Despite improvements in recent years, the health of the vast majority of sub-Saharan Africans remains in jeopardy. The figures are sobering. One in six children born in the region today will die before age five. African women face more than 100 times the risk of maternal mortality than do women in the developed world. And the average life expectancy in sub-Saharan Africa is a mere 51 years. Sadly, most countries in the region appear unlikely to meet the United Nations’ Millennium Development Goals for health,¹ let alone to address significant chronic issues beyond their scope.

The fundamental problem is a pervasive lack of access to primary health care. Conservative estimates suggest that four in ten people in sub-Saharan Africa have no access to medical facilities or personnel. Our experience in the region suggests that the actual figures are often much higher. Moreover, because of Africa’s vast distances and large rural populations, solving its access problem using only traditional clinics staffed with doctors and nurses would be prohibitively expensive and require decades to accomplish.² Meanwhile, millions of Africans would continue to suffer from diseases that are relatively simple to prevent, treat, and cure.

This need not happen. Our work in recent years suggests that a combination of three delivery approaches could catalyze Africa’s health systems and boost access across the continent, thus dramatically improving the lives of its people. The keys are to employ community-based health officers who would provide essential primary care at the village level, to adopt mobile phone–based “telemedicine” approaches that connect health officers and rural patients with specialized care, and to create networks of mobile health clinics that transport diagnostics and other technologies to remote places. Together, these approaches could quickly save many lives at relatively low cost—about $2 to $3 per person a year, compared with about $8 for traditional clinics.