Do African leaders finance health as set in the Abuja Declaration?

The Abuja Declaration that was adopted in April 2001 by African leaders declared that the response to HIV/AIDS, TB and other related infections would become the highest
priority in their national development plans.

Leaders committed themselves to take all necessary measures to ensure that the needed resources were made available from all sources, and that they are efficiently and effectively utilized. This pledge was made to target the allocation of at least 15 per cent of their annual budget to the improvement of the health sector and to mobilize all the human, material and financial resources required to provide care, support and quality treatment to their populations living with HIV,TB and other related infections.

Now 10 years down the road few countries have achieved this target with the regional average remaining at 7 per cent and even then this is largely influenced by international donor funding not domestic resources.

In June 2011 at the UN High Level Meeting world leaders recommitted to this target –committing to the achievement of Universal Access, Zero discrimination, Zero new infections, and Zero deaths and the achievements of all the MDGs.

Due to the global financial crisis, many government donor agencies and international donors are reviewing their financial commitment to funding health and HIV on the African continent.   

So Africa where is the money for HIV/AIDS?  Many donors are in doubt whether African leaders have actually committed themselves to the Declaration. At ICASA the conference highlighted African leaders past efforts and future responsibilities to own, scale up and sustain the HIV response, in light of global financial crisis and despite current global funding concerns.

“Domestic funding is very important, but African leaders have channelled the resources for health to other issues like politics. The Global Fund has invested in African communities, helping people on treatment  but these funds are now being diverted so  Heads of State should think about how to fulfil the requirements of the Abuja Declaration,” says Alice Kayongo from AVAC fellowship Alliance.

According to UNAIDS Director, Dr Meskerem Grunitzky Beleke, this is a wake up call and we need to ‘review our priorities, transfer capacity and competence to Africans’.

According to civil society organizations in many countries this has not been achieved. In Uganda the government has not put much effort into health, with only 8 per cent of the annual budget allocated. “Many issues come up focusing on politics, that’s why many health centers in  the country have faced problems of drug shortages, no equipment, few facilities and health workers who are not motivated, that’s why you hear many women die in labour wards,” says Apophia Agiresaasi  from Health Human Rights.

Botswana has reached the 15 per cent as set out in the Abuja Declaration; they reached and have cut down HIV/AIDS prevalence in the country. Gambia has also done enough for HIV and has reached the 15 per cent.

But according to health activist and Director for International HIV/AIDS Alliance Uganda, Leonard Okello many countries in East Africa have been dropping their contribution to health instead of increasing, the highest allocation rotates around 12 per cent.

“In Uganda according to the Ministry of Health, the proposed budget for the financial year 2011-2012 presents a shortfall of 18 billion Ugandan shillings for primary healthcare staff wages. A health centre III is on average allocated UGX 450,000 per month to deliver a range of services, such as maternal health including emergency obstetric care and outreach to the community. This amount is too low to cause any meaningful change in maternal and child health outcomes. There’s a shortfall of 4 billion for this area.

“Even the little they have, has not been invested in health centers. People must fall sick to get healthcare, the regional referral hospitals are shocking with large numbers of patients,” he adds.  

Towards the end of 2011, the Global Fund cancelled Round 11 due to a lack of funds up to 2014. African governments must show accountability for resources and fund HIV/AIDS.


  • comment-avatar
    barya abrahm 4 years

    quit very sad for the case of our health systems from health centres up to national referal hospital the situation is alarming hw can ahealth centre iii be alocated 450000 shillings for the whole month oprations surely do think there is any service offered at these centres come on uganda.