A Call for Action: Upholding the Commitment to 15% Domestic Funding for Health in Africa

Patience Masua
& Emma Theofelus

In 2001, in the historic city of Abuja, Nigeria, African Heads of State and Government gathered at a Special Summit to address the exceptional challenges posed by HIV/AIDS, Tuberculosis, and other infectious diseases.

This gathering led to the Abuja Declaration, a unified vow to directly confront these challenges and gather resources for effective interventions. Now, more than two decades later, it is crucial to reexamine and reinforce this commitment, particularly the pledge to allocate a minimum of 15% of annual national budgets towards the enhancement and improvement of the health sector.

The Abuja Declaration represented a visionary initiative undertaken by leaders who acknowledged the profound impact of these diseases on the African continent. It pledged decisive action, ensuring that resources would be efficiently utilised to control the spread of HIV/AIDS, Tuberculosis, and other infectious diseases. The commitment to allocate 15% of annual national budgets to the health sector was a beacon of hope, signalling a proactive approach to address the health needs of the continent.

According to the 2018 World Health Organisation Global Health Expenditure Database, progress has been observed, with over 64% of African Union Member States augmenting domestic investments in health. This has resulted in visible improvements in health systems at sub-national and national levels. However, the stark reality remains only two out of 55 African Union Member States meet the target of dedicating at least 15% of the government budget to health. This falls short of the

suggested threshold of US$86.30 per person required to provide a basic package of health services.

The world’s most youthful continent stands at a critical juncture where the future growth and prosperity depend on developing and nurturing human capital. While strides have been made, more than half of Africa’s population lacks access to essential health services, and millions succumb to preventable diseases annually. The commitment made in Abuja is a lifeline for those in need, and its fulfilment is a moral imperative for the well-being of our people. In alignment with the United Nations Sustainable Development Goal (SDG) 3, which emphasises that ensuring healthy lives and promoting well-being at all ages is essential to sustainable development, and in harmony with the aspirations of the African Union’s Agenda 2063, which enshrines the hopes for a sustainable Africa, where all its citizens are healthy, well-nourished, and have a high standard of living, it is paramount to recognise that access to these health services is not just a commitment but a fundamental human right that paves the way for a healthier,
more equitable future for all.

It is crucial to recognise that the Abuja Declaration, while not legally binding, is a powerful expression of collective aspirations. It represents a shared commitment to prioritise health and well-being, acknowledging that a healthy population is essential for sustainable development. As leaders, Africa Heads of States have the opportunity to turn these aspirations into tangible actions that will shape the future of our continent.

We urge African Heads of States to reaffirm and strengthen the commitment

made in Abuja. By allocating at least 15% of annual national budgets to the health sector, you can ensure the continued progress of successful interventions, the development of new and effective strategies, and the realisation of comprehensive multi-sectoral responses. This is not only a commitment to health but a commitment to the prosperity and well-being of the African people.

Let us stand together to fulfil the promise made in Abuja in 2001, and pave the way for a healthier, more prosperous Africa. Recent studies underscore the urgency of addressing funding gaps for children in comparison to adults, highlighting the imperative to prioritise children and young people in the HIV funding conversation. Ensuring that the youngest members of our society are not left behind is not only a moral obligation; it is an investment in a future where every individual can thrive, unburdened by the shackles of HIV/AIDS. As legislators and members of the Africa REACH Leadership Council, we continue to use every platform and opportunity to advocate for health rights, especially those leading to an #AIDSFreeGeneration. We therefore further call on our dully elected leaders, to do the same. Therefore, let us fortify our collective resolve as leaders, guided by the vision and commitment articulated in the Abuja Declaration. By reinforcing the pledge to allocate 15% of our annual national budgets to the
health sector, we not only honour a promise made over two decades ago but also pave the way for a brighter, healthier future for every African. Let us stand together, unwavering in our dedication, to ensure that health remains a fundamental right, driving progress, prosperity, and dignity across our beloved continent. Together, let’s write the next chapter of Africa’s narrative—one where health equity and well-being are not just aspirations but tangible realities for all.

Hon. Patience Masua and Hon. Emma Theofelus are Namibian Members of Parliament and Africa REACH Leadership Council Members

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