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Crafting an African victory for healthcare
July 16, 2017, 1:34 pm

With former Ethiopian Health Minister Dr. Tedros Ghebreyesus now heading the World Health Organization (WHO) as its Director-General, it is time for African countries to renew their commitment to healthcare and ensure effective funding for medical institutions and services in their countries.

In less than a month since being elected as the new Director-General, Dr. Tedros has drawn up a list of things that he would like to see the global health organization implement. They include, WHO working with governments to build national capacities for universal health coverage through strong and resilient health systems; strengthening the response by WHO to global disease outbreaks; and harmonizing emergency responses between WHO and its partners while bolstering frontline defenses at national and local levels.

The priorities make sense, especially in Africa where countries are often ill-prepared to deal with disease outbreaks, even though the continent is home to many emerging and re-emerging diseases such as Ebola, Yellow Fever and meningitis.

To help the new Director-General achieve his outlined objectives, African leaders can begin by reviving their commitment to the African Union’s (AU) 2001 Abuja Declaration, which resolved to increase healthcare budgets to at least 15 percent of each AU member’s annual budget.

However, over the last 16 years, while African governments have indeed improved their spending on healthcare, only a handful have achieved and consistently maintained their declared annual health allocations.

A survey prepared by the AU in 2010 found that of its 55 member states, only six, Botswana, Burkina Faso, Malawi, Niger, Rwanda and Zambia, had met the 15 percent benchmark. A more comprehensive report by the WHO in the same year found that only one African country, Tanzania, had reached the 15 percent mark, although 26 others had increased their spending on health. Regrettably, the WHO report also showed that 11 countries had in fact reduced spending on health.

On a more optimistic note, a new assessment by WHO in 2016 revealed that since 2000 most African governments have indeed increased their proportion of total public expenditure allocated to health. The average level of per capita public spending on health nearly doubled from about US$70 in the early 2000s to more than US$160 in 2014. It is worth observing that during the same period, the per capita expenditure on health across the world rose from $461 to $1,060 annually, while countries in the European Union spent up to $3,612 per capita and the US spent $8,990 per year on providing healthcare to its citizens.

The inequality in global healthcare spending aside, health financing in Africa faces several persisting challenges. These include reduction in healthcare spending by governments, misallocation of funds, inconsistent funding and bad financial management. Studies have shown that or every $100 in governments’ budgets, only $16 is allocated to health and less than $4 goes to the correct health services. Poor financial management of public health funds have often led to under-spending, which compromises the government’s capacity to sustain long-term progress; hampers effective planning; and undermines efforts to provide the same level of health services throughout a country.

Africa cannot continue to depend on global donor funding to maintain its health services. Currently, external aid makes up 24 percent of the health spend of governments on the continent. But this funding can be unpredictable and are subject to the vagaries of politics in donor nations. Moreover, donor priorities also may not always tally with the pressing health problems faced by African countries, and finally, without proper accountability and transparency, a large chunk of donor funds often get sucked up in a vortex of corruption and misapplication

It is clear that to realize the Director-General’s ambitious plans for improving health care on the continent, African governments can and need to do more on their own.

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