Twelve years after African governments pledged in the Abuja Declaration to allocate at least 15 percent of their annual budgets to healthcare by 2015, just six countries have met this goal.
Liberia, Madagascar, Malawi, Rwanda, Togo and Zambia have met the target, and five other countries are spending at least 13 percent of their annual budgets on health, according to data compiled by the UN World Health Organization (WHO).
While on aggregate spending on health has increased - up to 10.6 percent from 8.8 - about a quarter of African Union (AU) member-states have regressed and are now spending less on health than they were in 2001, adds the WHO data.
Recently, the AU held another special summit on HIV/AIDS, tuberculosis (TB) and malaria in Abuja, Nigeria, dubbed Abuja +12, which provided an opportunity for African governments and other stakeholders to review progress made and to discuss what should be done to ensure health funding targets are met before 2015.
The HIV/AIDS experience
“A renewed and bold commitment here in Abuja is essential as, drawing from experiences in the AIDS response, we know that smart investments will save lives, create jobs, reinvigorate communities and further boost economic growth in Africa,” said Michel Sidibé, the executive director of UNAIDS, in a press statement.
At present, funding for healthcare remains short of requirements and is very unevenly spread across countries. According to UNAIDS, an additional US$31 billion per year will be needed to meet the continent’s 15 percent health funding targets.
As of 2011, at least 69 percent of the world’s 34 million people estimated to be living with HIV/AIDS were in sub-Saharan Africa.
But there are encouraging signs. The number of new HIV infections fell by 25 percent in 2011 compared to a decade earlier.
“The main challenge in the fight against HIV and AIDS globally is how to ensure universal access to prevention, treatment, care and support, and… ensuring zero transmission of new HIV infections in children,” wrote Ghanaian President John Dramani Mahama in a blog article in May.
Among 21 priority countries in Africa, the number of children newly infected with HIV has fallen by 38 percent since 2009, according to a joint AU-UNAIDS report launched at Abuja +12.
Malaria and TB burden
Africa is also lagging behind in reducing cases of - and deaths from - TB and malaria.
Globally, Africa is the only region not on track towards halving TB deaths by 2015, and it accounts for almost a quarter of the global caseload, according to WHO.
Inadequate TB detection and drug-resistant strains of the disease, which can be 100 times more expensive to treat, pose significant challenges in Africa. About 40 percent of TB cases in Africa go undetected, adds WHO.
Malaria is also a serious health problem. Eighty percent of the world’s cases and 90 percent of malaria-related deaths occur in Africa.
“We are at a turning point for making historical gains in Liberia's health sector - where no child dies of malaria and every mother living with HIV can give birth to HIV-negative children while living healthy lives themselves,” wrote Liberian President Ellen Johnson-Sirleaf, in a statement to the Global Fund.
Liberia allocates 18.9 percent of its annual budget to healthcare, the second highest proportion in Africa; Rwanda spends 23.7 percent.
Health for development
According to the AU/UNAIDS Abuja +12 report, there is an economic case to be made for further investment in healthcare: For every year that life expectancy rises across the continent, it argues, GDP will increase by 4 percent. The average life expectancy in Africa is 54.4 years, the lowest globally.
“A sick population cannot generate the productivity needed to maintain the acceleration of our economy,” said Ghana’s President Mahama.
More funding for health could also mean more jobs within the health sector. In 2012 for example, the AU approved a business plan to increase the output of the local pharmaceutical industry.
“Focusing on three things that Africa needs to do urgently - decrease dependency by growing African investments, deliver quality-assured drugs sooner to the people who need them, and leadership - the blueprint will help African countries to build long-term and sustainable solutions,” stated Mustapha Sidiki Kaloko, the AU Commissioner of Social Affairs, in a statement, ahead of the Abuja +12 summit. “Africa’s health and our prosperity are inextricably linked.”