Sugar-Free Health Care

5/9/2014
Project Syndicate

LAGOS — While at dinner recently at a restaurant in Nigeria’s capital, Abuja, I observed a mismatched couple. The man appeared to be at least 60, but was dressed in skinny jeans and a skin-tight sleeveless top, with a large gold chain and dark sunglasses, though it was after eight in the evening. His companion, who looked no older than 22, skipped in behind him with three friends. She tried to include him in their conversation, even leaning in to kiss him occasionally, but a weak smile could not obscure her sugar daddy’s growing discomfort.

Of course, such relationships are neither new nor limited to Nigeria. Few people are shocked to see a wealthy older man take up with a younger, poorer women, promising to finance her education, travel, or shopping in exchange for her company. What is surprising is when one of these relationships develops into something deep and lasting.

The relationship between Africa and the West, especially when it comes to health care, strongly resembles this sugar-daddy dynamic. For decades, health-care innovations have been copied from developed countries, perhaps with slight variations, on the assumption that father knows best. But the results have been...

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