HETA: Powering Health with Clean Energy in Africa

Highlights

Unreliable power hinders access to life-saving healthcare in sub-Saharan Africa.
HETA is expanding electrification and digital connectivity for thousands of health facilities.
Renewable energy boosts the health sector’s resilience to climate change while reducing carbon emissions.

The Challenge

Across sub-Saharan Africa, at least 100,000 health facilities lack access to reliable electricity and internet connections. This gap threatens health when clinics can’t keep the lights on for nighttime services or reliably provide patients with oxygen and other life-saving care. Without reliable power, they also can’t refrigerate vaccines and other temperature-sensitive medical commodities or use the digital tools that modern medicine relies on.

Ensuring access to energy and digital connectivity for sub-Saharan Africa’s health sector is in part a challenge of funding. Renewable energy systems, such as solar panels with battery storage, typically require a higher up-front investment, but they beat out fossil fuel–powered solutions for reliability and ongoing costs within a relatively short time. And they support African health systems’ resilience and ability to adapt to climate change—from responding to new disease patterns to keeping the power on when extreme heat or storms interrupt grid-powered electricity.

Without sustainable funding and cross-sector coalitions to connect health facilities across the region, millions of people will continue to lack equitable access to life-saving health services. The Abt-led Health Electrification and Telecommunications Alliance (HETA) is Power Africa’s flagship initiative to meet these challenges.

The Approach

HETA is a USAID Global Development Alliance (GDA), a powerful mechanism for activating private sector expertise and resources toward sustainable development objectives. Our five-year goal is to reach 10,000 health facilities across the region. U.S. government funding from Power Africa and USAID funding (about $47 million over five years) helps launch implementation and catalyze strategic partnerships toward this ambitious target, but the overall need is estimated at $100–150 million in additional contributions from HETA’s partners.

As a USAID GDA, HETA started with four founding partners—Abt as the lead; RESOLVE, an NGO specializing in alliance building; bechtel.org (Bechtel’s social enterprise), providing social infrastructure expertise and co-investment; and Orange, HETA’s first telecommunications partner supporting work in countries where our priorities align. Unlike other GDAs, HETA is an open platform with space for many other contributors from the donor, private for-profit, and non-profit sectors.

Together with these partners, we deliver funds, technical assistance, and in-kind resources to design, install, operate, and maintain renewable energy systems linked to mobile or internet networks for health facilities across sub-Saharan Africa.

HETA’s approach seeks to solve a long-standing sustainability challenge for health facility electrification—securing financing, business models, and technical expertise to provide long-term operations and maintenance (O&M) of the systems after they are installed. We customize our approach to suit the needs and context in each country (down to the facility level), such as “energy as a service” models in contexts where energy and telecommunications companies are ready to partner with health facilities. In other areas, we are exploring community-led models in which women entrepreneurs and other local organizations co-design O&M funding models with HETA.

Where feasible, HETA seeks to facilitate partnerships that will enable sales of surplus power to businesses and families in the surrounding communities. Such arrangements help generate revenue for system O&M, supporting financial sustainability. This approach also opens the door for a range of productive uses of energy, from ensuring the facility’s ability to run state-of-the-art medical appliances to providing power for mobile charging stations or pumps to deliver clean water.

The Results

HETA’s partners are working toward a shared vision of resilient health systems and healthy communities across sub-Saharan Africa, powered by reliable access to renewable energy and digital connectivity. Our work is enabling improvements to health service delivery and sustained access to clean energy and internet connections for Africa’s healthcare providers. As of December 31, 2023, HETA has:

Launched USAID-funded country programs in
- Eswatini, in partnership with The Luke Commission and UNICEF
- DRC, in partnership with USAID IHP (also led by Abt) and OffGridBox and Eastern Congo Initiative
- Tanzania, in partnership with Maisha Meds, ZOLA, Caterpillar Inc., Assist International, Vodacom, Christian Social Services Commission, and local energy service providers.
Completed scoping and work planning for programs in Mozambique, Sierra Leone, and other countries in our second year.
Worked with PIND Foundation and local developers in Nigeria to support solar electrification of 12 health facilities in three states of the Niger Delta.
Provided 301 health facilities with new or improved energy access and 262 digital connectivity (supporting a total of 513 health facilities as of the end of 2023)—representing nearly 2 million people with access to improved healthcare services based on HETA’s support at those sites.
Catalyzed more than $10.77 million in leverage funding (direct co-funding and in-kind contributions from our partners) to amplify the impact of USAID and Power Africa’s investment in HETA.
To ensure we work with a vibrant partnership network, HETA launched an open call for concepts in 2023—seeking market-based solutions to health facility electrification and digital connectivity. Since launching the call, HETA has issued grants to partners across the region, accelerating progress toward our 10,000-facility target and incubating promising solutions for long-term O&M.

HETA’s long-term vision seeks organizational sustainability beyond these first five years. Working with Power Africa and cornerstone partners, Abt, RESOLVE, and bechtel.org are designing the governance structures and funding base for an independent organization to continue supporting energy access and digital inclusion for the health sector well into the future.

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