SAN FRANCISCO – Rwanda has achieved some of the most dramatic gains in health and poverty-reduction in the world. This small, landlocked African country (the size of Massachusetts, but with twice the population) has developed a primary health-care system with near-universal access to clinical care and insurance. Rwanda has reduced both economic and health-care inequality, and demonstrates how “health equity” helps to build strong societies.
The secret to Rwanda’s success is that its leaders are building “modern institutions on traditional values.” They built a system of community justice, called Gacaca, which integrated their need for nationwide reconciliation with an ancient tradition of clemency. They breathed life back into a civic tradition of Umuganda, where one day a month, citizens, including the president, gather together to weed their fields, clean their streets, and build homes for the poorest among them.
In 2015, the government of Rwanda and the Boston-based Partners In Health (PIH), with the help of the Bill & Melinda Gates Foundation and the Cummings Foundation, established the private, not-for-profit University of Global Health Equity (UGHE). The university is founded on the principle that every member of a community deserves the same care and opportunity, and focuses on the delivery of quality health care to those who need it most. Agnes Binagwaho, a co-founder of UGHE who is a former minister of health and an adjunct professor at Harvard Medical School, once said to me, “Why would I want to raise my children in a nation where all children don’t get the same medical care as they do?”
Rwanda’s government has already pledged $43 million to UGHE in land and infrastructure support. Its leaders have launched a two-year, part-time Master of Science in Global Health Delivery to teach how to create national health care in developing countries. Lecturers from Rwanda’s Ministry of Health, Harvard Medical School, Yale University, and Tufts University taught Rwandan students everything from epidemiology to budget management.
Last summer, UGHE began construction on a 250-acre campus in Butaro. This year, 250 professionals from as far away as Mexico and Australia will compete for 25 spots on that campus. Undergraduate and graduate degrees in nursing and oral health, and non-clinical programs in research and health management, are next. In 2018, UGHE’s campus will also be home to a school of medicine. It will provide space for generations of health professionals to learn how to heal patients, comprehend the sociology of disease, and build the health systems that make a strong society.
UGHE’s founders believe that, by the time the university celebrates its ten-year anniversary, 480 students will have graduated; another 870 will be earning their degrees; and over 2,500 professionals will have attended executive education courses. They expect that over 1,000 of the students passing through the UGHE’s doors in that first decade will arrive from the rest of Africa, Asia, Europe, and the Americas.
Rwandans will invite these international students to visit their communities to observe their traditions and learn how to care for their people. The young men and women will attend Rwandans’ weddings and funerals, learn to prepare and enjoy their foods, and acquire some of their language, the portal through which to view their sturdy values. Rwandans will teach their international guests that in Africa, family is an all-encompassing concept, and that, in Rwanda, an entire generation treats the next as its own children. The international network of UGHE alumni, unified by their commitment to realize health equity for their own communities, will become a global force for change.
UGHE will also strengthen Rwandan society. Though regarded by many as one of the safest and least corrupt societies in the world, Rwanda faces a great shortage of doctors and nurses. There are 684 physicians in Rwanda, a total that is far below the 1,182 physicians proposed by the Ministry of Health, and only 27% of the World Health Organization’s recommended minimum of 2,576 physicians.
UGHE has already generated jobs, by hiring local laborers, and has increased access to the region, by creating new roads. It could boost Rwanda’s GDP by 0.5% per year, and every dollar invested in UGHE could generate $2 worth of return in economic development, according to McKinsey & Company.
Some social scientists assert that poverty is not just a matter of poor nutrition, lack of medical care, and inadequate shelter; it also means exclusion from global networks of trade, science and commerce. This isolation is pernicious, because it destroys people’s hope and aspirations for a better life.
UGHE will be Rwanda’s newest institution, a public-private collaboration based on traditional values: community, trust, hard work, and optimism about the future. It will integrate each citizen of Rwanda into global networks of learning.
The Rwandans will accomplish this, as they do many things, because they believe that the only investment that can bring infinite returns is in their children, and because graduates of the University of Global Health Equity will be their sons and daughters, too.