Drop Abuja Declaration, says Prof. Omaswa

Nov 01, 2018

The Abuja Declaration is a commitment that was made in 2001 by the African Union countries, pledging to allocate at least 15% of their annual budgets to improve the health sector.

A senior health expert has called for the need to drop the Abuja Declaration and have it replaced with a per capita model of funding.

The Abuja Declaration is a commitment that was made in 2001 by the African Union countries, pledging to allocate at least 15% of their annual budgets to improve the health sector.

However, Prof. Francis Omaswa, the executive director of the African Center of the African Centre for Global Health and Social Transformation observes that despite efforts by countries to increase health expenditure, there is little impact on the ground.

Omaswa argues that per capita allocations would help improve the health outcomes.

"Let's argue for at least 68 dollars per capita. The percentage mode of allocation is still small when it comes in and hardly felt. Let's reverse the Abuja Declaration. Let us do it. Let's change it," Omaswa stated.

"We need to work to convince the ministers of finance that health brings in more returns. We need to ‘unteach' our finance people that health is a productive sector not consumable," he added.

Omaswa's remarks are not farfetched. A 2016 World Health Organisation(WHO) assessment report which shows that countries were not making much progress even with the Abuja Declaration.

The WHO report titled "Public Financing for Health in Africa: from Abuja to the SDGs"  reveals that for every $100 that goes into state coffers in Africa, on average U$16 is allocated to health, only $10 is in effect spent, and less than $4 goes to the right health services.

"This failure to ensure that public financial resources reach the health services that need them has undoubtedly had a negative impact, on health sector results… compromising efforts to achieve equity in both financial protection and service coverage,"  the report reads in part.

Omaswa implored policy makers to lobby for support of the per capita funding proposal at global meetings.

"I was on the committee (that drafted that Abuja declaration) and I was asking for per capita. We can still take the decision there(AU) and adopt it. We can take the proposal at UN meetings or World Health Assembly and support it," said Omaswa.

He stressed, however, that health promotion would also bring far more dividends.

"Planning for diseases and treating people who have already become ill is more expensive. Integrated primary health care is the answer," he said.

Omaswa made the remarks during a meeting of legislators on the African Parliamentary Health Committees held in Kampala on October 30 -31st 2018, organized by the Partners in Population and  Development.

Omaswa regretted that sloppiness and social cohesion were some of the challenges bogging down the health sector in African countries.
"Very often I have to defend the governments of Rwanda and Ethiopia on the progress made in their countries.  If we all said let's do this, for goodness' sake let's do it! Let's build health systems.

"Pay attention to the people's needs. Have their data. Have structures or forums such as civil society you can work with. Invest in the quality of education, schools and teachers, nutrition and pre-school. Otherwise, we are headed for disaster," Omaswa, who is also the former director general of health services said.

The WHO report notes that since the turn of the century most African governments have increased the proportion of total public expenditure allocated to health.

The average annual public expenditure on health was 10% of total public spending in 2014, ranging from 4% (Cameroon) to 17% (Swaziland). However, while some countries have increasingly prioritized health spending over time (Ethiopia, Liberia, Swaziland, Burundi or Lesotho), in recent years nineteen of them have been spending less on health as a percentage of total public spending than was the case in the early 2000s.

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