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HEALTH-AFRICA: Beef up Budget Allocations to Achieve MDGs

Moyiga Nduru

JOHANNESBURG, Apr 12 2007 (IPS) - African states should put in place sufficient budget allocations and the right policies if the continent is to meet the global and regional health care targets that governments have committed themselves to, say campaigners.

In 2000 African states, along with most of the world, agreed to meet the United Nations’ Millennium Development Goals (MDGs) by 2015. African heads of state also committed their countries to improving health care across the continent by 2010 at a meeting in Abuja, Nigeria, in 2001.

Of the eight MDGs, three relate directly to health. One calls for reducing child mortality, the other for improving maternal health and the last one is aimed at combating HIV/AIDS and malaria. Campaigners are concerned that the majority of African nations will not achieve these MDGs.

Therefore, representatives from 143 member organisations of the African Civil Society Coalition on HIV/AIDS and Allies came together in Johannesburg, South Africa, this week (Apr 9-13) to lobby African health ministers who were meeting at the same time to draft the Africa Health Strategy 2007-2015.

The coalition urged African governments to allocate 15 percent of national budgets to health care, as per the Abuja commitment of 2001. It also urged governments to engage civil society and line ministries in mobilising resources for tuberculosis (TB).

Member states should work towards closing the TB funding gap of nearly 11 billion US dollars over the next decade, the coalition demanded. It organised a demonstration on 11 April. About 1,000 people participated.

‘‘Eight million Africans are dying from HIV/AIDS, TB and malaria every year. We want to stop this,” Regis Mtutu of the Treatment Action Campaign (TAC) told IPS in an interview. TAC is a pressure group based in Cape Town, South Africa, which seeks access to drugs for people living with HIV/AIDS.

‘‘We cannot meet the MDGs at this pace. We need to double up our efforts through some extraordinary work, particularly in the areas of HIV/AIDS, TB and malaria,” said Mtutu.

Regarding the commitment to put aside 15 percent of national budgets for health services, ‘‘only Botswana and The Gambia have met this promise”, Mtutu said.

Following the demonstration in Johannesburg, the coalition presented its petition to the African Union (AU) commission for health. ‘‘We hope that they will listen to us. We are not fighting them. We are sending our message robustly,” Mtutu said.

Part of the African health ministers’ discussions included a plan to set up pharmaceutical plants for producing life-prolonging anti-retroviral drugs (ARVs). Mtutu pointed out that ‘‘the ministers for finance and industry were not part of the discussion. To succeed, the health ministers need mandates from their finance and industry counterparts.

‘‘If we are to achieve the MDGs, the key ministerial clusters need to meet in the next six to 12 months,” Mtutu said.

Some campaigners say meeting the health MDGs cuts across other areas such as combating poverty, improving sanitation and infrastructure. Eve Edete, policy officer at Oxfam Kenya office, told IPS that ‘‘‘MDGs’ is just a label. It is a brand.

‘‘HIV/AIDS, TB, malaria and other diseases are really the issue. It is about systems to deliver health care. This should be the starting point to meeting the MDGs,” said Edete.

Although governments have committed themselves to the MDGs and the Abuja target, some prefer to move at their own pace. Kenya’s government, for example, says it will commit 12 percent of its national budget to health by 2008, according to Ruth Charo of Kenya’s Health Nongovernmental Organizations Network based in the capital Nairobi.

‘‘It should be a step-by-step approach. Each country has its own strategy. If you set a time frame it might not work. For example, you cannot expect (strife-torn) countries like Somalia, Zimbabwe and the Democratic Republic of Congo to reach the 15 percent target. It is not practical,” she told IPS.

The coalition said in a statement that ‘‘the political and economic crisis in Zimbabwe deserves special mention as it is also a health crisis for Africa. People living with HIV/AIDS in Zimbabwe cannot obtain the care they need and the climate of violence is perpetuating the epidemics of HIV and TB.

‘‘The shockwaves from the crisis in Zimbabwe are reverberating throughout the continent as refugees seek health care and other services in neighbouring countries. Our health ministers must speak out on Zimbabwe on health and humanitarian grounds,” the coalition argued.

Civil society groups put the number of Zimbabweans who have fled their country since the crisis began in 2000 to 5 million, with 2.5 million of them believed to be living in South Africa. Others have fled to Botswana, Zambia, Namibia, Britain and the United States.

In a new report, ‘‘Paying for People”, published this month (April), Oxfam estimates that 13.7 billion US dollars must be invested every year to appoint an additional 1 million teachers and 2.1 million health care workers urgently needed to break the cycle of poverty in Africa.

Oxfam is an international charity which is part of the coalition which lobbied African health ministers in Johannesburg,

‘‘Today in too many of the world’s poorest countries health and education services are dependent on a handful of workers struggling heroically to do their jobs on pitiful wages and in appalling conditions. Becoming a doctor, nurse or teacher is like signing a contract with poverty,” Oxfam’s Elizabeth Stuart wrote in the report.

According to the report, ‘‘Africa has 13 percent of the global population and 25 percent of the global burden of disease but only 1.3 percent of the global workforce.”

The report cites Tanzania as an example. This southern African country produces 640 doctors, nurses and midwives each year. But to reach the World Health Organisation’s recommended staffing levels within 10 years it would need to produce 3,500 such health workers each year.

Another example is Malawi where only nine percent of health facilities have adequate staff to provide basic health care. The country loses around 100 nurses each year ‘‘who emigrate in search of a better wage”, according to the Oxfam report.

Charo told IPS that Kenyan health workers are not only moving overseas but are also seeking opportunities in the private sector for better pay. ‘‘If you work for government, you get 12,000 Kenya shillings (about 172 US dollars) but in the NGO or private sector you earn 40,000 shillings (nearly 572 US dollars) a month. People are tempted to move on.”

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