Tunis Report: African Governments Must Invest In Health

Healthcare

VENTURES AFRICA – African governments have been urged to improve their investment on health.

According to the Coordinator of the Africa Public Health Alliance 15% Plus Campaign, Rotimi Sankore; health budget in Africa is lower than that of other continent.

“The gap in health investment between industrialised and developing countries is currently too wide. Average percentage allocation of budget to health in Africa region is only 9.6 percent – but a much higher 16.9 percent in America; 14.6 percent in Europe; and 14.4 percent in Western Pacific,” Sankore explained.

He said this in his presentation to the Joint conference of Finance and Health Ministers while presenting both the New 2012 Health Financing and Health MDGs Scorecard; and Africa’s first Multi Year Health Financing Trends Analysis.

Sankore who is also the Secretary of Africa Public Health Parliamentary Network, stated that average per capita investment in the Africa region is as low as $41; but a much higher regional average of $1,566 in America; and $1,677 in Europe.

Individually, many countries in these regions invest between $3,000 and $6,000 per capita, while many African countries invest between $3 and $20.

“These figures suggest that human life has more value in other parts of the world,” Sankore declared.

He further stated that “The consequent difference in average life expectancy in Africa region of 54 years, compared to 76 years in Americas, 75 years in Europe and 75 years in Western Pacific, shows that this special joint conference of Finance and Health Ministers and necessary follow up action is long overdue – especially now that experts estimate that an extra year of life expectancy in countries could translate to as much as a 4% growth in GDP.”

Meanwhile, Equatorial Guinea and Botswana with $612 and $442 respectively – are Africa’s highest investors in health on a per capita basis.

Comparing Costa Rica ($449) and Cuba ($623) who has similar investment per capita to Botswana ($442) and Equatorial Guinea ($612); Sankore attested that although they both have similar per capita income, Costa Rica and Cuba have more efficient outcomes due to better investment in critical non-health sectors and social determinants of health including: education and retention of health workforce, higher coverage clean water, sanitation, hygiene and nutrition, more equitable distribution of health services, and preventive action on vaccines coverage.

He argued that the case is not of more industrialised nations outspending less industrialised.

Sankore however emphasised that, “Investment in health should be the top priority of every African government. Nothing can be more important than the health of people. Without people there is no society, no economy, (and) no markets. The evidence is clear that 11 years on – Africa needs to improve and refine the Abuja 2001 commitments on health financing if governments are to have a more positive impact on the lives of Africans, especially the poor, disadvantaged and marginalised.”

Suggesting likely solution to the indented gap in Africa health investment; the Africa Public Health Alliance 15% Plus Campaign Coordinator acknowledged that high level inter-governmental and development partners’ coordination on Health Financing policy across Africa is one of the most important preconditions for progress on health and related development goals.

While linking health financing to the Post MDG Agenda, Sankore pointed out gaps in the MDGs that must be improved in shaping a new development paradigm. He explained that although targets were set for MDGs; no targets were set for preconditions to meet those targets.

“Most African countries are operating with only 30 percent to 65 percent of capacity for Human Resources for Health – but no improved education and working conditions targets were set for training and retention of health workers.”

“We must identify the actual number of extra training institutions, and trainers required in each country, and the level of investment required over specific number of years for thee gaps to be bridged, “Sankore said.
He posited that while brain drain is a problem, the real problem is that there is a huge human capacity gap across a range of areas including health, but there is no accompanying human resources development plan”.

“In setting our development priorities, we must also not forget the millions of refuges and internally displaced persons – 13 million in the Horn and East Africa alone – the forgotten of the forgotten – whom more or less constitute the continents 55th country, but with no government to cater for them.”

He therefore call on the AUC, UNECA, Conference host AfDB with partner HHA agencies to join in an urgent collaboration for a working conference of leaderships of key sectors that impact on quality of life to define the African Post MDG Agenda.

These sectors include Finance, Planning and Economic Development; Social Development; Health, with Sanitation and Hygiene; Education; Population, Civil Registration and Statistics; Youth; Women and Gender; Agriculture, Food Security and Nutrition; Water Resources; Trade, Industry and Manufacturing; Power generation.

Meanwhile, African Finance and Health minister have agreed on a strategy to promote value for Money, Accountability and Sustainability in the Health Sector.

The minister made this decision at a recent meeting in Tunis which had in attendance parliamentarians, civil society, bilateral and multilateral partners.

These steps include:
• Intensifying dialogue and collaboration between Finance and Health Ministries and with technical and financial partners;
• Taking concrete measures in countries to enhance value for money, sustainability and accountability in the health sector for reaching the objective of universal health coverage, accelerating progress towards the Health Millennium Development Goals, and other internationally agreed development targets by 2015 and beyond;

• Effective integration of socio-economic, demographic and health factors into broader development strategies and policies;

• Effective investment in the health sector based on evidence led strategies and high impact interventions;

• Promoting equitable investment in the health sector ensuring health financing is pro-poor and benefiting disadvantaged areas; strengthening regulatory capacity and development of a strong African pharmaceutical sector as a growth and job-creating sector in Africa;

• Laying a path to Universal Health Coverage in each country, including social health insurance, and effective safety nets to protect vulnerable individuals, households and communities;

• Improved efficiency in health systems, and equitable access to skilled health workers;

• Solidifying sustainable health financing systems that build on and coordinate a diversity of sources, including predictability of external resources to ensure all have access to quality essential health services;

• Strengthening accountability mechanisms to ensure the highest possible level of results for money spent. And most importantly;

• Increase domestic resources for health through improved revenue collection and allocation, reprioritisation where relevant, and innovative financing – including giving priority to immunisations, non-communicable diseases, AIDS, Tuberculosis and Malaria, as well as reproductive, maternal, newborn and child health.”