I hope this is an answer to your question. A number of years ago The Economist had a cover that called Africa a basket case. It was as if to say that as bad as Africa was, it's now worse. That was because Africa had a double-digit percentage rates of HIV. You read that and just thought it was hopeless. More recently, The Economist had a cover, “Africa rising”, and cited the fact that six out of the ten top-growing economies of the past decade had been African countries.
What happened in-between was that an international development program called PEPFAR, funded by the U.S. government and led by a gentleman who was just here a few weeks ago, Mark Dybul, combatted AIDS on a continental level and installed a minimal infrastructure for health care. There are a very few other things you can point to that allowed this tremendous transformation. How did Africa suddenly go from a basket case to Africa rising? A massive contributor was actually investment, through PEPFAR, in health care. I think that's a big lesson. It's very important.
The other sustainability factor that comes to mind is that in sub-Saharan Africa about $75 billion a year is spent on cellphones—people talking and texting in a continent that people thought had no funds for that. But here's an industry that demonstrated a sustainable practice, which according to many presidents in Africa has contributed hugely, as much as international development has.
The answer, at least the one that leads us, is a focus on health care as it relates to other sectors, and on non-traditional business models for health care. Most notably—let's copy what's succeeded—we have the example of the cellphone, globally $600 billion a year in lower- and middle-income countries. That demonstrates there is a pathway to sustainability to health care.