Abuja Declarations Ten Years On: Outstanding Challenges to Improving the Health of People in Africa
May 11, 2010
Dr. Luis Gomes Sambo, Regional Director for Africa of the World Health Organization, offered a progress report Friday on the Abuja Declarations on health, signed ten years ago by African heads of state. The declarations promised a continent-wide response to malaria, HIV/AIDS and tuberculosis, committed to increased domestic expenditures on health, and called for additional international partnerships. The ten-year anniversary comes at time when the United States is looking to African governments and leaders to take an increasing role in setting national health priorities and ensuring the sustainability of public health approaches.
The first Abuja Declaration, signed on April 25, 2000, committed African heads of state to halve malaria deaths by 2010, provide financial resources and incentives to access goods and services, and support malaria research. April 25 was declared African Malaria Day (in 2007, President Bush declared this Malaria Awareness Day). The second Abuja Declaration, signed April 24, 2001, committed African heads of state to allocate 15 percent of their national budgets to health as well as mobilize resources for improved access to HIV medications, vaccine research, and prevention programs.
Despite considerable progress in malaria prevention and HIV treatment, Dr. Sambo said that several challenges remained. Ten years after the first declaration, one-half of at-risk children and pregnant women do not sleep under insecticide treated bed nets, 88 percent of suspected malaria cases are not confirmed by a laboratory test (leading to possible misdiagnoses and incorrect treatment), and 75 percent of those suffering from malaria do not have access to anti-malarial drugs. For HIV, new infections are outstripping the expansion of access to treatment. HIV prevention programs are failing to adequately reach young people, and 55 percent of HIV-positive pregnant women do not receive the simple intervention that can prevent the transmission of HIV to their babies. On top of this, drug resistance is becoming a growing problem for both malaria and HIV treatment regimens.
Narrowing the funding gap and expanding the reach of health programs was s the core theme of Dr. Sambo’s talk. Only half of the estimated $38 billion in funding is currently available, and both infectious diseases such as HIV, tuberculosis and malaria, and the emerging challenges of non-communicable diseases (diabetes, hypertension, for example) and health systems strengthening are competing for inadequate resources. Addressing upstream determinants of health such as poverty and education, building in-country capacity, and strengthening preparedness for disasters are essential elements of a sustainable health strategy. In the next five years leading up to the Millennium Development Goals’ deadline, Dr. Sambo emphasized a renewed emphasis on the following goals:
- Strengthening partnerships and harmonization
- Supporting health systems strengthening
- Putting the health of mothers and children first
- Supporting accelerated actions on HIV/AIDS, Malaria & TB
- Intensifying the prevention and control of neglected tropical diseases, non-communicable diseases and epidemics
- Accelerating the response to broader health determinants
During the question and answer portion of his talk, Dr. Sambo urged increased communication between Ministries of Health and Finance. The WHO and the Economic Committee for Africa are discussing this and other financial incentives at the next meeting of the Harmonization for Health in Africa (HHA). The HHA, part of the International Health Partnership (IHP+), is a mechanism to reduce funding bottlenecks and align country processes for health budgets. Ultimately, the brain drain of health personnel—from rural to urban areas, public to private sector, poor to wealthier countries, and from the health field to more lucrative sectors—could be the deciding factor for many of these countries. Without a sizable work force of doctors, nurses, pharmacists, public health professionals and community health workers, sustained progress may be untenable. The WHO/AFRO Human Resources for Health Programme will be convening in soon to discuss national and regional action plans on this issue.
To view the entire presentation, please click here
For a brief interview with Dr. Sambo, please visit the CSIS Africa Program
To listen to the event, including questions and answers, please click here
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