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