The sustainability of healthcare systems across Africa is being forced to the forefront of international development discussions as significant reductions in UK aid budgets compel a fundamental rethink of how care is sustained and who sustains it.
The clinicians bridging two worlds
At the heart of this evolving model are diaspora clinicians, whose daily work embodies a dual reality. Figures like Dr Jacqueline Bamfo, a consultant obstetrician and foetal medicine specialist in the NHS, also serve as president of the Ghanaian Doctors and Dentists Association UK (GDDDA UK). This network exemplifies how health professionals maintain active roles in strengthening care both in the UK and in their countries of heritage, contributing time, skills, and resources through partnerships with local institutions.
This contribution is not abstract. During a recent visit to Ghana, Dr Bamfo witnessed the urgent need for improved maternal care, where access to timely scanning can be life-saving. From the UK, she has been working with colleagues at the University of Ghana Medical Centre through virtual teaching, with plans to deliver hands-on training later this year. This direct sharing of knowledge in both directions is part of a wider pattern of diaspora engagement, which included stepping up during the Covid-19 pandemic and delivering health outreach to diaspora communities in the UK itself.
Their role is magnified by the structure of the NHS, where international health workers are foundational. The service relies on skills and expertise developed across many countries, including those now facing increasing pressure on their own systems.
The impact of shrinking aid
This diaspora work has gained critical importance against a troubling backdrop of declining official development assistance. Recent UK government allocations confirm a sharp shift, with UK bilateral aid to Africa set to fall by 56 per cent. The effects of such reductions are already being felt in countries like Ghana, resulting in fewer outreach services, stretched training programmes, and growing pressure on local healthcare workers.
In this context, diaspora contributions act as a vital lifeline. These encompass both the financial remittances sent home to families and the coordinated work of clinician networks like the GDDDA UK. While these efforts cannot and should not replace government investment, they bring together funding, skills, and trusted networks to help sustain care as other forms of support diminish.
A call for recognised partnership
This activity is not peripheral; it is increasingly seen as a blueprint for modern health partnerships. It represents a shift from top-down, aid-dependent models to approaches that are led and shaped locally, with diaspora groups as key facilitators.
The upcoming Global Partnerships Conference, to be hosted by the UK in May, will bring together governments and civil society to consider the future of development cooperation. Dr Bamfo, who is also a member of the Action for Global Health network, argues that for such discussions to be meaningful, they must be led by those with lived experience of the systems in question. This includes ensuring diaspora voices have a real say in how decisions are made and resources are directed.
Organisations like the GDDDA UK are already building relationships, caring for patients, and strengthening services in ways that are often overlooked. They represent not a temporary fix but a foundation for a more sustainable system. The central question posed is whether this reality will be formally recognised, and whether diaspora groups will be treated as full partners in building a more just future for global health.
