by Wallace Mawire
African health ministers have reaffirmed their commitment to funding health and HIV services at a meeting held alongside last week’s International Conference on Family Planning in Addis Ababa, Ethiopia.
The meeting was convened by the African Union Commission (AUC) in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The response to HIV and major diseases like tuberculosis and malaria over the last three decades has mobilised unprecedented resources, commitment and action at the national, regional and global levels.
However, Tawanda Chisango, AIDS Watch Africa programme advocacy and partnership expert, said: “The results achieved and the progress made is not sustainable.”
He added that African countries rely heavily on external financing, leaving them vulnerable to the unpredictability of donor funds. “This also leads to considerable weakening of national ownership of programmes that fight against the diseases,” Chisango said.
Ambassador Joseph Nsengimana, permanent representative to Ethiopia for the AUC and the United Nations Economic Commission for Africa, said the meeting provided an opportunity for African countries to share experiences on how to have better internal financing for HIV and major diseases.
“We also brainstormed innovative mechanisms to increase internal financing for health in different countries,” Nsengimana said, such as health insurance and public-private partnerships.
He admits that domestic financing for health in African countries is being stalled because of challenges, including competing priorities in most of the countries. However, he said some countries have already begun the process of putting domestic funding mechanisms in place. For example in his home country Rwanda, 98% of the population has health insurance.
Finding creative ways to fund HIV services
Paul Chimedza, deputy minister of health and child care in Zimbabwe, said African countries should explore other avenues to finance primary health care, including public-private partnerships and bridge financing, to maximise resources.
Without singling out any country, he highlighted the need for more transparency and accountability in the use of local resources, saying: “There is need for proper use of funds and implementation of proposed plans if countries are to achieve their intended objectives.”
He added that he was excited his country already has a mechanism for domestic funding, the National AIDS Council AIDS Fund, which raises money for HIV services through a 3% income tax.
Other countries from the region and internationally – including Zambia and Botswana – have visited Zimbabwe to learn about domestic funding for HIV services. And the Southern Africa AIDS Information Dissemination Service has documented Zimbabwe’s AIDS fund as one of the best worldwide.
Combating dependence on donors
Zambia’s Deputy Minister of Health, Christopher Mulenga, said that the AUC had an obligation to come up with a strong policy for African countries to resist donor dependence syndrome. “Africa is a rich continent but we are not making use of the resources we have to develop ourselves,” he said.
Mineral resources have been identified as ideal and can be channeled towards healthcare improvement in many of African countries. Mulenga added that any programmes implemented by African countries have to help people in the poorest communities.
Shu-Shu Tekle Haimanoti, senior specialist for advocacy and partnership at the Global Fund, said the ministers’ commitments need to be translated to country-level progress. She also highlighted the need for domestic health financing to focus on other neglected diseases. “There is need for more dialogue on the issue of domestic financing for health and bold leadership to achieve this objective,” Haimanoti said.
Photo © Gideon Mendel for the Alliance