Global health and financing leaders and experts have come together at a high-level virtual event to tackle one of the most pressing issues facing the world today-health security. The event, "Investing in health is investing in economic recovery: Financing for HIV, stronger public health systems, and pandemic preparedness and response" was held ahead of the sixth Africa - European Union (EU) Summit which is taking place on 17 and 18 February.
While hosting 16% of the global population, and facing 26% of the global disease burden, Africa accounts for only 2% of global health spending. Despite the 2001 Abuja Commitment of governments to allocate 15% of their budget to health, the average is still only 7%.
Speakers discussed how Africa has been left behind in the COVID-19 response, with less than 12% of people in Africa fully vaccinated against COVID-19. Insufficient access to vaccines, medicines and technologies, and weak health systems have impeded the realization of the right to health of all Africans during the pandemic. In addition, fiscal constraints and unsustainable debt burdens, are hindering the path to recovery.
Cosponsored by the Government of France, the event was convened by UNAIDS, the African Union, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the United Nations Development Programme, and the World Health Organization. Moderated by Dr. Donald Kaberuka, High Representative for Financing, African Union (AU), the session strived to find ways of broadening the revenue base available to African countries to increase health financing and to boost global solidarity.
Participants underlined the overarching need for investment in strengthened public health systems for universal healthcare, including community-led services, and avoiding overburdening the most vulnerable with out-of-pocket expenses to overcome the COVID-19 crisis. Further, tackling the current pandemics of HIV and COVID-19, and other infectious diseases such as malaria and TB, must happen simultaneously to prevent future pandemics and protect global health security.
"If we continue as we are - if we do not take the steps necessary to speed access and close inequalities in the HIV response - the world could face 7.7 million AIDS deaths over the next ten years - 4.7 million of those deaths would be in Africa"
Leaders stressed how essential HIV, health systems and pandemics preparedness investments are to save human lives and for economic recovery, and how there will be no steep recovery for Africa without health security for all.
"Less than half of health clinics in Africa have water and electricity. We have to do more, we know where the funding gap is: investments in health, human resources and infrastructure"
Tackling existing pandemics, such as COVID and HIV, needs to happen at the same time as countries strengthen health systems and build up pandemic preparedness.
"Diseases are not a choice, but pandemics are a choice that we could choose to avoid. Ultimately the key to sustainably protecting everybody from the deadliest infectious diseases is through domestic financing"
Participants praised the increased African leadership and sovereignty and called for a renewed Africa-EU partnership that would support African institutions and rely on its leadership, in collaboration with multilateral institutions. Specifically, they called on the EU to further dedicate financing mechanisms for HIV, health and pandemic preparedness, including sustained and increased overseas development assistance (ODA). .
"Investing in health is a political decision. Africa's youth can be its greatest asset. Quality healthcare is the foundation upon which Africa's youth will flourish. We can no longer treat healthcare spending as an afterthought"
The panel members also recognized the importance of domestic financing for long-term sustainability.. However, the current financial constraints are overwhelming for many countries in the region. Decisive action to eradicate tax evasion and tax dodging will be critical: every year between 25 and 50 billion that could be used for the health and education of Africans are lost. Increasing domestic revenues requires brave international and national tax reforms. Possible ways forward discussed for broadening the revenue base included combating tax evasion, improving the conditions under which African countries obtain financing, debt relief and cancellation policies, and Special Drawing Rights reallocation.
"The pathway to achieving global health security for humanity is to strengthen African support to achieve health sovereignty"
Speakers highlighted that a growing share of revenue allocation, as well as better investment and the use of health and pandemics´ resources are urgently needed, leveraging the AIDS infrastructure and lessons learned from the rights-based AIDS response to prevent future pandemics.
"The COVID-19 pandemic has created a tragic opportunity to revise thinking fundamentally, strengthen health systems effectively, and reshape resource mobilization in health, including domestic investment"
The leaders called for robust international financing, through special drawing rights reallocation, debt relief, new concessional sources and additional ODA. They identified The Global Fund replenishment in 2022 as a key moment to ensure overarching support for the fight against AIDS, malaria and TB, to get back on track.
