by Olayide Akanni

Africa has the 2nd highest rate of economic growth in the world, and as
the mantra of a “rising Africa” continues to be re-echoed in various local
and international forums, there  is also a need to reflect on whether
the efforts of African Leaders  geared  towards  accelerating economic
growth are  truly commensurate with  the interventions  aimed at
enhancing the  quality of life and well being of the average African

The Special Summit of the African Union on HIV/AIDS, Tuberculosis and
Malaria (Abuja +12) with theme “Ownership, Accountability and
Sustainability of HIV/AIDS, Tuberculosis and Malaria Response in
Africa: Past,Present and the Future which held from the 15th-16th July
2013 in Abuja, Nigeria, provided a platform to reflect on the progress
made by African leaders since they adopted the Abuja Declarations and
Action Frameworks on Roll Back Malaria (RBM) and on HIV/AIDS, TB
and other infectious diseases in 2000 and 2001 respectively.

In his Opening remarks at the Summit, Prime Minister of the Federal
Democratic Republic of Ethiopia and Chairperson of the African Union
Mr.Hailemariam Dessalegn underscored the need for focused investment
in health when he aptly noted:

“Our collective  aspiration to bring about socio-economic transformation
will not be achieved  without having a healthy and productive human
resource. Although Africa is richly endowed  with natural resources,
its human capital is the key to unleashing its potential  for
socioeconomic growth and development.

Therefore, without ensuring the wealth and overall well being of our
peoples, we cannot be able to guarantee the sustainability of the
robust economic growth that we have been able to achieve over the
past decade. That is why expanding universal access to health
services is very critical”, he said.

So how  have our  leaders fared  in ensuring the health of their
citizenry twelve years after they made these landmark declarations
in Abuja?

The Progress Report 2010-2012 which reviews the Implementation of the
Abuja Call for Accelerated Action towards Universal Access to HIV/AIDS,
Tuberculosis and Malaria Services presented by the Department of Social
Affairs of the  African Union Commission(AUC) at the Summit showed
that only 12 out of the 53 AU member States submitted timely data to
the AU Commission on the Progress made.

While substantial progress has been made by countries in certain areas
such as demonstrating willingness and political commitment at national,
regional levels,in addressing  the challenges posed by HIV/AIDS, TB and
Malaria, gaps still exist.

The report also notes that the low compliance with commitments to monitor,
evaluate and  communicate progress amongst Members States critically
puts at risk, efforts  to measure progress..

A key outcome of the 2001 Abuja Declaration was the commitment to
allocate at least 15% of national budgets to health by 2015. Over the
last five years, health spending in Africa has risen by about 10%
annually. However, spending is still no where near where it needs to be.

According to Abuja +12: Shaping the future of health in Africa, a report
by UNAIDS and AUC released on July 16, as at 2011,less than ten AU member
states have achieved the 15% Abuja target, and an additional US$ 31 billion
is required to close the funding gap. 75% of this gap occurs in six
countries namely (Egypt, Algeria, Nigeria,Angola, South Africa and Libya).

In her remarks at the Summit’s Opening, Chairperson of the African
Union Commission Dr Nkosazana Dlamini-Zuma noted: “Even though we are
making progress, Africa still remains off track in reaching the MDG
target of halting and reversing the global TB epidemic  by 2015 and
is the only continent not on track  to achieve a 50% reduction in TB
mortality. Despite being  preventable and curable in Africa, malaria
continues to kill on average a child every 30 seconds and action needs
to be stepped up to ensure there are no new HIV infections.

One of the greatest challenges we need to address is the dependency of
many national responses to AIDS, TB and Malaria on external financing
and imported medicines. On HIV alone, 60% of the continental investment
is mobilized externally and over 80% of treatment is imported.

We therefore need to accelerate the implementation of the earlier Abuja
Commitments stepping up the mobilization of domestic resources  and
strategies  for innovative financing  to strengthen  the health systems.
Access to health is a fundamental human right for all”,she stated.

Nigerian President and host of the Summit, Dr Goodluck Ebele Jonathan
also reiterated the call for Africa to a develop home grown sustainable
financing framework adding that ownership and sustainability should be
the basis of the continent’s actions in response to the 3 diseases.

As country after country made interventions in the course of the Summit
on their progress and challenges in responding to the 3 diseases, they
highlighted  the urgent need to: increase funding, strengthen health
systems  and sustain the gains made with the efforts of the development
partners.Clearly the progress  made still leaves much to be desired.

At the end of their deliberations , the African Heads of States through
their Declaration  tagged the “Abuja Actions Towards  the Elimination
of HIV and AIDS, TB and Malaria by 2030″resolved to  take serious action
toward the elimination of the 3 diseases .

They pledged to scale up the implementation of the earlier Abuja Commitments;
implement effective and targeted poverty elimination strategies and
social protection programmes that integrate HIV and AIDS, TB  and
Malaria for all, particularly vulnerable populations; strengthen the
use of effective insecticides  for control and elimination  of malaria
including the  use of dichlorodiphenyltrichloroethane (DDT) where
suitable;strengthen mechanisms to increase coverage and access to
services  for detection and treatment of TB, Multi Drug Resistant TN
and TB in children,vulnerable populations and involvement of communities
in TB interventions,increase access to prevention programmes targeting
the youth, especially young women, to ensure an AIDS-free generation as
well as eliminate mother-to-child transmission of HIV while keeping
mothers alive.

Apart from  requesting the  Africa Union Commission to work out the
modalities of establishing an African Centre for Disease Control,
the leaders also  committed to step up the mobilization of domestic
resources to strengthen the health system while ensuring that strategies
are in place for diversified, balanced and sustainable financing for
health, in particular AIDS, TB and Malaria through development of
strategic health investment plans and strategies for innovative financing,
including from the private sector .

“We also undertake to  explore in particular, the important South-South
Cooperation and collaboration with Brazil, Russia, India,China and
South Africa ( BRICS) partners to scale up investment in African
pharmaceutical manufacturing capacity, especially for generic
essential medicines and other essential commodities as well as the use
of effective insecticides for control of malaria, including the use of
dichlorodiphenyltrichloroethane”, they stated.

At the sidelines  of the Abuja Special Summit  on July 16, selected
African leaders under the aegis of the AIDS Watch Africa Champions (AWA)
mapped out action to accelerate advocacy, accountability and resource
mobilisation efforts towards ending AIDS, TB and Malaria in Africa.

The meeting of Heads of State who are the AIDS Watch Champions hosted
by the President Goodluck Jonathan adopted a schedule of initiatives to
be implemented in the last 900 days before the deadline for achieving
the Millennium Development Goals.

Based on their Action Plan, Gabon will lead efforts to champion the
getting to Zero campaign in Africa- Zero new HIV infections, Zero
discrimination and Zero AIDS-related deaths.

Cote d”Ivoire will champion strengthened partnerships for AIDS, TB while
Malawi will champion the elimination of mother to child transmission of
HIV. Tunisia will champion the Pharmaceutical Manufacturing Plan for
Africa to ensure access to affordable and quality assured drugs.

Tanzania will champion malaria control and build on the role that the
President has played in the African Leaders Malaria Alliance.

The action plan also sets out clear activities for the Champions to
utilize Regional Economic Communities as the fundamental pillars for the
implementation of the AU Roadmap, galvanise strong linkages with
various continental initiatives including the Elders, Champions for
an HIV Free Generation, Organization of African First Ladies Against
HIV/AIDS (OAFLA), African Leaders Malaria Alliance (ALMA), Regional
Health Organisations (RHOs) and support the speedy implementation of the
African Medicines Regulatory Harmonization Programme (AMRH) and the
Pharmaceutical Manufacturing Plan for Africa (PMPA) initiatives.

Clearly, Words, Commitments and Declarations  of the  Leaders made in
Abuja and other  African capitals  alone  will not be enough to ensure the
Elimination  of HIV, TB and Malaria on the continent by 2030.

African countries need to review the progress on their 15% of budgetary
allocation to  health  as well as their current levels of per capita
investment in health of their citizens and put their money where their
mouth is.

These commitments will need to be backed by country levels actions
that  promote integration of services including maternal and child
health care services, strengthening of health systems at all levels,
cost effectiveness and efficiency of interventions as well as efficient
monitoring and accountability mechanisms.

While the AU envisions an integrated, prosperous and peaceful continent,
without sustained  and serious action aimed at improving the healthcare
system, no real change can happen. Clearly, Africa’s growth will not
rise beyond the quality of health of its citizens.

* *

*Additional Sources:*

Abuja +12: Shaping the future of health in Africa

Progress Report 2010 -2012 =96 Implementation of Abuja Call for Accelerated
Action Toward Universal Access to HIV/AIDS, Tuberculosis and Malaria

Abuja Action Towards the Elimination of HIV and AIDS, Tuberculosis and
Malaria in Africa by 2030

Press Release : AU Press Release No 105/2013 : AIDS Watch Africa Champions
Map Out Action to Accelerate Efforts Towards Ending AIDS, TB and Malaria


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