Africa needs to rely less on donors and pump more money into its public health systems, Botswana’s Health Minister said in Johannesburg on Tuesday. ”We are trying to get Africa not to rely heavily on donors. We must devote at least 15% of our budget to health. A few of us have done that,” said Professor Sheila Tlou.
She was briefing journalists following the opening of the third ordinary session of the African Union Conference of Ministers of Health.
The chairperson of the African Union’s commission, Professor Alpha Konare, said African countries have to make sure they get better prices for their raw materials, stop the ”ruinous wars” that prevent health strategies from being carried out, and stop money from flowing out of the continent illegally.
The gathering, held once every two years, aims to develop an integrated health strategy for Africa.
”I’m convinced that if we can better harmonise our programmes, we can save money,” Konare said.
If no policy changes are made, Africa’s health will be in a decade where it is at present. ”Last year we made new commitments to make resources available, but when I look at the tools being implemented, I see no positive developments,” he said.
The commissioner for social affairs of the AU, Bience Gawanas, said that on average between 3% and 10% of government spending in AU countries goes towards health. In 2001, a commitment was made that this be at least 15%, she said.
A pharmaceutical manufacturing plan is one of the conference’s agenda items. Most of the AU’s 53 member states are ”heavily dependent” on imported medicine.
Gawanas said the plan emerged from the belief that Africa has the capacity to produce both the required quality and quantity of drugs. ”I’m very confident that we are moving closer to a more collective approach to the issues.”
South Africa’s acting health minister, Jeff Radebe, said he thinks it is possible for Africa to manufacture its own medicines. He called for uniform policies and standards as well as standardised institutional arrangements for drug distribution.
On Africa’s continuing malaria problem, he believes a ”concerted effort” can eradicate it. The World Health Organisation has noted that South Africa’s use of the controversial pesticide DDT ”could go a long way” towards eradicating the problem, said Radebe.
Other programmes the conference will be asked to approve included ways of dealing with tuberculosis, traditional medicines, violence, and the scarcity and exodus of health workers.
According to a Global Burden of Disease report, road-traffic accidents are the eighth leading contributor to the burden of disease in sub-Saharan Africa, and the third in North Africa.
The staffing of Africa’s health systems has hit crisis levels. Just 3% of the world’s health work force is in Africa, while the continent suffers from 25% of the world’s burden of disease.
On the margin of the conference, civil society groups said the eight-year African health strategy under consideration lacks clear targets.
”We note with dismay that the document has little direct reference to the clear and ambitious targets which were already defined in the Brazzaville, Abuja and Maputo declarations [in 2006],” said Regis Mtutu, of the Treatment Action Campaign.
In a statement signed by 53 NGOs and civil society groups, they demand that African leaders prioritise implementing the Plan for Achieving Universal Access to HIV/Aids, Tuberculosis and Malaria, 2007-2010. They acknowledge that it is detailed and well thought out, and cuts across all agenda items.
Since the 2001 Abuja declaration, only Botswana and The Gambia have fulfilled the commitment that 15% of government spending go towards health. It was also recommended that at least 2% of national health budgets be spent on community participation and empowerment.
Miano Munene, of the Kenyan Human Rights Commission, said the strategy does not cover diseases that arise during cross-border conflicts in countries such as Somalia and Ethiopia.
A representative from Nigerian’s Youth Network on HIV/Aids said more than 90% of funding for anti-Aids campaigns comes from foreign governments and NGOs.
”What are African governments doing with their own resources? They need to look for ways to finance the fight against the HIV/Aids pandemic,” said Azubike Nwokoye.
Gcebile Ndlovu, from a Swaziland-based NGO supporting women with HIV/Aids, said the health ministers’ meeting should acknowledge that the biggest HIV/Aids burden in Africa is borne by women and that they are particularly vulnerable to the disease in conflict-ridden areas.
The Treatment Action Campaign’s Mtutu made no apologies for singling out Zimbabwe. ”It seems to be getting worse both politically and economically and we see this as a health crisis,” he said. — Sapa