Monthly Archives: July 2013

Timeline of the African Union and AIDS Watch Africa key commitments

2000: The Rollback Malaria Abuja Declaration and Plan of Action committing themselves to take concrete steps in their countries to intensify the fight against Malaria.

2001: Abuja Summit on HIV/AIDS, TB and Other Related Infectious Diseases, eight Heads of State and Government; AIDS Watch Africa (AWA) created as an advocacy platform at Head of State level to monitor the African response and mobilize resources.

2003 Maseru Declaration on HIV and AIDS/ Maputo Declaration on Gender Mainstreaming/ Maputo Declaration on HIV/AIDS, TB, Malaria

2004: AWA Secretariat was relocated to the AU Commission

2003 The Protocol Relating to the Peace and Security Council (PSC) of the African Union (especially around violence)

2004-2005 Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa (Maputo Women Protocol)

2004 Solemn Declaration on Gender Equality in Africa (SDGEA)

2005: Continental HIV/AIDS Strategic Framework and AWA Action Plan approved

2005: Maputo Plan of Action for implementing the Continental Policy Framework on Sexual Reproductive Health and Rights (SRHR)

2005 Continental Policy on Sexual and Reproductive Health and Rights, (Maputo Plan of Action related)

2006: Brazzaville Commitment on Scaling Up Towards Universal Access to HIV and AIDS prevention, treatment, care and support in Africa by 2010

2006: Reaffirmation of Abuja Declaration Plan of Action, Special Summit of the AU on HIV/AIDS, TB, and Malaria (ATM) adopts the Abuja Call for Accelerated Action

2006 Maputo Plan of Action, Plan of Action on Sexual and Reproductive Health and Rights 2007-2010 (renewed till 2015)

2007: African Union Ministers of Health adopt Africa’s Health Strategy;

2010: AU Heads of State and Government approve “A Partnership For The Elimination of Mother-Child Transmission of HIV in Africa”

2010: African Union launches Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA)

2011: AU adopts Common Position on HIV/AIDS in activities pertinent tothe prevention and resolution of conflict and post-conflict peace-building

2012: AU Heads of State and Government adopt the African Union Roadmap on AIDS, TB and Malaria

Key highlights of the Abuja+12 Special Summit on AIDS, TB and Malaria

By AIDS Watch Africa

The Africa Union Abuja +12 special Summit will be held in Abuja, Nigeria from 12 to 16 July 2013. The theme of the special summit is “Ownership, Accountability and Sustainability of HIV/AIDS, Tuberculosis and Malaria Response in Africa: Past, Present and the Future’’. The overall expected outcome of the special summit is renewed leadership and stewardship by African leaders to eradicate HIV/AIDS, Tuberculosis and Malaria.

The special summit will review the status of African Governments investment in the various national responses to AIDS, Tuberculosis and Other Related Infectious Diseases (ORID); and will adopt a set of actions to enhance the continent’s response and efforts towards reversing the impact of these diseases by ensuring universal access to services and strengthened health systems, especially for the poor and most marginalised people. The Abuja+12 summit will review the efforts of the continent in addressing AIDS, Tuberculosis, Malaria and the impact of this response on the health, financing and government systems.

Forthcoming events during the summit

CSOs Forum – 4-5 July 2013

The civil society and Non – State Actors will engage in an interactive and constructive consultation as from the 4-5 July 2013. Participants for the forum would be drawn from CSOs and development partners relevant to the wide range of themes of the Abuja declaration review process (Health Financing, HIV/AIDS, Tuberculosis, Malaria and related health themes) and the health MDGs.The key outcome of the consultations will include recommendations on the key topics as well as a CSO Action Plan to facilitate the delivery of the identified result areas.

 Meeting of Experts- 8-9 July 2013

The Special Summit will be preceded by the experts meeting on the 8-9 July 2013 to review the background documents and make recommendation for consideration by the Permanent Representatives Committee. The experts will: review the progress and achievements in the attainment of the targets of the 2000, 2001 and 2006 Abuja Summits, in the framework of the Millennium Development Goals (MDGs); review and identify factors that underpin the persistent burden of HIV, TB and Malaria on the continent; identify gaps, constraints and challenges to the achievement of the Abuja and health related MDGs targets; and make proposals on renewing commitment by African Leaders to address challenges in meeting the Abuja Call and MDG targets and recommendations on Africa’s position on post 2015 development agenda

AIDS Watch Africa (AWA) Champions Breakfast Meeting-16 July 2013

The AIDS Watch Africa (AWA) Champions will be hosted to a breakfast meeting b H.E. President Jonathan Ebele Goodluck of the Republic of Nigeria. This will be the first AWA Champions meeting to be convened bythe Chairperson of AU/AWA,H.E Ato Hailemariam Desalegn, Prime Minister of the Federal Democratic Republic of Ethiopia. During the meeting the AWA Champions will deliberate on concrete strategies to championthe Future Direction framework of AWA 2012-2015, the Roadmap on Shared Responsibility and Global Solidarity for AIDS, Tuberculosis and Malaria response in Africa as well as update on the One Year Progress on AWA mandate.

Meeting of the Executive Council: 13 July 2013

The Meeting of the Executive Council will consider the reports of civil society and the meeting of the experts and submit a report to the Heads of State and Government Summit.

Special AU Assembly of Heads of State and Government: 15-16 July 2013

The special Summit will review the status of African Governments’ investment and the various national responses to HIV/AIDS, Tuberculosis, Malaria and Other Related Infectious Diseases (ORID); and will adopt a set of actions to enhance the continent’s response and efforts towards reversing the impact of these diseases by ensuring universal access to services and strengthened health systems, especially for the poor and most marginalized people.

Wither AIDS, TB and Malaria: Snapshots of Africa’s Progress

By AIDS Watch Africa

Progress in responding to AIDS

The annual number of people newly infected with HIV in Africa has been reduced by 25% since 2001. From 2009 to 2012 new HIV infections among children have been reduced by 38% in the ‘Global Plan’ priority countries and access to treatment remains low for children––only 3 in 10 children in need of treatment have access in most of the ‘Global Plan’ priority countries. The number of people who died from AIDS-related causes was 32% lower in 2011 than in 2005.

Various countries are developing more robust, inclusive, results-focused national strategies and related investment cases. The Pharmaceutical Manufacturing Plan for Africa Business Plan, an African-wide framework for increasing pharmaceutical capacity, has been developed and approved and will be supported through a consortium that is now being set up.

AIDS Watch Africa, an advocacy platform for African Heads of State on AIDS, TB and Malaria set up in 2001, has been reinvigorated in the past year, as African leaders recognized the need for accelerated momentum towards meeting the targets of Millennium Development Goal 6 by 2015 and for leadership beyond to fulfil their commitments to the Roadmap. All Member States of the African Union are now members of AIDS Watch Africa.

Progress in reducing Malaria deaths and cases has been substantial

In the course of the last decade, the global effort to control and eliminate malaria expanded significantly. As a result of a scale-up of control interventions – including an expansion of access to long-lasting insecticidal nets, indoor residual spraying programmes, diagnostic testing and quality-assured treatment – more than a million lives have been saved. Malaria mortality rates decreased by 33% in Africa between 2000 and 2010. What Africa will need to do- maintain high-levels of coverage with malaria interventions, strengthen malaria surveillance and response systems, prevent drug and insecticide resistance and engage sectors outside of health.

We are at a critical time in the fight against TB

In the last 13 years, critical progress has been made in the development of new tools, and in identifying the right approaches to fight the disease. TB is curable and can be defeated, but there are three challenges that underpin the TB emergency. The emergence of drug-resistant TB, which can cost up to 100 times more to treat in comparison to drug-sensitive TB, makes timely investments more critical. Domestic financing for TB in Africa is low. On average, African governments contribute 30% of their national TB budgets, whereas in the rest of the world governments contribute 70% on average . This makes many African governments highly dependent on external financing – and extremely vulnerable to any international aid fluctuations. 88% of external donor financing for TB is from one source: the Global Fund. This provides US$ 440 million each year for the fight against TB globally. However, most of this money is not going into Africa. For every $100 going to Sub-Saharan Africa from the Global Fund, only 6% is for TB. This small amount still represents half of Africa’s available TB funding (54%). Much greater ambition is needed in terms of providing diagnosis and access to treatment for all TB patients in most African countries. It is time for an emergency response. This need for scale-up should be reflected in ambitious national strategic plans, aiming at universal coverage and zero-TB related deaths.

Health Financing

Member states of the African Union are on average still far from meeting key health financing targets of the Abuja Declaration. In 2010, only 5 countries reached the target of allocating at least 15% of their annual budget to health. Twenty eight countries out of fifty spent the minimum of US$ 44 per capita as estimated by the High Level Task Force on Innovative Financing for Health Systems (HLTF).Only three countries in Africa reached the targets set in both the Abuja Declaration and the HLTF report. Out-of-pocket payments (OOP) still represent more than 20% of total health expenditure (THE) in 40 countries in Africa. A key challenge for member states and their partners is to ensure effective and efficient use of available international and domestic resources, improved predictability, alignment to national priorities and use of government mechanisms. The reinforced dialogue between Ministers of Health and Finance, as spelt out in the Tunis forum organized by Harmonization for Health in Africa in 2012, has shown increased engagement towards financing for health and improving the effectiveness of available resources.

Africa’s five priorities for AIDS, TB and Malaria 2014-2017-A Snapshot of AU’s Strategic Directions on AIDS, TB and Malaria

By AIDS Watch Africa

Global attention has focused much attention and resources on the big three– AIDs, Malaria and Tuberculosis which have been a major challenge in Africa. These three epidemics continue to claim millions of lives in Africa and represent a continuing global threat. Therefore Africa and its partners should commit to scaling up investments made in the responses to AIDS, TB and Malaria:

– More African countries should meet their Abuja commitment to allocate 15% of public expenditures to health, and most importantly, African countries should increase domestic investments and diversify funding sources, including through innovative financing.

– The G8 is called upon to allocate at least 0.7% of gross national income (GNI) to official development assistance.

-Emphasis will be placed on accelerating implementation of the Africa Health Strategy, the Abuja ―Call and the promotion and Result Delivery & Accountability on Universal Access to HIV/AIDS, TB, MNCH & Malaria services.

-Support will also be provided to enhance the training and capacity building in medical and health sciences.

-An important emphasis will be placed on advocacy towards Member States to increase national budget allocations to health, and to address the rising tide of chronic non-communicable diseases linked to urbanization and lifestyle changes.

Africa is moving -The Abuja Declarations, AIDS Watch Africa, The Global Fund, Stop TB Partnership, African Leaders’ Malaria Alliance, the Roll Back Malaria Partnership all point to strong political commitment.

A Critical Moment in African Health

By Mark Dybul

“Drop by drop, the pot hits the brim,” goes an African saying. The Abuja+12 Special Summit comes at a momentous time in our history. The call to take stock of Africa’s investments in health cannot be timelier. In today’s fight against AIDS, tuberculosis and malaria, every input will count immensely.

We are at a pivotal moment in the fight against these three diseases. Africa, especially sub-Saharan Africa, has been disproportionately affected by these diseases. Millions have died. With the loss of life and health, much else has been lost. The social fabric of many African societies has been torn, family incomes and country economies upset.

But the tide is turning. Today, data across the world tells us that the three diseases we fight against are in retreat. Fewer people are dying, fewer and fewer infections are occurring. In the art of war, when the enemy loses step, it is time to press forward. Forward fast and firmly.

At the Global Fund, we believe this is a transformative moment in the history of the fight against the diseases. The world has the tools and the knowledge to defeat these maladies. We need to raise enough money to implement these groundbreaking innovations.

This year, we are asking our donors for US$15 billion to enable us support the world to intensify the fight against these diseases over the 2014-2016 cycle. It is our assessment that such an investment will have a transformative effect in the incidence and death rates of HIV and AIDS, TB and malaria.

Nonetheless, this amount in itself will not be enough to free the world from the burden of these three diseases. To do that, we estimate a total global need of US$87 billion between 2014-2016. Money set aside by African and other governments around the world in their annual budgets will go a long way in helping us meet this target.

In April 2001, African leaders met in Abuja, Nigeria, and resolved to boost government spending in health to least 15 percent of their countries’ annual budgets. In a bid to spur collective investments from varied stakeholders, the leaders also urged economically advanced countries to meet the target of committing 0.7 percent of their GNP as Official Development Assistance to developing countries as provided for by the UN.

The Abuja Declaration, as it came to be known, was an unequivocal appeal for improved funding in the fight against infectious diseases such as AIDS, tuberculosis and malaria. That Abuja call has never been more resonant. While only a few countries have met this target, there has been remarkable progress in investing more in health in many countries across Africa.

Every extra dollar that has gone into investing in health as a result of that visionary act of leadership 12 years ago is an extra step towards defeating Africa’s infectious diseases. As African countries move forward along this trajectory of health investment and as we at the Global Fund seek to invest more in this cause, we are moving closer towards the common objective of reducing HIV, tuberculosis and malaria to low level epidemics.

Investing today will save millions of lives and tens of billions of dollars that the world would have to pay in future costs. If we do not invest now, the long-term costs will be staggering. We have a choice: we can invest now or pay forever.

As African countries meet once more in Abuja, this is a chance to renew our commitment towards these health investment goals. It is an important moment to press forward with that ambitious call at the cusp of the millennium in the Nigerian capital.

Along this journey, the Global Fund will continue to be a partner to Africa, a reliable friend as the continent seeks to achieve the milestone of controlling the three diseases and removing them as threats to public health.

As we work hard to galvanize support to fill the pot, we appreciate every contribution that African countries make towards investing in health in their own countries. It is all these types and sizes of support and efforts that will help us win the fight. Together, we can bequeath our children a world free from these diseases.

Recommitting to Investing in Malaria Control: The Final Lap to 2015

By President Armando Guebuza

As chair of ALMA Heads of State and Government, we commend the Chair of the African Union, the Prime Minister of Ethiopia, the President of Nigeria and the Chair of the African Union Commission for holding this Special Abuja +12 Summit at such an opportune time. Over the last decade since the first Abuja summit in 2000, we have registered dramatic increases in access to HIV, TB and Malaria control interventions. Malaria cases have fallen by more than 75% in 8 ALMA countries. Over this same time period, Malaria mortality rates have fallen by approximately one quarter, globally, and by more than a third in the WHO African Region.

As African heads of States and Government, we have closely monitored progress over the past 12 years.  Over the past three years, using the ALMA scorecard for accountability and action, we have tracked policy compliance, financing in-country as well as implementation of recommended interventions and their impact on malaria.   We acknowledge rapid gains in all these areas, and the excellent support from development partners that has been invaluable in our collective battle against the disease and its toll on our growth and development. We are concerned about the current reduction in funding and the resultant slow-down in scaling up of effective interventions, portending possible reversal of fragile gains in the fight against this silent killer disease. It is critical that we act decisively now to prevent malaria resurgence and deaths across the African continent.

The Global Fund to Fight AIDS, TB, and Malaria; a key funder of Malaria programmes in Africa, is currently seeking replenishment. ALMA and the Roll Back Malaria Partnership estimate the funding gap to achieve the 2015 malaria control targets as US$3.6 billion.  It is critically important that we in the African Union, use ALMA and the rest of our friends in the development fraternity, to work together to mobilise these resources.  Our continent bears the burden of 90% of all Malaria deaths worldwide – the vast majority being in children younger than five years of age. These children and their families must be protected, to release the level of learning and earning potential that will deliver the high economic levels our economies need.

Twelve years ago African heads of state and government pledged to increase government funding for health. Many of us still have to deliver on that commitment.  Today, we must seek not only to increase public sector budget allocations to health, but also invite our expanding vibrant private sector to co-fund health with us, together with our external development partners; through the different traditional and innovative financing mechanisms. At the same time, let us ensure that we use existing and new resources effectively and efficiently to enable us to reach our goal of not only controlling but eliminating Malaria from our continent. Getting more health for the money is critical for sustainability and holds us accountable for results.

It is imperative that we finish this fight together. Even as we recommit our own resources, and implement innovative financing mechanisms; we call upon our global friends to replenish the coffers of The Global Fund to Fight AIDS, TB and Malaria, the biggest funder for the African Union’s ALMA member states in the fight against these three diseases.

 Africa’s time is now, and our people can no longer afford to wait for health, well-being and sustainable development.

 His Excellency President Armando Guebuza is the President of the Republic of Mozambique, Chair, African Leaders Malaria Alliance, (ALMA), Chair, Southern Africa Development Community (SADC), Chair, Community of Portuguese Language  Countries and Vice –Chair, AIDS Watch Africa (AWA).

The road to Abuja +12: Africa is moving

By Dr. Mustapha Sidiki Kaloko*

As Africa’s leaders assemble in Abuja for a Special Summit on AIDS, TB and Malaria (Abuja+12) there is a lot of progress to celebrate and there are good things to come and greater hurdles ahead to overcome. The African Union Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria (2012-2015) heralds sustained efforts to end the three diseases. With astute and farsighted leadership in Africa the roadmap    consolidates the progress that the countries have made in the past twelve years since the 2000 Abuja Declaration and charts the way forward to achieve the set targets.

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.

The political will is unquestionable, AIDS, TB and Malaria have remained high on our political agenda with several commitments to address the challenge in 2000 and 2001 (Abuja Declaration), 2006 (Abuja Call) and 2010 (Kampala Declaration). Over the past twelve years, AIDS Watch Africa has served as an African-led advocacy, accountability and resource mobilisation platform to press for the urgent acceleration of continental action to combat AIDS with a broadened mandate in 2012 to also address TB and Malaria.

The results[i] are encouraging, the annual number of people newly infected with HIV in Africa has been reduced by 25% since 2001, the number of children acquiring HIV infection has declined by 24% between 2009 and 2011 and the number of people who died from AIDS-related causes was 32% lower in 2011 than in 2005. Since 2001, nearly 13 million people in Africa have been reached with TB treatment. There are also encouraging signs in the effort to prevent new cases of malaria: the burden of malaria in Africa is down by one third, and eight countries have already achieved the targeted reduction of 75% in the incidence of malaria since 2000.

However, although 29 countries have reached the level of US$ 44 total health expenditure per capita, 22 of these have out of pocket payments exceeding 20% of total health expenditure. This level is higher than the ceiling at which financial risk protection can be ensured. Countries that have reached the US$ 44 per capita but have a high level of out of pocket payments still need to focus on developing and strengthening pooled prepayment mechanisms.

 While domestic investments for health continue to increase substantially it’s not yet time for Africa to stand on its own. International investments, which have remained stable in recent years, must be sustained and increased. There is need for new and diversified sources of international investments especially from countries with emerging economies. The potential to identify new sources of tax can also be further explored and various countries have already started along this path. Possible innovative financing tools include airline ticket levies and financial transaction taxes; private sector financing through bonds; pooled or bulk procurement.

The AUC, Regional Economic Communities, AU Member States and development partners have already risen to the challenge of leading the changes needed to see the vision of the AU Roadmap made a reality. Countries have developed more robust, results focused national strategies and related investment cases. AU member states continue to streamline disease coordination and governance to make best use of limited national human and financial resources.

To accelerate progress in achieving the Abuja commitments the African Union will continue to work with Member States to encourage them to develop financial investment plans for health, especially AIDS, TB and Malaria. Furthermore there is need to  ensure that the AUC’s Pharmaceutical Manufacturing Plan for Africa (PMPA) Business Plan Consortium is fully functional and resourced to work with Heads of States and Government to champion the African Union Roadmap at the national, continental and global levels.

However, the fight against the three deadly diseases will remain an unfinished business in 2015. HIV/AIDS, TB and Malaria control should remain a high priority in the post-2015 agenda, together with efforts to strengthen maternal and child health services and expand community health worker programmes. A strong focus on health systems strengthening is also key to making visible progress against these diseases. Coordinated action through regional inter-governmental mechanisms by the African Union and RECS, will be critical for fostering national support for strong multisectoral collaboration. Sustained political commitment and an effective global partnership will be fundamental to future progress.

*H.E Mustapha Sidiki Kaloko is the Commissioner of Social Affairs of the African Union Commission

[i] African Union Roadmap: Progress in the First Year, African Union Commission and UNAIDS 2013 Report

Source: http://globalhealth.thelancet.com/2013/07/04/road-abuja-12-africa-moving