The new Director-General of East, Central and Southern African Health Community (ECSA-HC), Dr Ntuli Kapologwe, shares a bold ten-year vision to transform health in the region. He pledges to elevate the organisation’s visibility, expand membership and pioneer regional Centres of Excellence. He emphasises decentralised financing, digital innovation and cross-border health diplomacy and outlines strategies for pandemic preparedness, human resource development and sustainable partnerships, asserting that Universal Health Coverage (UHC) is within reach. He calls for urgent reforms, strategic collaboration and local leadership to bridge gaps and build resilient health systems in this exclusive interview with The Arusha News’ Journalist/Researcher SUKHDEV CHHATBAR. Read on…
Q: Question: Could you briefly describe the mission of the East, Central and Southern Africa Health Community (ECSA-HC) and what makes it unique compared to other regional health organisations?
Answer: The mission of ECSA-HC is to foster collaboration and strengthen health systems in East, Central and Southern Africa. We do this through the implementation of policies and programmes that improve the lives of people in member states. What sets us apart is the 9 country-driven model that builds on the unique strengths of our member states and accelerates progress through locally tailored, evidence-based and cross-border cooperation.
ECSA-HC is unique because of its strong focus on leadership development, policy harmonisation, and regional health diplomacy. We operate through regional technical working groups and Centres of Excellence that support capacity building and knowledge exchange in critical areas like nutrition, health systems, pharmaceuticals and human resources for health.
Q: As the newly appointed Director-General of ECSA-HC, what is your bold vision for the organisation in 2024–2034?
A: My vision is to build a stronger, more competitive, resilient and impactful ECSA-HC: a community where everyone has access to affordable, high-quality healthcare and where health systems are equipped to withstand both current and future challenges.
To realise this, I will prioritise expanding membership, increasing visibility and elevating ECSA-HC as a leader in health diplomacy and regional cooperation. I will also push for stronger collaboration with international partners and drive innovation in digital health financing, data-driven planning and resilient systems. My goal is to position ECSA-HC as the region’s think-tank for Universal Health Coverage (UHC), advanced disease preparedness and sustainable partnerships.
Q: How do you intend to leverage your experience with Tanzania’s Direct Health Facility Financing (DHFF) and preventive services to advance Universal Health Coverage and health system strengthening in ECSA-HC member states?
A: My experience with the Direct Health Facility Financing (DHFF) initiative in Tanzania taught me the transformative power of decentralising funds and decision-making to the local level – directly from the Treasury to over 8,000 primary healthcare facilities. As Director of Health, Social Welfare and Nutrition Services at the President’s Office – Regional Administration and Local Government (PO-RALG), I witnessed first-hand how DHFF reduced delays in fund disbursement, enhanced transparency and accountability and empowered local health facilities to respond more effectively to community needs.
This model made Tanzania a regional exemplar in implementing Decentralisation by Devolution (D-by-D), especially in integrating financial decentralisation into the health sector. The results were profound: Significant improvements in service quality, better health outcomes, increased efficiency and a notable rise in UHC index.
I intend to draw on these lessons to support ECSA-HC member states in strengthening primary healthcare, adopting results-based financing models and ensuring that funds flow efficiently to frontline service providers. These reforms are critical to accelerating progress towards UHC, with the region’s UHC index currently at just 46 – well below the global average of 68 – we must act decisively and urgently to close the gap.
Q: ECSA-HC is stressing digital health innovation. What specific technologies or platforms do you believe will be most impactful for improving health outcomes across the region?
A: Digital innovation is essential for leapfrogging health systems in our region. I will champion the integration of telemedicine, cloud-based health applications, digital disease surveillance systems and interoperable electronic health records. These tools will improve healthcare access, data-driven decision-making and health outcomes – especially in rural and under-served regions.
We will work closely with tech innovators and private sector partners to roll out sustainable, scalable digital solutions. At the same time, we will place equal focus on data governance and cybersecurity to ensure safe and ethical use of digital health platforms.
Q: Drawing from your leadership during disease outbreaks and Tanzania’s Marburg and COVID-19 responses, how will ECSA-HC enhance regional preparedness and response to future pandemics?
A: I led Tanzania’s Marburg and COVID-19 responses and understand the need for strong and coordinated regional collaboration. I intend to replicate this success by fast-tracking ECSA-HC as the region’s leading centre of excellence for Emergency Preparedness and Response. This centre will offer technical support, capacity building and rapid response capabilities for member states.
We will also improve early warning systems, strengthen cross-border collaboration and actively participate in global emergency response networks. Given our region faces over 100 public health emergencies annually, this area has to be a top priority and is a necessary investment in our collective resilience.
Q: One of your priorities has been workforce development. How do you plan to address shortages in human resources for health across the region, especially in rural and underprivileged areas?
A: Health workforce shortages are critical to address. I plan to strengthen ECSA-HC’s coordination with all affiliated health science colleges, ensuring they are aligned to the needs of member states. We will also establish a centre of Excellence for Health Sciences Education, promote task-shifting policies, and improve cross-border licensing to improve workforce mobility.
We will further scale up regional training initiatives, including a regional workforce observatory, and align them with emerging needs in sexual and reproductive health (SRHR), mental health, digital health and laboratory sciences. With dedicated funding and high ownership, we ensure long-term sustainability.
“My vision is to build a stronger, more competitive, resilient and impactful ECSA-HC: a community where everyone has access to affordable, high-quality healthcare and where health systems are equipped to withstand both current and future challenges.”
