 Right here, Jean-Claude, and the woman down here, and then right here. We'll take these first three, and then see where we are. Well, congratulations for a great discussion. A very short question for you, Brian. Why as the CEO of United Way, you care about health in Africa? Because Robert does, I'll answer that. Yes, to the woman lady down here, and then the man in front, and then we'll... Thank you. I want first to join Mr. Siegel in commending the World Policy Conference for dedicating a special panel on healthcare in Africa and asking for attention for that. Because I consider that healthcare in Africa is the single most important challenge African states are facing. So there are a lot of problems. You spoke about it globally, infrastructure, training, and you know that there's not one single head of state, African head of state, which who believes it can be treated in Africa. They all go abroad because they know their hospitals are broken, and then they sort of a wasteland they don't care about. I mean, they are, of course, progress, and you spoke about some good examples. But I think of Central Africa, basically. And there's something I just don't understand. I understand lack of training, I understand lack of infrastructure, all the problems you listed. But I don't understand the lack of compassion. I mean, there is so much abuse against the patients there that people are sort of tortured, they are being ripped off. I mean, we wanted to open a website on the model of me too. Just tell about the abuse you are having there. How would you put that into a question? Yeah, that's a question, that how do you tackle that? It's not technology, it's not infrastructure. The lack of human compassion. That's it, where do you put it into? Good, and then final question here, and then we'll see where we are. Right here, please. Yeah, it's on infrastructure and how to make some of the white elephants less so. And Juliet knows this that years, decades ago, there was a policy in Ghana to build a hospital in each district. At that time, I don't know how many districts there and 110 districts, and hospitals were built. And in that particular case, it came along with equipment. But I don't think the energy to run these hospitals were touched through, because at that time, if in many, and most of these districts are rural districts, of course there are some in the urban center, if renewable energy, just solar panels, had been used to provide energy, most of the equipment would probably still be functioning by now. But they were put on the national grid, which Ghana's sort of reliable, but the power cuts still happen. And so you find that within a year or two, very sophisticated equipment put across these hospitals. So you're saying there needs to be an integration of the energy strategy with health care strategies. Especially as we were just talking about climate change and energy. That's very good. So who, how would you? I'm sorry? There's a question there. Okay, one more, and then we have four minutes left. So we're going to give each one of you an opportunity to react to the questions you've heard. Merci, Monsieur le Président. Je vais parler en français, donc mettez vos écouteurs. Merci. Je voudrais apporter ma contribution juste sur trois points. Le premier, c'est les hommes. Je m'en tirais si je dis qu'aujourd'hui, sur le continent africain, nous n'avons pas de médecins qualifiés, hautement qualifiés. Nous en avons. Mais nous n'en avons pas en quantité suffisante. Et l'accessibilité à ces médecins pose problème parce que le pouvoir d'achat de citoyens lambda est faible pour aller payer une consultation. C'est médecin que je connais, donc je connais. La compétence, et j'en connais beaucoup. Dans tous les domain de spécialité, ils ont un problème. Il y a mon ami Chambasqui a souligné un aspect du problème, mais il y a le problème de l'équipement pour faire le diagnostic. Madame Nardo, ça évoquait l'aptitude des étudiants africains à inventer. J'ai un compatriote d'origine du béné. Moi, je m'appelle Robert Dossou. Je suis du béné. Je suis un has-been ancien, c'est un de beaucoup de choses. Et j'ai un compatriote d'origine bénénoise qui a mis au point du matériel médical en Europe et qui est utilisé aujourd'hui dans les hôpitaux, en France et ailleurs. Mais ce matériel, on l'a pas en Afrique. Ensuite, lorsque le matériel est fabriqué, on ne tropicalise pas souvent. Et les vendeurs de matériel, de matériel médical, ils amènent trois jours après, c'est en panne, l'entretien n'y est pas. Mon propre médecin, plusieurs de mes médecins m'ont dit, va faire une radiographie de ceci. Je fais, j'amène, ils regardent, ils disent, c'est fou. Comme tu es tout en Europe, tu vois, je fais ça en Europe, je te fais la prescription. Donc j'ai profité d'un passage à Paris, j'ai fait la radiographie, je lui apporte, il était heureux de me voir. C'est net, il était heureux. Je suis sorti malheureux. Parce que les films sont importés, gardés sous la chaleur, et au moment de les utiliser, eh bien, tout est flou. Alors, la question, c'est même la télé. Ensuite, deuxième point. Deuxième point, c'est les médicaments et la médecine traditionnelle. Nous avons négligé et nous avons tué. Alors que, dans toutes les facultés, de médecine, de pharmacie, et dans les laboratoires, les matières médicales les plus nombreuses et les plus efficaces sont tout au long des tropiques. Il y en a plein à la tropique. Et nous sommes combattus parfois par les laboratoires pharmaceutiques pour des médicaments traditionnels qui se peuvent être valorisés. Je n'en dirais pas plus, plus les faux médicaments. Merci, merci. Les faux médicaments. Non, les faux médicaments sont à l'ordre du jour au plan mondial. Mais aucun état ne peut lutter contre cela tout seul. Donc, c'est un problème vaste. Et le président français, Jacques Chirac, a venu à Cotouron, lancé ça. Thank you, thank you. We have to let us know. Donc, il faut l'inscrire dans la conclusion de l'autre travail du jour au lendemain. So, I would take that, and then I'm sorry, we have to close with those. I would take that last comment as there are lots of resources in Africa and the world. We're sub-optimizing those resources. We're not taking advantage of whether we're, we're not customizing them to local conditions and so forth. But I also, the idea of integration of energy policy and healthcare policy and the different cabinet ministry level in government. And then finally, this idea of human compassion that shouldn't it just be part of our DNA, that healthcare and how we treat each other should be priority one, yes? So, any of that or however you'd like to take 30 to 45 seconds to make your final point. I'd like to address- And we'll come this way this time, we'll come this way. I'd like to address the issue of compassion because it was one of the first problems, if you will, that I had to deal with in setting up a practice in Ghana. I had been at Harvard and taught there and set up practices in Boston. And the very first thing that hit me was the seeming lack of compassion. And yes, in many ways it was a lack of compassion. But the working conditions under which many of the doctors work, I bring it back to the issue of leadership and poor management. The management of the resources within the medical facilities does not support those physicians who put themselves out to really do what they're supposed to do. And I think it's almost like systematic trauma that they are incurring, both as medical students and doctors because even during the training, they abuse, if you will, starts there. They're expected to work much longer hours than they do in the West. And I do mean much longer hours. Nobody can work for three full days with barely a satisfactory meal and then see a patient and be compassionate. I am not trying to exonerate our healthcare workers. I can assure you I'm not because it is a major, major problem. And even hiring skilled workers for the practice that I run, that's one of the first things I look for because I will not exonerate it. But I do have a better sense of having practiced for 15 years in Ghana, seen some of the conditions under which they're being taught. That's why I don't teach at the hospital there because I cannot teach in that environment. I simply cannot and offer quality medicine. It's impossible. But I bring it back from the actual physicians themselves who don't know any better at that time to the leadership. You know, we don't have our leaders trained in medical management. The people who run the hospitals are usually physicians themselves that have been plucked because somebody liked the way they looked and put them in charge of the hospital. That's not adequate. It's not enough. It's not good enough. And so it really is an issue of leadership. And I can be sure that if I were to go to a Rwandan hospital, I haven't been there in a while, but even when I went there decades ago, you could see that people were selecting people based on qualification, not because of some arbitrary interpersonal relationship that they might have with the person. And once you have somebody who understands what quality medicine is and how to get it out of a doctor who has been trained, they will not allow, they will not permit some of the conditions under which those physicians have to work. We lose our doctors annually, annually because they just give up and move out or into NGOs and other organizations. But it's a dreadful situation. Thank you. Thank you, Juliet. So leadership and quality came out of that, Robert, briefly. In 1950s, the life expectancy in Africa was around 45 years old. Now today we are at 60, a little bit 61. So it's still the lowest in the world, still the lowest in the world, but it has tremendously progressed. And there are all reasons to think that it will continue to progress. So it's, of course, science. It's, of course, financing. It's, of course, humanity. But it's, of course, leadership. And I think the question again in this conference, the question of leadership is absolutely key because you have some force which have to be empowered and drive this effort. Excellent. Here. Again and again. Leadership. I think the problem is not to respond to each of the challenges. We will not settle all the problems. I think what we need in Africa, leadership, commitment for action, to change the life of the people. I talk about Ethiopia. They are not rich. I talk about Rwanda. 20 years back they had a genocide. I talk about Capoverdi. It's not a rich country. I talk about Botswana. They have Daimon. But we have so many rich countries in Africa. The health sector is failed. They are not able to provide the minimum package of essential health services to the people. I think the problem in Africa, we need leaders in their involvement to change the life, the situation of the people. Very good. Nardos. I'll start with the compassion. But I would expand it a little bit. In the entire world, it's not Africa, values and standards have really gone down, completely down. And therefore, the world has to think on how to really bring back societal values, family values, professional values into the forefront. Truly. And I think this should be a discussion, a universal global discussion, and not really specific to Africa. Yes, you know, the compassion in passion is associated with the means, you know, with the environment. And again and again, what I said first comes, you know, when we plan in a silo, we will never get anywhere. So we have to start adopting an integrated planning, an integrated budgeting, you know, and develop ecosystems. And therefore, you know, when we talk about, you know, what my big brother Robert Osus just said, when we talk about health care system, we shouldn't look at it from just one aspect of it, which is a treatment. We should look at it from the preventive side to the treatment, you know, the whole integrated, you know, system. And looking at all environment, when you plan, you have to really know where are the disease burdens and how many medical doctors in what fields we should train them. And then the institution should respond to that, you know, academic institution should produce them. So, you know, we have to really look at research institutions, like I said, you know, the biomedical engineering, you know, they do engineering, they go out. Of course, they run out of job because it's not relevant to the socioeconomic development. We do everything outside the socioeconomic development needs of the country. And that's where we run into problem. Just one thing, I think also for Africa, we need to really move out from thinking of and talking about just all the time what we don't have and really highlight on what we have and on how to scale it up. There are many best practices everywhere. There are many best institutions everywhere. Each country cannot afford to have research institutions, but it can piggyback on an institution that exists. CSIR in South Africa is not an institution, innovation centers. African governments and leaders come there. They don't even visit that research institution. So we have to really know on how to share our resources and on how to talk about, you know, highlights about prosperity, what are the areas, points of excellence that we can share with others. Thank you so much. You know, this is one of those examples. Yeah, please. That we could take a great deal more time, but that's what lunch is for. That's what hallway conversation is for. Let me finish with this one thought. United Way is the largest privately supported NGO in the world. We generate about $5 billion US per year. And one of the things we've learned and you heard here is that no longer is innovation and scaling gonna come from the top down or the center out. It's going to come from the out in and the bottom up. And whether it's individuals, patients, countries, we're growing very quickly in India, Mexico, China now starting in Africa because we're coming bottom up. Scaling healthcare will, as I think you heard, be about leadership, quality, transparency, but in engagement of individuals, patients driving their own care and our institutions responding to that. That's why we care about healthcare in Africa. Bon appetit. Have a great lunch.