The “Abuja Actions toward the elimination of HIV and AIDS, tuberculosis and Malaria in Africa by 2030” has four major planned strategies. The first strategy is to significantly scale up implementation of previous continental commitments on the three health conditions. This is a wise recommitment since it is common knowledge that despite improvements in access to lifesaving medicines, significant proportions of at-risk and in-need populations remain underserved in Africa.
Additionally, 13 years after African leaders committed to spending at least 15% of national budgets on healthcare issues, African Union figures indicate that only six African countries – Liberia, Madagascar, Malawi, Rwanda, Togo and Zambia – have met the mark. It would be a powerful scenario if by 2030, the remaining 48 African governments have stepped up proportion of health expenditure to 15% of national budgets. However, the cost burden appears heavy: an existing funding gap of US$31 billion, and counting.
The second strategy for an Africa free of AIDS, Tuberculosis and Malaria is the urgent need to integrate implementation of programs targeting the three health conditions with existing poverty reduction and social service initiatives. In particular, the integrated program approach will focus on the needs of vulnerable populations. Again, this is a very important commitment. Poverty remains at the nexus of the continued menace of these health conditions in the continent. Prevalence and incidence rates are much higher among communities living in poverty and among those at the mercy of internal displacements, conflicts, climate changes and social discrimination.
The third strategy is targeting African youth, especially young women with expanded access to preventive programs.This will be a formidable challenge since AIDS, Tuberculosis and Malaria have a preponderant feminine face in Africa. To address this feminine skew, African leaders and their governments need to invest on women empowerment initiatives. Efforts should continue to strengthen implementation of existing human rights laws and to continuously review and update laws on domestic violence, sexual violence and family inheritance.
In addition, creating enabling opportunities for young people to have viable employment after school, including self-employment is a major action step. Integrating the youth in mainstream political and economic discourse is another obvious step in a continent with a prominent youthful population bulge. The future of Africa literally rests on the young, tender shoulders of Africans less than 30 years of age supporting the population pyramid bulge. Another prominent action step as agreed upon by African leaders is the need to drastically reduce mother-to-child HIV transmission. This will address a current, untoward situation whereby Africa contributes 92% of all such transmissions around the world.
It would have been helpful if African leaders declared war on AIDS Orphans as part of the comprehensive programs targeting African youth. More than 12 million AIDS orphans in Africa, often under the care of frail grand-parents labor to attend school, access healthcare services and integrate into communities of dead parents. As I noted with another colleague in our book on Africa AIDS orphans, the fate of millions of orphaned African children under the watchful eyes of their impoverished grandparent may become he ultimate nightmare of the AIDS rampage in the continent.
The fourth and one of the most important strategies and the cornerstone of the continental commitment is the agreement by African leaders to mobilize domestic resources in the fight against AIDS, Tuberculosis and Malaria. Today, Africa, with ongoing economic struggles in the West, have no choice but to forge ahead on continental sources of funding. It is gratifying to note that African leaders noted the unique funding opportunities occasioned by burgeoning South-South cooperation and the continued, central role of BRICS in the global economy.
African governments now have unique opportunities to partner on specific needs and priorities with various continental and international stakeholders on implementation of viable programs targeting AIDS, Tuberculosis and Malaria. The organized private sector in Africa have a major financial, logistics and catalytic role to play to meet the 2030 commitment. Africa’s professional organizations, the civil society and the public sector have irreplaceable roles in a robust fight against the three health conditions. Tightened processes for articulating and implementing continental platforms of action are now imperative, especially as it relates to collaboration and cooperation efforts with bilateral and multilateral stakeholders.
Involving ordinary Africans at grassroots levels in continental policies and programs is absolutely essential to assure that planned programs of action reflect felt rather than perceived needs of target populations. Developing forward looking, accountable community-based health systems is an indispensable next step to ensure that every family at risk and in-need have timely access to quality health services. Strengthening the technical role of regional economic communities in the continent will be helpful, especially in regards to smaller African countries with limited number of appropriately trained health professionals.
African leaders deserve credit for making bold commitments on eliminating AIDS, Tuberculosis and Malaria on or before 2030 in the continent. This bold commitment should be backed by demonstrable action, including verifiable budgetary appropriations and program implementation templates. The clock is already ticking towards 2030 when today’s African youth will hopefully be leading a continent not only on its way as an anchor of global prosperity but may also due to the commitment of its today leaders managing an ancient land finally free of AIDS, Tuberculosis and Malaria.
By Dr. Chinua Akukwe
The author firstname.lastname@example.org is the former Chair of the Technical Advisory Board, Africa Center for Health and Human Security, George Washington University, Washington, DC. He has written extensively on health and development issues. His latest book is on Global Public Health Policy.