Memorandum: Health is Wealth

Posted by ARASA on May 6, 2010


Thu, 2010-05-06 18:33

5 May 2010

Memorandum from Participants at the African Civil Society Advocacy Forum to attendees of the World Economic Forum in Dar Es Salaam, Tanzania, from 5 – 7 May 2010:

Noting that:

1. World Leaders, in the Millenium Development Goals, recognized health as a critical pre-requisite for human development and as such made pledges to targets on HIV, TB, Malaria and reducing maternal and infant mortality – progress towards most of which is off track due to lack of resources;
2. African states pledged in several charters to recognize the right to the highest attainable standard of health by all citizens;
3. Sub-Saharan Africa, despite having more than 25% of the global disease burden, is home to less than 3% of global health expenditure;
4. African heads of state, in the Abuja Declaration of 2001, stated that HIV, TB and other infectious diseases:


“constitute not only a major health crisis, but also …the greatest global threat to the survival and life expectancy of African peoples, [and] a devastating economic burden, through the loss of human capital, reduced productivity...”

5. These leaders further committed to placing the fight against these diseases as the highest priority issue in their national development plans until 2025, and agreed upon a target of allocating at least 15% of their annual budgets to the improvement of the health sector;

6. Only a handful of countries have achieved this target, with the regional average remaining at 7%; and African finance ministers at their meeting in March 2010 reportedly dismissed it as a “colossal mistake”;

7. Many African countries have not respected their pledge to make HIV, TB and other diseases the highest priority in their national development plans, and are still overwhelmingly dependent on external funding – most notably the Global Fund to fight AIDS, TB and Malaria and the US government’s Presidential Emergency Plan for AIDS Relief (PEPFAR) – for financing their HIV programs;

8. A double standard exists between the developed and developing world – for example, HIV in children has been almost eliminated in the developed world, and 90% of the world’s paediatric HIV is in sub-Saharan Africa;

9. Since the establishment of the Global Fund in 2001 and PEPFAR in 2005, extraordinary progress has been made in the fight against HIV, TB and Malaria, which has saved more than 10 million lives;

10. Short-term monetary and political interests, rather than long-term scientific and economic evidence and people’s needs, are driving a global retreat from universal. Despite world leaders committing to universal access by 2010, threats to funding cutbacks have dominated current discourse amongst major donors, although we are less than halfway to the global universal access target;

11. The Global Fund, which supports more than 80% of the people on ARV treatment in East Africa, needs at least US$20 billion – much of which will need to come from the G8, G20 and private sector – for its replenishment;

12. HIV is linked to a broad range of health needs including TB, malaria and maternal and child health – all of which are drastically affected by inadequate investment in HIV treatment;

13. According to the World Bank, “Responding to immediate fiscal pressure by reducing spending on HIV treatment and prevention will reverse recent gains and require costly offsetting measures over the longer term”;

14. The poorest among us are most vulnerable to health problems, but are least likely to access health services, thus creating a vicious cycle of poverty and disease that can only be broken by a dramatically increased injection of resources into the health sector, especially in the African region;

15. That the International Monetary Fund recently observed that accelerated social spending in the African region made an unexpectedly significant contribution towards shielding the region from the impact of the global economic recession;

We call on:

· African governments to reaffirm their commitment to the Abuja 15% target at the AU Heads of State summit in Kampala in July, and to develop a clear time-bound and indicator-based roadmap to achieving this target as part of efforts to mobilize more domestic resources for HIV, TB and malaria;

· National governments and donors to acknowledge that lack of adequate access to HIV treatment presents a threat to socio-economic development and therefore to ensure that discussions at the World Economic Forum recognize the critical importance of continued scale-up towards universal access;

· Global leaders, particularly the G8 and G20, to pledge a minimum of US$20 billion towards the replenishment of the Global Fund in October 2010;

· All leaders to ensure that there is transparency and adequate civil society inclusion in decisions on resource allocation and expenditure.