Over three decades ago, Alma-Ata Declaration signatories expressed the need for urgent action to protect and promote the health of all people. It was the first international declaration underlining the importance of primary health care. Fast-forward many years later, the World Health Assembly resolution from 2005 emphasized this by saying that everyone should have equitable access to key promotive, preventive, curative and rehabilitative health interventions at an affordable cost, with no subjection to financial hardships. The World Health Report 2010 put forward two messages vital in making progress on Universal Health Coverage (UHC) agenda:
Countries need to ensure that they spend adequately on health
Countries should improve health system efficiencies so that no-one is left behind
The path to UHC is relatively simple – at least on paper! Eighteen years after the Abuja Declaration and according to the Africa Scorecard on Domestic Financing for Health (2018), only 2 out of 55 African Union Member States have met the regional target allocation of at least 15% government budget towards health.
African Civil Society pre-conference meeting in Kigali, Rwanda Photo credit: Rwanda NGO forum
As African Civil Society, we are concerned at the low commitments by our governments to increase domestic resources for health. With regard to the three major epidemics – HIV/AIDS, TB and Malaria – which are still a threat in Africa; ending them requires sustainable financing to ensure research, development and progress towards UHC.
Today, at least half of the world’s population do not have full coverage of essential healthcare services. In Africa, a staggering 11 million people fall into extreme poverty each year due to out-of-pocket (OOP) health expenses. Unless Governments increase the allocation of resources for health and design intervention to promote equity, persisting gaps in service coverage will remain. On the sidelines of the Africa Health Agenda International; civil society in their statement echoed the need for more political will by African Governments and emphasized the need to invest at least 5% of GDP towards health to make UHC a reality in Africa. In addition, they called for African Governments to mobilise support for a successful 6th Global Fund Replenishment.
On International Women’s Day (IWD), we celebrate the social, economic, cultural and political achievements of women. As we mark IWD 2019, we toast to women’s achievements – at home, at work and in our communities, as mothers, wives, sisters, daughters, workers, citizens and leaders. The theme of this year is #BalanceforBetter. A balanced world is indeed a better world. Gender balance is essential for economies and communities to thrive. In fact, gender balanced communities and institutions are more prosperous.
Kenya has made commendable strides in women’sempowerment. For example, our country has the highest number of women serving on company boards in Africa at 19.8 per cent, above the global average of 15 per cent, according to a report by the International Finance Corporation. Twenty six percent of the Cabinet is made up of women.
These achievements are admirable, yet with room for improvement. Progress has been painstakingly slow and is a sign of resilience and strong – will in our society which is laced with unacceptable inequalities in health, education, leadership and at the work place. More than half of Kenya’s population is female. Investing in the well-being of women, then, is investing in the good of more than half of the population. It’s no brainer then, that nations must invest in women to make sustainable progress.
Key to investing in women is, investing in their health. Womenbear the brunt of dysfunctional healthcare systems. More women than men in Kenya are victims of gender based violence. Gender-based prejudices, violence, discrimination and inequalities not only violate rights of women but also impact their health and wellbeing. Women are caregivers and almost all the time take care of the sick and bear the emotional burden of providing care in inefficient and challenging healthcare environments.
According to WHO, gender requires us to ensure health policy, programmes, services and delivery models are responsive to the needs of women, men, girls and boys in all their diversity.
Like many women in sub-Saharan Africa, women in Kenya are disproportionately affected by diseases such as HIV. Worth noting is that gender-based violence and HIV are strongly entangled. In 2016, 34,000 adult women were infected with HIV, compared to 22,000 adult men, and adult women accounted for 910,000 of the 1.6 million people living with HIV in the country. Women also face challenges with sexual and reproductive healthcare, such as limited access to family planning, as well as stigma and discrimination.
As health advocates in Kenya, we commend President Uhuru Kenyatta for rolling out Universal Healthcare Coverage a component of health – one of the Big 4 agenda. We are grateful too, for the linda mama maternity package. These investments in health when fully rolled out will ensure that all Kenyans have access to quality healthcare without getting into financial hardships and sinking into poverty when they pay for healthcare services. This then requires the provision of adequate resources for health. We are asking the Government to allocate more funds for health – at least 5 per cent of GDP.
Further, forming partnerships with the private sector, and urging donors to contribute to international health funding initiatives such as the Global Fund whose 6th replenishment is scheduled for October 2019 will provide the much needed resources for investments in health for womenand indeed, for all Kenyans.
Increasing investments in health is good for the economy. It will enable Kenya realise the social pillar of Vision 2030 which aims to improve quality of life for all Kenyans through the roll out of human and social welfare projects and programmes in key sectors such as health. Further, the investments will enhance the roadmap to achieving Sustainable Development Goal 3 on health and wellbeing as well as Goal 5 on gender equality.
As we celebrate women’s achievements, each one of us is called to action. Especially to resist traditional ideas about the roles of girls and women which are detrimental to their health and restrict their contributions to society. We must take personal responsibility to accelerate gender balance by being sensitive to inequalities, raising awareness against bias and taking action for equality. It starts with you and me.
Nay Maps a South African actor and Fahe Kerubo a Kenya youthful human rights defender have been appointed as Champions to work with WACI Health for the next one year. The duo will support GFAN Africa’s advocacy work especially in ensuring a fully funded Global Fund and urging Governments to allocate more domestic resources for health.
In her own words, Fahe said “I am honoured and it’s a privilege to have been chosen as a champion” She is eager, optimistic and excited to work with WACI Health.
Nay Maps a South African actor is delighted and is looking forward to working with WACI Health and positively impact society.
In his own words, Nay said “I feel honored and responsible for Global Health Awareness and I stand for Universe Health Coverage and believe that through this platform, more lives will be informed and saved and educated…which therefore means that diseases decrease and begin to be eradicated and healthy living is promoted.”
At WACI Health, we are excited to have these two champions on board and look forward to running successful campaigns with them.
This civil society meeting was on the side lines of the first-ever platform Africa Leadership Meeting on Investing in Health held to discuss resources for health to accelerate universal healthcare coverage. Only 2 out of the 55 AU member states have dedicated the recommended government budget, at least 15%, to health. This, according to the Africa Scorecard on Domestic Financing for Health (2018) fails to meet the suggested threshold of $86.30 per person required to provide a basic package of health services. In the 2008 ‘Bamako Declaration’, 26 African countries made commitments to allocate at least 2% of their ministry of health budget to research – a commitment which has not been realized.
The health advocates noted that the greatest driver of the Africa’s economies is human capital. Financing health will boost productivity, save money and lead to economic growth. While remarkable developments have been made in global health, many people in Africa still die each day from preventable diseases such as HIV, TB and malaria. At the meeting, the health advocates pledged to continue playing their role through constructive engagement with all stakeholders Read More Here as well as ensure accountability on how health is governed and delivered in Africa.
Increasing domestic resources for health is key to achieving SDG 3 on the health and wellbeing of all and to achieve the 10 year action plan of the Africa Union Commission’s Agenda 2063. Healthy nations are indeed prosperous nations.
On 14th February – Valentine’s Day, communities and civil society organizations in over 45 countries sent “love letters” to embassies and high commissions of donor countries to appreciate their support to the Global Fund. Since its establishment in 2002, the Global Fund has disbursed a total of over US$ 40.2 billion and saved over 27 million lives affected by the three epidemics.
Rosemary Mburu presented a letter and roses to the EU Commission in Kenya Photo Credit: GFAN AfricaAngela and Jacqueline presented a letter and roses to H.E. Mrs Aline Kuster-Menager, Ambassador of France to Kenya Photo Credit: GFAN Africa
Representatives of Uganda Network of Young People Living with HIV presented flowers and a thank you letter to the Ambassador of Sweden to Uganda H.E. Per Lindgarde Photo Credit: GFAN Africa
The Valentine’s day campaign was coordinated by GFAN Asia Pacific. Countries presented thank you letters and flowers to Embassies, High Commissions and Governments for their contributions to the Global Fund while urging them to contribute more during the 2019 6th replenishment. Special thank you letters were presented to the Embassies of Ireland to the India High Commissions. We thanked Ireland for pledging towards this year’s replenishment and appreciated India for hosting the pre-replenishment conference in February. 13 countries in Africa participated in this very successful campaign.
The 6th Replenishment of the Global Fund will take place on 10th October in Lyon, France. It will be another opportunity for Global Fund donors and implementing countries to demonstrate their continued commitment in scaling up work to defeat HIV/AIDS, TB & Malaria.
A lot of progress has been made, yet, the world is not on track to end HIV, TB and malaria as epidemics by 2030. The Global Fund fundraising target of US$14 billion, for the next three-year cycle (2020-2022), is significantly lower than the estimate in the GFAN Report “Get Back on Track” of US$16.8 – US$18 billion. There is huge concern that the US$14 billion target will only maintain current levels of programming and will not enable us to step up the fight!
GFAN Africa and health advocates, strongly call on governments and donors to: demonstrate their political will by making early and increased pledges for the 6th replenishment as well as fulfilling their previous commitments. . An increased and fully funded replenishment will enable the Global Fund to help countries accelerate progress toward universal health coverage. Health advocates are also asking African governments to commit 5% of their GDP towards health to ensure successful, life-saving interventions.
At a high-level meeting in Dakar, Senegal, UNAIDS, United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) urged countries in western and central Africa to do more to stop new HIV infections among children and adolescents and increase HIV testing and treatment coverage.
25 January 2019 – Nairobi, KENYA. In preparation for the Africa Leaders Meeting on Investing in Health, taking place in Addis Ababa, Ethiopia, on 9th February; and in the lead up to the 6th replenishment of the Global Fund in October, health advocates in Africa, under the Civil Society Platform for Health and the Global Fund Advocates Network (GFAN) Africa, have met and emphasized the need for African governments to step up domestic resources for health.
There are about 1.8 billion young people aged between 10 to 24 years in the world. This is by far the largest generation of youth in history! Approximately half of them – 900 million – are adolescent girls and young women.
Majority of the adolescent girls and young women live in low and middle-income countries. With regards to HIV, this young cohort is disproportionately affected by the virus. In 2016, 2.3 million adolescents and young women were living with HIV. Eastern and southern Africa regions carry the heaviest burden with an estimated 230 000 new HIV infections annually. Overall, the number of African adolescents and young people is estimated to increase to more than 750 million by 2060. Bearing these projections in mind, new HIV infections among young people are expected to rise even if our global progress to HIV response is maintained.
To end AIDS as a public health threat by 2030, UNAIDS estimates US$26.2 billion is needed for the global HIV response in 2020 alone. This means the world must increase the amount of resources available for HIV by US$1.5 billion each year between 2016 and 2020. There is a lot more emphasis on countries most affected by the HIV epidemic to finance their own responses and find more efficient and cost-effective ways to do so.
The world will convene in France in October 2019 for the 6th replenishment of the Global Fund to raise new funds towards ending AIDS, TB and Malaria by 2030 in alignment with the Sustainable Development Goals. In addition to the pledges which will be made, there is an increasing need for implementing countries (of the Global Fund grants) to step up their domestic resources for health especially investments in young women. There is limited research within the HIV evidence base specifically among adolescents and young women. Where data on youth exist, the way it is presented sometimes fails to tell the full story.
Photo credit: PEPFAR
Girls and women are powerful agents of change as well as drivers of sustainable development. Evidence from around the world confirms that investing in girls and women, by education and health, creates a ripple effect that yields multiple benefits such as greater accumulation of human capital; increased productivity, income and economic development. For example, a study in Botswana found that each additional year of secondary schooling by adolescent girls reduced cumulative HIV infection risk by 8.1%. Yet, despite all we know, decision makers have failed to consistently make adolescent girls and young women a priority. They are deprived of access to health services, confront barriers to education, are vulnerable to gender-based violence and face discrimination in political and economic spheres.
Now, at the dawn of the SDGs, we have an opportunity to correct this wrong and prioritize the health, rights, and wellbeing of girls and women everywhere.
NAIROBI, Jan. 25 (Xinhua) — African lawmakers and civil society organizations on Friday urged governments to increase domestic healthcare expenditure in order to end life-threatening epidemics such as HIV, malaria and Tuberculosis (TB).
Stephen Mule, Kenyan legislator and chair of the Africa Parliamentary TB Caucus, told a health forum in Nairobi that African countries have not yet prioritized the health sector in their budgets.
“On average African governments health budgets are less than 1 percent of their gross domestic products (GDP) against an ideal figure of five percent,” Mule said during the Conference on Raising Resources for Kenya’s Health Pillar Under Agenda Four.
The day-long event brought together African civil society organizations and parliamentarians to share their views on how Kenya can raise resources to deliver universal healthcare to all its citizens by 2022.
Mule also noted that most African states are yet to fulfill the 2001 Abuja Declaration where African Union member countries pledged to allocate at least 15 percent of their budgets to the health sector.
He added that most of the funding for health in Africa comes from foreign donors, a situation that is not sustainable in the long run.
The parliamentarian said that rich countries are also facing pressures from their citizens to reduce overseas development assistance to poor countries.
Rosemary Mburu, executive director of WACI Health, said that Africa should embrace innovative measures to enhance domestic resource mobilization to fund the health sector.
Mburu said that Africa should prioritize the health sector due to its significant influence on national development.
Olivia Ngou, global coordinator for Civil Society for Malaria Elimination, said that in October 2019, the international community will come together in Lyon, France, to raise funds for the sixth replenishment of Global Fund to Fight Aids, Tuberculosis and Malaria.
Ngou said that African countries are key beneficiaries of the global fund and should strongly support this international effort to raise more funds for the global fund.
By Sophie Edwards, 26 September 2018 – www.devex.com
TBILISI, Georgia — As world leaders gear up for a landmark United Nations meeting on tuberculosis this week, two pivotal trials in the small Eurasian country of Georgia are promising to break new ground in the fight against multidrug-resistant TB.
July saw the launch of the SimpliciTB trial at the National Center for Tuberculosis and Lung Disease in the capital, Tbilisi, which combines four new medications and aims to slash treatment times by a third or more.
A pill in a hand. Photo by: rawpixel
It comes on the back of the ZeNix trial, launched last November, which targets patients with the most resistant form of the disease and is already showing signs of success in cutting treatment times. Both trials are being run by the TB Alliance in a country that has one of the highest prevalence rates for drug-resistant TB in Europe.
Drug-resistant TB has become a growing problem, with an estimated 558,000 new patients in 2017. The majority of these patients are classed as having multidrug-resistant TB — or MDR-TB — meaning they are resistant to more than one first-line drug. Treatment in these cases can be lengthy, complex, and expensive, with severe side-effects. As a result, only 55 percent of MDR-TB patients are cured, according to WHO.
Countries of the former Soviet Union, including Georgia, have the highest rates of drug-resistant TB, but infection rates have been increasing rapidly in parts of Africa and Southeast Asia.
While there have been innovations in treatment, these have taken time to approve and are still not widely available, especially for poorer patients.
The Tbilisi drug trials offer hope for patients with drug-resistant TB by giving them access to combined oral-only regimens — in place of older, injection-based treatments — which are less toxic and require a shorter treatment time.
Patients on the ZeNix trial, set to run for four years, are already showing promising results almost a year in, according to lead clinician Lali Mikiashvili. Eight patients have now finished the six-month treatment and have been “cured,” she said, although they will be kept under close observation for signs of relapse for a further 18 months. The remaining nine patients are still on treatment but are responding well, she said.
“It is a revolutionary regimen; it’s unbelievably simple and short,” Mikiashvili said, adding that while the trial is ongoing and will be formally evaluated at a later date, so far “every patient has responded quickly, showed high efficacy and tolerability … [and] none have shown serious side effects.”
“If successful, this is the future treatment for hundreds of thousands of patients suffering from one of the most dangerous diseases in the world,” she said.
While ZeNix focuses on patients with highly-resistant TB, SimpliciTB is for those with both ordinary TB and MDR-TB. The trial is testing a regime of four drugs, all of which can be taken orally, known as BPaMZ, to see whether it can cut and simplify the treatment process down to four months for those with drug-sensitive TB, and six months for those with more resistant strains. Current treatment times for MDR-TB can be up to two years.
Marika Eristavi, who is leading the SimpliciTB trial, said patients are responding well to the new treatment. If successful, it could “reduce the rate of TB in Georgia as well as worldwide,” she said.
Other SimpliciTB trials are also being set up, with the aim of treating 450 people across 10 countries in Africa, Asia, Europe, and Latin America.
TB Alliance, a nonprofit that works to accelerate the development and affordability of new TB drugs, is managing both trials.
“As resistance to current TB treatments continues to grow, we need to introduce all-oral drug regimens that can treat every person with TB in six months or less, regardless of their resistance profile,” said Mel Spigelman, president and CEO at TB Alliance. “If proven successful in SimpliciTB, the BPaMZ regimen would represent a major step toward this goal.”
Eristavi told Devex she hopes the forthcoming high-level meeting on TB can help secure more funds for research and development.
“R&D will help … discover new medicines, treatment regimens, and vaccines, which is essential to tackle this disease,” she said.
But while both trials offer hope, Mikiashvili pointed out that TB is one of the oldest diseases in the world and has a history of defeating so-called cures, including streptomycin, to which the disease showed resistance within months of it being introduced in the 1940s.
“The TB bacteria is very flexible … It has the ability to acquire resistance to all medications,” she said. “When streptomycin was introduced it was said it was the end of TB … worldwide, but who now remembers streptomycin?”
NCDs. Climate change. Financing. Read more of Devex’s coverage from the 73rd U.N. General Assembly here.
