Much has been said in recent weeks about the need for developing countries, particularly in sub-Saharan Africa, ask for debt relief from multilaterals such as the World Bank, the IMF and other creditors.

Rather than asking to completely replay the 1990s, when some of the world’s low- and middle-income countries negotiated debt cancellation for the Paris Club coalition of some of the world’s wealthy countries, this time the talks focused on the suspension of debt repayments that has been accumulated over the last decade of relatively cheap credit.

The idea is that if these countries can suspend debt repayment for two years, they can focus on their much more difficult immediate problems of dealing with a health crisis that can be easily exacerbated by weak health infrastructure, such as a lack of medical personnel in hospitals in many countries in sub-Saharan Africa.

“Because governments in sub-Saharan Africa lack the resources for significant fiscal stimulus programs, we believe it is essential to suspend interest payments from governments,” says Yvonne Mhango, analyst at Renaissance Capital. “Ghana spends five times more on interest payments than on health care. Freeing up these funds would help mitigate the impact of the crisis.

Mhango also points out that Nigeria spends three times and Kenya twice their respective health budgets on debt repayment.

Even before the merits of discussing whether or not these countries have racked up too much debt, part of the challenge has often been that they weren’t spending enough on health care in the first place. Kenya, where President Uhuru Kenyatta has focused on investing in health care as part of his “Big 4” program, still spends at least two Kenyan shillings in interest payments for every shilling he spends. spending on health care, notes Mhango.

Nigeria, Africa’s largest economy with its largest population of some 200 million, spent only around 0.5% of its 2017 budget on health.

Ghana spent about 1% of its budget on health in 2017, but President Nana Akufo-Addo seems determined to ensure that the country is better equipped for future public health in general and not just crises. On Sunday, the President announced what would be the biggest health investment in Ghana’s history in build 94 new hospitals all to be completed within a year. It would also establish three infectious disease centers in the north, center and south of the country, eventually leading to the establishment of a Ghana Center for Disease Control.

Both Kenya and Nigeria hastily expanded their temporary health facilities long before we have a substantial number of Covid-19 cases in a bid to prevent traditional hospitals from being prematurely overwhelmed. Even better-resourced health systems in the United States and Europe have been overwhelmed by a sudden surge in the number of coronavirus patients. So far, the number of confirmed cases in most of Africa has been relatively manageable with 35,000 cases in a continent of more than 1.2 billion people.

Economists and analysts often point out that borrowing is not the problem when managing a country’s economy. Often, especially for developing countries with low tax bases or no major exports, debt is usually an important tool to finance hospitals for social protection and road networks to serve the economy, for example. However, there is sometimes a more contentious debate over how the debt is used and whether it simply serves the priorities of the government in power rather than its citizens.

Ultimately, according to Mhango, the main argument in favor of suspending debt payments is that sub-Saharan African countries lack the fiscal tools to stimulate the richest and most advanced economies. Instead of being a stimulus, when Ghana, Kenya and Nigeria receive concessional debt from the World Bank and the IMF, among others, these loans will mainly be used to repair the huge shortfalls and expenditures on health and emergency social protection that the Covid crisis has created for their budget plans.

Additional reporting by Kwasi Gyamfi Asiedu

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