Inauguration of the Heart and Cancer Centre at AKUH, Nairobi

Mawlana Hazar Imam addresses those gathered for the inauguration of the Aga Khan University Hospital Heart and Cancer Centre in Nairobi. Aziz Islamshah


Your Excellency President Mwai Kibaki, President and Commander-in-Chief of the Defence Forces of the Republic of Kenya
Deputy Prime Minister and Minister for Finance, Honorable Uhuru Kenyatta
Minister for Medical Services, Honorable Professor Peter Anyang’ Nyong’o
Chief Executive Officer of Agence Francaise de Developpement, Mr. Zerah
Honorable Ministers, Your Excellencies
Members of the Corps Diplomatic
Chairman and Members of the Board of Trustees of the Aga Khan University
Distinguished Guests, Ladies and Gentlemen

I am enormously pleased to celebrate with all of you this benchmark moment in the evolution of the Aga Khan Development Network and the Aga Khan University.

I think of this as a “benchmark” because it signifies another step on a long pathway of medical advancement.

We can trace that pathway back a thousand years - to the great hospitals that were founded in Cairo by my ancestors, the Fatimid Imam-Caliphs of Egypt. More recently, we remember the founding - some 53 years ago - of the Aga Khan Hospital here in Nairobi. That event was part of the Platinum Jubilee of my late grandfather, Sir Sultan Muhammad Shah.

From its very first day of operations in 1958, this has been a distinctive hospital. From the start, we were determined to go beyond the traditional concept that such a hospital should serve a separate, individual community - and instead to build an institution for the whole of the Kenyan nation.

In that same spirit, at the time of my own Golden Jubilee four years ago, we extended, within this hospital, the role of the Aga Khan University’s Faculty of Health Sciences.

Today’s inauguration of the Heart and Cancer Centre follows in this long tradition - and points the way to broader, future horizons. We are planning for the day when this Faculty will include undergraduate education in medicine, nursing and allied health professions, as well as post-graduate nursing and medical studies - and a 600-bed hospital. We plan to award bachelors and masters degrees in medicine, surgery and nursing, and, in due course, to offer Ph. D. degrees as well.

Meanwhile, beyond the medical field, the Aga Khan University is planning bold steps in other directions, including a new campus in Arusha to house a Faculty of Arts and Sciences, and the expansion of our Institute for Educational Development in Dar-es Salaam. Later this week, we will hold the Foundation Ceremony here in Nairobi for a new Graduate School of Media and Communications. And we envision other new Graduate Schools as well - in fields such as Management, Leisure and Tourism, Law, Government and Public Policy, and Economic Growth.

It is a substantial, demanding agenda.

And the agenda for our health-related programmes is equally ambitious.

We see our medical programmes here in Nairobi as nodes in a broad, regional health care network, reaching from Arusha to Kampala, from Nyeri to Mtwara and from Kigali to Malindi. Our goal is an integrated, best practice regional health system – providing a continuum of services from preventive and primary care to tertiary hospital-based care.

This will be a bracing challenge - involving not only the University and the Hospital - but also a wide array of cooperating partners, governments, schools and medical institutions. We have already established active partnerships, for example, with the University of Alberta and the University of California at San Francisco. And let me emphasize our deep gratitude to the Government of France, through the Agence Francaise de Developpement. Indeed, let me be frank in saying that without this international support, from France and others, including many individual donors, our solidly founded initiatives for the future would be but slender dreams.

In describing our hopes for this regional system, let me emphasize the challenge of creative joint planning - in which both the public and private sectors work together in preparing long-term strategies. The initiatives I share with you today are integral to Kenya’s Vision for 2030.

Such long term planning is not an easy thing. Overburdened national health care institutions, understandably, are often hypnotized by immediate crisis situations. But we cannot allow the system as a whole to be obsessed only with the short-term. Yes, we need to meet immediate costs, but we also need to generate surplus resources - in order to keep pace both with growing demand and new technologies. We need joint public/private planning for the medical needs of tomorrow - for expanded facilities and improved equipment - for quality education and innovative research.

We are finally arriving at a point where oncology and cardiology in East Africa are no longer served with outdated equipment and proficiencies. But to keep pace, we must plan ahead.

As part of this planning, we also need a fundamental reappraisal of the economics of health care. Throughout the world, the cost of good health care is prohibitively high - especially for poorer populations. This is why the Aga Khan University Hospital, through its Patient Welfare Programme, provides an average subsidy of 50% to those patients who are unable to afford their care. But in the longer run, we will also need an imaginative combination of cost redistributions, endowment funding, credit and insurance offerings and other innovative financial products. I hope that creative financial institutions will join the medical sector in addressing this difficult challenge.

For all of us, the medical frontier represents a compelling priority. A recent study by the International Finance Corporation - working with McKinsey & Company - describes what they call a “global travesty”- the fact that Sub-Saharan Africa - with 11 percent of the world’s population - bears 24 percent of the global burden of disease. And yet Sub-Saharan Africa presently accounts for only one percent of global health expenditures. A “global travesty” indeed!

In addressing this situation, the IFC Report emphasizes the role of private, non-governmental institutions, including not only profit-making businesses, but also not-for-profit institutions - and the vast potential of what we call “civil society.”

Such private resources already provide more than half of all health care in Sub-Saharan Africa. Their work cannot be replaced - and it does need to be enhanced.

Finally, let me mention two investment areas that are most sadly short-changed in the developing world. The first is research, and the second is education.

The intimate link between quality research and quality health care is well established. Productive research needs to be rooted in patient-based experience, even as sound practice must be informed by new knowledge. The two dimensions are mutually dependent.

This combination of informed practice and creative research will also provide an ideal context for superior medical education - and thus for building an expanded corps of accomplished medical professionals here in East Africa.

Let us put behind us the day when young Africans thought they had to go to other parts of the world for quality medical education - and then, too often, they stayed abroad. Similarly, let the day also pass when African patients think they must go to other parts of the world to find quality medical care.

As we pursue these goals, there is no time to lose. That is one reason we are focusing initially on Cardiac Disease and Cancer - chronic, non-communicable diseases that are on a rapid increase in Africa, stretching health systems and budgets even further beyond their existing limits. The World Health Organization warns us that heart disease and cancer will reach epidemic proportions in the next decade or two - unless we take decisive counter-measures.

In Kenya alone, some 80,000 new cancer cases are diagnosed each year, with an unusually high number among young people.

The mission of the Heart and Cancer Centre is to grapple with this pending African epidemic. It has been long established, for example, that there are forms of heart disease and cancer that may be Africa-specific. The new Centre will be ideally positioned to address such issues.

The Centre will offer specialized fellowship training in cardiology and oncology - training not now available in East Africa. It will recruit outstanding faculty from around the world - including returning East Africans who have been studying and practicing abroad.

Our goal is to assemble multidisciplinary teams - in fields such as radiation and chemotherapy, open-heart surgery, angioplasty, and others. And all of these resources will be accessible to those who cannot normally afford them.

The Heart and Cancer Centre represents a critical investment in the people of this region. We hope that future generations will look back on this moment - much as we look back to earlier steps along the way - and see that the work we undertake today does indeed mark an important benchmark on the path to a happier and healthier future.

My thanks to all of you for sharing in this memorable moment.

Thank you.