Future of health financing in Africa

Yvonne Chaka Chaka discusses the future of health financing in Africa with specific references to Nigeria — drawing on her experience as a United Nation (UN) ambassador and experiences at FFD last week. Yvonne’s is the President, Princess of Africa Foundation; UNICEF & Roll Back Malaria Goodwill Ambassador; partner of the ACTION global health advocacy partnership. 

During my travels across Africa as a United Nations ambassador, I have been deeply affected by fellow mothers. I have listened to strong and inspiring women tell stories of elation when a child survived a treatable disease like tuberculosis or malaria. I have also heard devastating stories of loss when a precious child succumbed to a preventable disease like pneumonia.

These women have inspired my continued commitment to one vision for the future of our continent: An Africa where all can access health care; an Africa where all can lead healthy lives and fulfill their potential. So I was thankful that last month’s African Union (AU) Summit in my home country of South Africa focused on women and development, and ended with a strong reaffirmation of leaders’ commitment to health. But these words have been said before, and they must be paired with action.

Yes, Africa has made great progress on health since the creation of the Millennium Development Goals (MDGs) in 2000. Nigeria, for instance, has drastically reduced hunger levels and is making progress to reduce maternal and child deaths, although more is needed.

Progress made has not been distributed equitably, and many of our continent’s most poor and vulnerable people still cannot access essential health services.

According to UNICEF, the gap between child mortality rates among the poorest and wealthiest households has narrowed in all regions except sub-Saharan Africa. A recent report from RESULTS UK, the Kenya AIDS NGOs Consortium, and the World AIDS Campaign International argues that an increase in domestic resources for health, as well as additional donor funding, are needed to ensure progress on health is felt by everyone.

So donors and governments now have a choice to make: Will we stay on the current path where only some benefit from progress, or will we take action to strongly support community health systems for all? Last week, I was at the 3rd United Nations Financing for Development Conference in Addis Ababa, Ethiopia.

There, the global community made plans to fund the next phase of the global development agenda started by the MDGs. As I left this meeting one thing was very clear in my mind — to finance the future of our continent, we want not just commitments but also sustainable and costed plans with timelines and deliverables to make these commitments a reality for all Africans.

Firstly, international donors must renew and strengthen their commitment to support health programming and financing. Continued donor investment – through government-to-government partnerships and life-saving global mechanisms like the Global Fund to Fight AIDS, Tuberculosis and Malaria, Gavi, the Vaccines Alliance, and the Global Financing Facility in Support of Every Woman and Every Child – remain critical.

Donors: Your investments up until now have clearly paid off – please don’t abandon this unique opportunity we have to finish the job.

We must continue preventing and treating deadly diseases like TB, malaria, and pneumonia, while also investing in strong and equitable health systems.

But while donor assistance has helped increased access to health services for many, it cannot deliver sustainable development on its own – African governments must play a leadership role on health. To Africa’s leaders: With democratic election comes great responsibility to improve the lives of your people.

In line with the promise of the 2001 Abuja Declaration, you must adequately fund your health system, by both stepping up domestic investments and also increasing per capita expenditure on health. Nigerian President Muhammadu Buhari is scheduled to meet U.S. President Barack Obama shortly.

President Obama has devoted much effort to improving health access in the United States, so I hope the two will discuss the continued strengthening of health systems in Nigeria, Africa, and the world.

A small number of countries like Nigeria, Central African Republic, Ethiopia, Malawi, Rwanda, and Swaziland should be congratulated for meeting this agreed-upon target; but the vast majority of African countries have not.

The strong and inspiring women I have met on my travels deserve creative leaders committed to finding solutions. In addition to raising the priority of health within national budgets, leaders can promote other tactics such as innovative financing, and the strengthening of national social health insurance programs to ensure everyone can access health care.

All African people deserve the chance to live a healthy life, and see their children, families, and communities not only survive, but thrive.

Donors, governments, and experts must not forget them. It’s time to build the Africa we want — a just Africa with health for all.