AU Must Address Africa's Health Crisis

Published on 30th June 2008

Two hundred and five African and global organisations and networks have called on the Assembly of Heads of State of the African Union to  ensure the Implementation Plan of the AU Africa Health Strategy is  urgently and adequately funded, and for the AU Abuja 15% Commitment  to health to be implemented by all member states.

The Implementation Plan was adopted by African Ministers of Health on the 17th of May 2008 following presentation of the Health Strategy last year by the AU Commission Social Affairs Division. It provides guidelines for implementing various African health frameworks, health MDGs and global Universal Access targets including on TB, HIV and AIDS, Malaria, Child and Maternal Health.

The Health Strategy Implementation Plan will be presented for final approval to the Assembly of Heads of States meeting in Sharm El Sheikh, Egypt on the 30th of June and 1st of July.

In a statement on the eve of the Assembly, Rotimi Sankore Coordinator of the Africa Public Health 15% Now Campaign stated: "The AU Africa Health Strategy is a landmark document. But without funding for its Implementation Plan from our Heads of State and  Finance Ministers, it will be reduced to an empty gesture resulting in even more deaths than the current 8 million African lives lost annually to mainly five health conditions being TB, HIV and AIDS,  Malaria, Child and Maternal Mortality."

He added that: "While many of our Finance Ministers recognise the urgency of health funding, they have not acted on this and need to do so. It is also serious cause for concern that some think that there are other issues more important than health. We are not saying that roads, or energy are not important. But we are saying that dead or dying people have no need for them."

He emphasised further that: "Africa's human capital is its greatest development asset. But with Africa loosing 4.8 million infants and  children annually, and average healthy life expectancy dropping to less than 40 years in many countries - not only is our future dying before our eyes, millions of skilled workers and professionals that provide the engine for economic development, and underpin the purchasing power vital to growing economies are dying in their prime."

He cautioned African governments against being carried away by hollow economic growth statistics stating that - "Statistical economic growth - with no sustainable investment in social development: health, food production, education, gender equality, water and sanitation - is negative growth - because there is no real improvement in living standards and social and economic rights."

The 15% Now Campaign Coordinator underlined that: "We must start investing sustainably in health now before the cost of containing infectious diseases in particular spirals out of control. For instance, latest Stop TB partnership / World Bank analysis indicates that the cost of not treating TB to Africa between 2006 and 2015 would be $519bn while TB can be controlled with $20bn in the same period."

Reacting to the views in some quarters that some disease specific issues have allegedly cornered more than their fair share of funding, the 15% Now Campaign Coordinator stated that funding the Africa Health Strategy Implementation Plan means funding both health systems and disease specific issues. It is not appropriate to suggest too much money has been spent on any one disease, when it is clear from prevalence and mortality levels of all   diseases that not enough has been spent on any disease.

Without a shadow of doubt we need more, and better working conditions for health workers and professionals to ensure wider access to healthcare. But we also need specific medicines and commodities for prevention, treatment and care - be it for HIV, TB or Malaria.  Medicines will not prescribe or dispense themselves, but health systems without specific and adequate medicines and commodities are also ineffective. With the growing interaction between TB and HIV, between Malaria and Child Health, or with the cross cutting nature of Reproductive and Sexual Health, it is also clear that we need more  integrated health funding".

Calling on African leaders to ensure that they go from the AU Summit to the Japan G8 in early July with a message that they are meeting their own commitments alongside calls for global commitments  to be met, the 15% Now Campaign Coordinator stated further that sustainable investment in health can only come from our own  governments. Overseas Development Solidarity from TICAD, G8, the EU or private global foundations can only be useful if it is seen as an addition to, and not a replacement for African governments meeting their own commitments to health and other development issues.

Japan which hosts the G8 next month and Nigeria have 127m and 144m people respectively. Japan spends 17.8% of its budget on health.  Nigeria only 3.5%. Japan has 270,371 doctors, 1.2m nurses and midwives, and 241,369 Pharmacists. Nigeria only 34,923 doctors, 210,306 nurses and midwives, and 6,344 pharmacists. Japan’s healthy  life expectancy is 75 years and Nigeria's a mere 42 years. Japan has 17,000 people living with HIV, Nigeria has 2.9m. Japan has a TB prevalence of 37,490, Nigeria has 889,666.

Even taking into account the poaching of African health workers by developed countries to subsidise their own health systems, at current levels of investment in health systems and disease specific issues,  Japan’s health will get better while Nigeria's  will get worse unless Nigeria increases its own health investment to  ensure that international solidarity is meaningful.

With only 0.3 percent of external health funding compared to between 10% and 60% of external funding for health in most African countries, a country like Cuba has demonstrated that it is possible for a medium income country to achieve equivalent healthy life expectancy as G8 countries through long term sustainable investment in health systems and disease specific interventions.

By Media @Africa Public Health

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