Like many others in global health, I am astounded to hear about the successes that Rwanda has made in providing health care to its citizens in a time frame just shy of two decades since the small African nation was in the midst of a genocide that killed nearly a million of its citizens.
According to a January article published by Partners in Health co-founder Paul Farmer and his colleagues, Rwanda is currently “the only country in sub-Saharan Africa on track to meet most of the millennium development goals by 2015.” Much of this progress can be attributed to a focus on developing health care systems that focus on how to best deliver services to patients throughout the country, ensuring that all citizens have access to medical care. Chief among the accomplishments of such a system is the reduction in the prevalence of HIV/AIDS, which, according to the BMJ article has been three percent for the past seven years.
Rwanda also boasts some of the highest rates of vaccination for HPV, at 93 percent after the program’s first year of implementation, according to statistics from the Rwandan Ministry of Health. The United States, by comparison, has vaccinated less than 25 percent of its population against the virus, according to the BMJ article. Similarly, Rwanda’s success rate at treating multi-drug resistant tuberculosis, which classifies patients as being cured or have completed the full course of treatment is 88 percent, compared with 68 percent worldwide. Additionally, with the increase in access to healthcare services, 98 percent of Rwandans are covered by health insurance and the country’s mortality rate has dropped 78.4 percent from HIV over the past 10 years and 77.1 percent from tuberculosis.
Despite these gains, “Rwanda faces one of the greatest shortages of human resources for health in the world,” according to the BMJ article. In the time I spent with Rwanda’s Minister of Health, Dr. Agnes Binagwaho, she constantly stressed the need for education and training of Rwandan physicians, nurses and community health workers. Accordingly, the Honorable Minister, as her colleagues call her, has been part of a crucial effort by the Rwandan Ministry of Health to bring education to the country. The Honorable Minister has encouraged all members of her team to pursue masters and doctoral studies, and the Ministry of Health itself has partnered with several American schools, such as Harvard University and Dartmouth College, to create programs that will create learning opportunities for students between Rwandan and American universities.
Due to these initiatives and their subsequent successes, “substantial credit for Rwanda’s progress is due to the central government, including the Ministry of Health,” according to the January BMJ article. Dr. Binagwaho assures me that many new undertakings are on the way, and that she and her team in Rwanda are constantly learning how they can improve Rwanda’s health care system even more, so that no citizen will be left without access to any health services they may need.
