The United Nations since the beginning of the new millennium has been championing universal access to health, education, poverty eradication and inclusive growth.

Ironically, with respect to inclusive growth, at a continental level, although not consistent, growth in only 18 of the 48 countries which inter alia include Djibouti, Côte d’Ivoire, Togo, Ghana, Madagascar, Liberia, and Niger registered inclusive growth with data showing faster average consumption for the poor and lower inequality between different population segments (African Development Bank, 2020).

As noted by African Development Bank (2020), in most African countries, despite faster growth for most countries since 2000, increases in the living standards of poor populations in most countries have not significantly reduced the consumption gap between rich and poor.  In 18 African countries, the average rate of pro-poor growth reached 3.6% per annum against 1.5% for the average population, inducing reductions in both poverty (0.7% a year) and inequality (0.5% a year) (African Development Bank, 2020).

With respect to poverty, nearly two thirds (65.8%) of Africa’s economically vulnerable population live in Nigeria, Ethiopia, Egypt, United Republic of Tanzania, Kenya, Sudan, Uganda, Democratic Republic of the Congo, South Africa and Niger (Mugano, 2021 and UNECA, 2020). UNECA (2020) estimates shows that 567 million people are within the range of the mean consumption level of $1.90–$5.20 per day.

Amongst the 10 countries, Nigeria, Egypt and Ethiopia have the highest number of people in the vulnerability category,  which constitute 39.5%, 66.8% and 60.7% of the respective countries’ total population.

In Africa, from a regional perspective, 43.2% of the population of East Africa lives in extreme poverty whilst the population in extreme poverty in other regions is 37.8%, 34.2%, 33.8% and 3.9% for West Africa, Southern Africa, Central Africa and North Africa, respectively (UNECA, 2021).

The situation has been worsened by the advent of COVID-19 pandemic which has seen countries instituting lockdowns with a view to contain the pandemic. Because most African economies are largely informal, the persistent lockdowns, prevalence of the COVID 19 pandemic and increased probability of significant size and long duration GDP contraction which is likely push more than two thirds of African population into extreme poverty thereby dampening the attainment of the SDGs (UNECA, 2020 and Mugano, 2021).

To make matters worse, the COVID19 pandemic has resulted in massive disruption of health systems which again derails the attainment of the SDGs. Naturally, evidence has shown that when confronted with pandemics of this magnitude, governments panic and scramble to respond to the immediate consequence of the pandemic and divert resources from other health efforts that nonetheless remain critical (World Bank, 2020). In West Africa, between 2014-15, governments responded to the Ebola pandemic in a panic and uncoordinated manner which saw closure of health facilities, health worker deaths, and excess demand placed on the health system led to further loss of lives (World Bank, 2020). In Ebola affected areas, as a result of this action, in particular, malaria admissions for children under the age of 5 fell by 40%, maternal and delivery care dropped by more than 80% and vaccination coverage was also considerably reduced (Elston et al., 2017).

Because of pre-existing vulnerabilities, unlike Ebola, the impact COVID-19 on human capital is likely to more magnified in a number of ways. Albeit the fact that most national health systems in the poorest countries bear a disproportionately high share of the burden of disease and injury, 36% of the public health is financed out-of-pocket expenditure due to low health-care spending by African governments which averaged around 5- 6% of GDP in the period 2000 -2015 (UNECA, 2020).

Undoubtedly, based on this foregoing, COVID19 pandemic is exerting massive pressure on the already failing health systems in Africa. Children and pregnant mothers, in particular, are anticipated to severely suffer from weakened service delivery capacities and curtailed access to services (World Bank, 2020). The situation is worsened by the fact that lockdown restrictions result in loss of income considering the fact about 80% of the labour force in Africa works in the informal sector which doesn’t offer safety nets and social securing thereby impeding patients suffering from other illnesses from going for routine checkups (World Bank, 2020).

Resultantly, because of  the interruption of services, Africa is  likely to witness numerous deaths, many of them avoidable which will place  further strain on human capital. The severity of this  is that,  in high-burden countries in particular, it is estimated that in the next five years deaths due to HIV, tuberculosis and malaria will increase by 10, 20 and 36 percent, respectively thereby reducing African chances in achieving the SDGs (Hogan et al., 2020).

Based on the foregoing observations, the United Nations is calling for an action across sectors and adoption of a whole-of-society approach in addressing developmental challenges in Africa.

It is against this background that Africa Economic Development Strategies, Durban University of Technology and CareNet Africa have innovatively established a Livelihoods and Export Aided Programme (LEAP) and Community Based Health Financing (CBHF) with a view to complement initiatives  for  the attainment of the SDGs with specific focus on inclusive growth, poverty eradication and access to health in selected African countries with a specific focus on Nigeria, Ethiopia, Egypt, United Republic of Tanzania, Kenya, Sudan, Uganda, Democratic Republic of the Congo, South Africa, Niger and Zimbabwe.

In this regard, DUT, AEDS and CareNet Africa’s LEAP and CBHF, in line with World Bank (2020) policy advice, is paying significant attention  to measures aimed at  strengthening primary health care with specific focus on infectious disease control programs for HIV, tuberculosis, and malaria; reproductive and child health and nutrition and community-based health promotion and disease prevention.

The consortium is using a blend of market system development and donor support, in supporting smallholder farmers in rural areas to grow horticultural products for export and guarantee access to basics such as health, education and decent shelter in various communities in Africa. In addition, the LEAP and CBHF aims to support various livelihoods projects under Small and Medium Enterprises, which inter alia include carpentry, arts and crafts, poultry and animal husbandry through market linkage programmes.

This project will address the concept of livelihood enhancement which reflects on the ability of households to sustain their daily needs and draws on the combination of a large array of resources which are natural, physical, human, social and financial in  nature. Most importantly, in order to complement resilience driven from diaspora remittances and as a total departure from the traditional donor programmes which cultivate a dependency culture, this programme, being market led or driven from a market system developments, that is, making markets work for the poor, will be run on a commercial basis so as to guarantee positive return on investments and sustainability of programme.

Using a market system development, on the back of a strong off-taker agreements, with the support of letters of guarantees from Zimnat General Insurance, the programme will mobilise resources from financial markets aimed at implementing a large array of interventions such as climate smart agriculture, climate information services to climate-proof vulnerable communities, asset-based community development, natural resources value additions and marketing, community-level participatory disaster programming, participatory needs and asset-based assessment, women and youth empowerment, and  basic health for the rural communities, among others.

In cases where donor funds are secured, funds will be availed as revolving funds with a view to guarantee sustainability and guarantee a going concern.

The Community-based healthcare financing facility proposed in this project, which is already being piloted in Norton, will be supported by receipts from agricultural and other economic activities. It is proposed that low-cost but wholesome healthcare plans supported by private healthcare providers will be crafted. The healthcare plan is intended to target farm communities, communities where internally displaced persons reside, low-income urban suburbs and hard to reach rural communities. This is expected to complement efforts by governments and other development organisations to provide high quality healthcare to these communities. This model is expected to reduce maternity fatalities and promote good health for women, children, girls and communities at large. The target of the programme will be to empower communities to take care of their health and each other through the captive collective community care model.