Financing health in Africa: the time to reflect is now

Sub-Saharan Africa is home to only 12 per cent of the world’s population but accounts for 22 per cent of the total global disease burden and 68 per cent of people living with HIV/Aids.  Out of approximately 800 women who die each day worldwide due to pregnancy and childbirth complications, 440 (55 per cent) are in Sub-Saharan Africa.  And children born in Africa are 16 times more likely to die before the age of five than those in the developed regions.

The grim health situation is the result of a crisis in healthcare financing in the continent.  With only one per cent of the world’s health expenditure being used in Sub-Saharan Africa, countries are ill-equipped to adequately address their health problems.   

It is the realisation of this health crisis that made African governments commit in April 2001 to dedicate at least 15 per cent of their annual budgets to the health sector in the Abuja Declaration. Thirteen years later, the same governments are yet to honour this promise. Only six countries — Rwanda, Botswana, Niger, Zambia, Malawi and Burkina Faso — have reached or surpassed the Abuja target. In 60 per cent of the countries, the health sector share of total government expenditure is below 10 per cent.

Achieving the 15 per cent target would reflect government commitment to some degree of health sector prioritisation in expenditure. It does not imply that this level of funding would be adequate to meet national health needs.

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