioneering and budding Chinese company is at the forefront of cancer diagnosis using urine and blood.

Cancer is a global health concern ravaging millions of lives every year especially in Africa. According to the World Health Organization (WHO), cancer is the second leading cause of death globally killing nearly 1 in 6 persons and approximately 70% of these deaths are from low- and middle-income countries.  The early detection therefore is very vital for successful treatment and outcome of the affected. The approach used by Targene is poised to transform the landscape of cancer diagnosis to make it more accessible, non-invasive and economical. Targene’s work holds a promise for the future where early cancer diagnosis is within reach for all. The incredible work at Targene Biotech is in tandem with WHO’s two components of early detection that is; early diagnosis and screening.

Targene Biotech Ltd., is the brainchild of Mr. Shao Jian Yong who is the current President and Chief Scientist of the company. He recognized the need for less invasive methods and cost-effective means of diagnosing cancer. He therefore set out with a team of researchers to explore the power of liquid biopsy especially urine and blood to detect cancer in its early stages. The concept of this biotech company is ingenious: cancer cells shed DNA fragments into bodily fluids carrying with them genetic information about the tumor. By analyzing these DNA fragments, scientists at Targene are able to identify specific cancer mutations and alterations associated with different cancer types including urinary bladder cancer, colorectal, cervical, liver, prostate and esophageal cancers. All that is needed is circa forty milliliters of urine sample to detect one of these cancers.

The advantages of targene’s approach includes but not limited to; First, non-invasive; traditionally, biopsies have been done and they are very painful. For example, the bone marrow biopsy. Targene’s method being entirely non-invasive, patient is free of pain requiring only a blood and or a urine sample. This without doubt, reduces patient discomfort and associated complications.

Secondly, early detection; targene’s tech is highly sensitive, capable of detecting cancer at its earliest stage when treatment can be most effective and survival rates higher. A 95% survival rate has been reported if detection is done early among the cancers mentioned.

Thirdly, by identifying specific genetic alterations, this allows for treatment to be tailored individually to their unique cancer profile; and the fifth is that the method being used by Targene is cost effective compared to the costly traditional imaging and invasive biopsy picking.

The clinical impact of Targene’s approach cannot be underestimated as the ability to diagnose cancer at an early stage is crucial since this often times leads to better treatment outcomes and for the most part, complete remission of the cancer. This minimally invasive approach makes it easily acceptable and accessible to a larger population. Early diagnosis is relevant in all settings and in its absence, patients are diagnosed late when curative options may not hold much water.

Targene’s technology has showed significant promise in detecting a wide range of cancers including breast cancer, cervical cancer, esophageal cancer, prostate cancer and liver cancer which are very common in our Motherland-Uganda. Cervical cancer is the leading cause of cancer in the African region accounting for 22% of all female cancers and 12% of all newly diagnosed cancers. This method is especially suitable for such cancers that are notorious and often asymptomatic in their early stages.

It goes without saying that Targene’s future is a bright one as well as other partners that will get on board to explore this game changer in the field of cancer diagnosis. Despite this, there are some hurdles that Targene has to jump to be able to achieve successful outcomes. As with any emerging technology, standardization and validation are crucial ensuring that the method is consistent and delivers accurate results. Technology must undergo rigorous regulatory approval processes in areas where it will be embraced and considered. Collaboration with health authorities comes in handy in this case. Affordability and accessibility for a wide range of patients remains a valid concern especially in Africa where economies are just developing. Achieving the highest level of sensitivity and specificity is essential to minimize false positives and false negatives. Amazingly, the chief researcher at Targene, Mr. Binjie Xu, reported that the sensitivity of this cancer diagnosis method is at 95% while the specificity at 89%. Despite these challenges, the future prospects are promising with potential for early diagnosis to become a standard of care in our oncological practice so as to have better outcomes. Since 2012, China set up policies on early cancer diagnosis and the goal was to reach about 60% early screening rate amongst its population. This was only slowed down by the COVID-19 pandemic. However, there is no turning back and Targene reports show that there is steady progress to achieve this target by 2035.

The clinical impact of Targene’s cutting edge technology is very vital for cancers like liver cancer, bladder cancer that are often diagnosed late and hence poorer outcomes. However, the field of cancer detection using non-invasive methods faces challenges as mentioned above. Nonetheless, Targene’s future is bright and will even be brighter if African nations partnered with her so as to have better clinical outcomes for its people. For Uganda, the journey could start with the Uganda Cancer Institute benchmarking at Targene Biotech in China so that together, we continue efforts of building a community of shared prosperity for future of mankind in the new era of cancer diagnostics.

Dr. Ham Wasswa M. is a medical doctor and a Research Fellow at the Development Watch Centre.




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