CategoriesArticle WACI Health News

WACI Health at UNGA 79

WACI Health at UNGA 79

As the 79th United Nations General Assembly (UNGA) unfolded in New York, civil society and communities from across the world joined the discussions both within and outside the UN’s formal halls, striving to hold leaders accountable to the people-centered principle that begins the UN Charter: “We the peoples of the United Nations.”

Nombasa Gxuluwe (Programs Manager), Fitsum Lakew Alemayahu (AU Liaison Manager, CiSPHA Coordinator), Laura Philidor (CSEM Advocacy and Communications Officer), and Carthi Mannikarottu (Communications Lead) from WACI Health attended the Summit of the Future Action Days, the High Level Meeting on Antimicrobial Resistance, and various side events discussing issues of health and civil society engagement in global governance.

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Highlights from #UNGA79

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Looking to the Future
At the Summit of the Future (20-23 September), Member States adopted The Pact for the Future, which includes a Global Digital Compact and a Declaration on Future Generations. The Pact pledges actions in five focus areas: peace and security, sustainable development, science and technology, youth and future generations, and the transformation of global governance. While it includes aspirational statements on the future we want, it lacks specific timelines and targets or commitments to resources for the change we need. It also fails to highlight health as a specific action clause despite the outsized role health plays in driving success of all other sustainable development goals.

Leading up to the Summit, the Health ImPACT Coalition – co-led by STOPAIDS, International Treatment Preparedness Coalition, Global (ITPC), Frontline AIDS, Global Fund Advocates Network (GFAN), Global Network of People Living with HIV (GNP+) and WACI Health – mobilized over 300 health advocates to elevate issues of health, community leadership and engagement, community data, and accountability in the Pact discussions (See toolkit for more). At the Summit of the Future, ITPC’s Executive Director Solange Baptiste delivered a statement on behalf of the Coalition.

The Health ImPACT Coalition co-leads hosted a civil society side event to discuss next steps for the coalition and take stock on our joint advocacy since the Coalition’s creation in May. The co-leads agreed to maintain the momentum through continued consultations and connect with other advocacy groups for experience sharing. While the Pact for the Future lacks the concrete targets and accountability mechanisms needed to drive true transformation, we – along with our civil society partners – remain committed to holding world leaders accountable to their commitments for a better future for all. This includes continuing to push for more inclusive and effective governance, including within the UN system and global initiatives.

Add a little bit of body text 3Tackling the Silent Pandemic
At the UN High-Level Meeting on Antimicrobial Resistance (AMR) on September 26, world leaders adopted a political declaration, which sets key targets to combat AMR and address the growing threat of drug-resistant infections. Antibiotic resistance directly caused 1.2 million deaths in 2019 and was linked to nearly 5 million associated deaths; a recent study projects that from 2025 to 2050, 39 million deaths will be directly attributable to AMR. The declaration emphasizes a One Health approach to tackle antibiotic resistance and includes targets such as reducing AMR-related deaths by 10 percent by 2030 and mobilizing USD $100 million to implement AMR National Action Plans. It also reiterates a commitment to universal health coverage (UHC) as being critical in AMR efforts, aligned with CSEM messages.

WACI Health worked with the Stop TB Partnership to amplify a set of Key Asks developed by Stop TB Partnership, along with partners. Strong advocacy resulted in TB being a top priority in the Political Declaration on AMR with seven references to TB in the final declaration. In addition, WACI Health with other CiSPHA partners and the Ecumenical Pharmaceutical Network (EPN) produced an African CSOs Common Position on AMR through consultations and inputs from CSOs in Africa and around the world.

Notably, the final declaration fell short in addressing antibiotic use in food systems. At a civil society side event hosted by ReAct and a global coalition of civil society and community advocates, environmentalist Sunita Narain emphasized that the role of civil society is in advocating for the prevention agenda – ensuring that antibiotic misuse is prevented, particularly in industrial food systems, before drug-resistant infections threaten the overburdened health systems of LMICs. A civil society Call to Action was shared with leaders ahead of the High-Level Meeting.

The link between climate and AMR is a critical priority for our advocacy for the upcoming G20. Dr. Ethel Maciel (Ministry of Health, Brazil) noted at a side event hosted by the Pandemic Action Network that the G20 declaration that is being developed will focus on linking climate change, a One Health approach, and AMR. WACI Health is an active participant in the C20 discussions on health, including on the sidelines of UNGA. Civil society continues to engage in TB and AMR advocacy to the G20, calling for investments in TB research and development for better diagnostics and shorter treatment regimens as well as for the implementation of local and regional manufacturing that supports equitable access and affordability. 

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Recommitting to UHC
At the 5th Annual Ministerial Meeting of the Group of Friends of Universal Health Coverage (UHC) and Global Health on September 24, global leaders emphasized the need for financial protection to achieve equitable health access for all. Several ministers shared stories of national progress in increasing domestic resources for health, such as Uganda’s health budget reforms that helped lower out-of-pocket spending and Sierra Leone’s experience with a debt swap program to increase health investments.

The CSEM with WACI Health and other Health ImPACT Coalition partners held a civil society discussion on the Lusaka Agenda on September 24. The Lusaka Agenda, launched in December 2023, presents five key shifts for the evolution of global health initiatives and the long-term strengthening of the global health financing ecosystem. WACI Health’s Fitsum Lakew Alemayahu participated in the presentation about implementing the Agenda and principles of civil society engagement.

UHC2030 and the UN Foundation also hosted a multi-stakeholder roundtable on the Lusaka Agenda along with leadership from the governments of Canada, Japan, Mozambique, and Nigeria. Participants discussed concrete steps for advancing the Agenda, focusing on country implementation, areas of joint work, and cross-sector collaboration. WACI Health participated in the roundtable as part of the Future of Global Health Initiatives consultation group.

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Financing Health
The World Health Organization (WHO) announced a new Health Impact Investment Platform in partnership with regional multilateral development banks (MDBs), and low- and middle-income countries (LMICs). The Platform aims to strengthen primary healthcare and build resilience against pandemic threats. An initial contribution of EUR €10 million was signed by the European Investment Bank (EIB) and WHO to support efforts in 15 countries. The countries identified for phase one investment plans include Ethiopia, Senegal, and Zambia. 

At UNGA, the President of Kenya highlighted the International Development Association (IDA), the World Bank’s fund for LMICs, and reinforced the call for USD $120 billion made by African heads of states at the IDA 21 Summit in April 2024. Denmark announced a pledge of USD $491.7 million, a 40 percent increase over the country’s contribution in the last replenishment cycle. WACI Health continues advocacy efforts for a successful IDA replenishment with the ACTION Global Health Partnership and will participate in the World Bank Annual Meetings in October 2024 in order to ensure civil society priorities are elevated in financing discussions.


Reform was a key theme across UNGA79 and side event discussions. It is clear that today’s challenges and opportunities – including climate change, the largest youth population in history, and artificial intelligence – require reforms in global governance institutions and financing structures as well as in the thinking around leadership and decision-making. Other critical conversations we participated in included protecting the right to health for all, championing gender equality, enabling the digital transformation of health, strengthening cross-sectoral local governance, harnessing African leadership including in research and manufacturing, and building sustained inclusion of civil society and communities in governance. Many of these discussions will continue as we look into the last quarter of the year, carrying forward the momentum of UNGA 79 to build a better future for all.

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CategoriesArticle WACI Health News

Panel: Domestic Resource Mobilisation for Sustainable Health Systems

Panel: Domestic Resource Mobilisation for Sustainable Health Systems

On September 6, WACI Health participated in a panel discussion, “A Resolute Pathway to Sustainable Domestic Resource Mobilisation for Health” led by the Health NGOs Network (HENNET). The session was held at the Kenyatta International Conference Center in Nairobi, Kenya under the Medic East Africa and Medlab East Africa Expo and Conference 2024.

Panellists – including Dr. Margaret Lubaale of HENNET, Regina Ombam from the East Africa Community, Dr. Samual Kinyanjui of AHF Kenya, and David Kabera from WACI Health – discussed the need for Domestic Resource Mobilisation (DRM) for health and strategies to improve domestic funding. DRM aims to reduce dependence on external funding and ensure sustainable financing for health services. The session was moderated by Rosemarie Muganda from PATH.

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David Kabera (left), Regina Ombam (centre) and Dr. Samual Kinyanjui (right)

David Kabera, Policy and Advocacy Officer at WACI Health, spoke about essential components needed to build resilient health systems, including the critical role of domestic funding for health. He emphasised that it is not enough to increase resources but rather, ensure that strategic investments are made in critical areas like primary health care. He noted that strategies must be tailored to each country’s unique context and that in addition to developing better health policies, ensuring their effective implementation is the pressing charge for the African continent today.

The panel highlighted approaches to ensure the efficient use of available resources, improving budget absorption, and using evidence to ensure strategic upstream investments. Accountability was a recurring theme with panellists noting the role of localised decision-making to promote transparency and ensure health systems are responsive.

A healthcare model that focuses on community welfare and value-based care is needed to reduce inefficiencies and strengthen systems.

The session was attended by healthcare professionals, policymakers, industry experts, and civil society representatives interested in the evolving healthcare landscape in the region. A recording is available here.

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CategoriesAfNHI WACI Health News

AFNHI YOUTH MENTORSHIP

AfNHi (Africa Free of New HIV Infections) is a prominent network of dedicated champions from across Africa who tirelessly advocate for biomedical HIV Prevention Research in collaboration with partners. With the aim to accelerate progress and prioritize the biomedical HIV Prevention Research agenda on the continent, AfNHi actively promotes local ownership and the utilization of indigenous strategies. The network not only advocates for the effective use of existing HIV prevention tools but also endeavours to drive the development of new tools and technologies. In addition, AfNHi diligently monitors the implementation of commitments made by African governments, ensuring the efficient use of resources, while advocating for increased public sector investment in health.

Despite the ambitious vision of achieving an Africa free of new HIV infections and an end to the AIDS epidemic by 2030, the continent currently faces challenges with several countries falling behind key elimination milestones. Recognizing the crucial role of young people in driving biomedical HIV prevention efforts, AfNHi emphasizes the need to empower youth to actively participate and shape the discourse in this field. Strong youth-led leadership and advocacy will play a pivotal role in determining the impact of existing and emerging technologies on reducing new HIV infections in Africa. In line with its strategic plan for 2022-2024, AfNHi is rolling out phase 2 of a structured
mentorship program, seeking the involvement of 12 dedicated young individuals. This program aims to enhance knowledge, amplify youth voices, develop advocacy skills, and foster leadership among young people in Africa, thereby contributing to AfNHi's overarching goals.

Ensure you adequately fill in the following sections for your application to be considered for shortlisting.
A.Eligibility Criteria:
B.Bio Data: Detailed bio-data of the applicant.
C.Implementation requirements: Detailed in the application form
D.References: Please provide the email and phone contacts of 3 professional references on the
application form.
E.Declaration:

 

Please submit your application through the online form provided at: or any pre-application inquiries or questions, please contact: [gloria@wacihealth.org]

CategoriesWACI Health News

Behind Her Make-UP Lies The Untold Story

Most of us, I’m sure, grew up in households or communities where it was acceptable for a man to abuse his wife or a woman he cohabited with. Some saw it as a means of spicing up the marriage because not hitting the wife was seen as a sign of lack of love.

Think about that for a second; why should violence be described as love?

The UN defines violence against women as, ‘any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.

2019 Estimates published by WHO indicates that globally about 1 in 3 (30%) of women worldwide have been subjected to either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime.

Worldwide, almost one third (27%) of women aged 15-49 years who have been in a relationship report that they have been subjected to some form of physical and/or sexual violence by their intimate partner.

GBV can manifest in a large variety of ways. Some of these include: physical violence, such as assault or slavery; emotional or psychological violence, such as verbal abuse or confinement; sexual abuse, including rape; harmful practices, like child marriage and female genital mutilation; socio-economic violence, which includes denial of resources; and sexual harassment, exploitation and abuse.

This issue is not only devastating for survivors of violence and their families, but has a significant impact on the country at large. Most victims and survivors of GBV are unable to report due to societal stigma and name calling. For most victims, this scares them alot and prevents them from seeking justice.

The prevention, response, and eradication of all forms of sexual and gender-based violence (GBV) against women and girls depend heavily on access to reproductive health services. Most women and girls’ lack access to basic services like safety, protection, and recovery, which makes them vulnerable to unplanned and unintended pregnancies, and high rates of unsafe abortion. GBV also makes women more susceptible to contracting HIV and other STDs (STIs).

This devastating situation cannot be overlooked. GBV can be eliminated if it is prioritized globally as this will aid to achieve gender equality as stated in goal 5 of the SDGs and the empowerment of all women and girls.

As the youth mentorship cohort of AfNHi, this is s clarion call to all, especially African leaders to

  1. Prioritize issues of GBV and women empowerment
  2. Respect, protect and fulfil their human rights obligations to gender equality and to a life free of violence for all, including women, adolescents and girls
  3. Increase funding for SGBV prevention, mitigation and response
  4. Ensure the enforcement of laws addressing SGBV
  5. Ensure access to emergency helplines, police and justice sector response, sexual and reproductive health care, safe shelter and psycho-social counselling.
  6. Increase funds to reproductive health education and services.

Elimination of Gender-based violence is a collective effort. To ensure that there is zero tolerance for GBV, all systems, structures, and institutions must collaborate. It is important for governments, the corporate sector, and all parties involved to make the most of this window of opportunity (16 days) to commit firmly to achieving equal rights for women and girls and put an end to all forms of violence and harmful practices against them.

The time to act is now, more than half of the world population depends on you!

CategoriesGFAN Africa WACI Health News

CHOGM: GFAN Africa joins parliamentary delegation for a study tour to Bugesera district in Rwanda

GFAN Africa Members were part of a delegation to Bugesera District in the Eastern Province of Rwanda for a study tour led by the Rwanda Ministry of Health through Rwanda Biomedical Center and CCM Rwanda. The delegation included Members of Parliament from United Kingdom; Zimbabwe. A delegation from Global Fund and Malaria No More UK; and Rwanda CSOs. The delegation set out to learn about the Malaria response in the Rwanda.

WhatsApp Image 2022 06 23 at 7.53.53 AMThe study tour included visiting the Health Center which demonstrated how they treat various diseases including malaria. The experience sharing and learning sessions gave the delegation the opportunity to interact with the Healthcare Providers at the Health Center and Community Health Workers who support and deliver health services.

This included passionate community field workers, like Mary who has been a Community Healthcare Worker since 2003 who reiterated the joy and pride she gets from interacting with former malaria patients who were now healthy and happy.

The study tour was an important reminder of the effectiveness of strong health systems in prevention, diagnosis and treatment of diseases for communities. It strengthened the civil society and community resolve to continue fighting for what counts, to have strong and resilient health systems that can respond to any pandemic and continue saving the lives of people in Bugesera district, Rwanda and all over the world

CategoriesAfNHI WACI Health News

Investing in women, children, and nutrition is not optional. The world’s future depends on it

The global health financing landscape has drastically changed since the end of 2019. The emergence of Covid-19 dramatically increased the need and urgency for investment in global health and additional funds have been needed to respond to the pandemic and its direct and indirect consequences.

Overall, countries around the world are not on track to meet the World Health Organization’s Sustainable Development Goal of reducing maternal mortality. While the global maternal mortality rate fell 38% from 2000 to 2017 — a significant achievement — this is still less than half the annual rate needed to achieve the goal of less than 70 deaths per 100,000 live births by 2030.

In many countries, the lack of access to universal basic health care has hampered the pandemic response, while the pressure of Covid-19 has overwhelmed vulnerable systems, undermining the provision of maternal and child health and the administration of routine vaccination programs. These setbacks are likely to affect child and population health for years to come and reverse hard-won gains.

Source: STAT

CategoriesAfNHI WACI Health News

HIV Vaccine Awareness Day Celebration

AfNHi this year culminated the HVAD celebrations by having a VUKA Show that was targeting young people’s voices on the progress of the HIV vaccine. In public health history, it’s important to note the greatest impact in eradicating or controlling infectious diseases has successfully been achieved through vaccination. However, most of the current HIV prevention methods need regular adherence or daily use. To help end the epidemic, an HIV vaccine which provides long-lasting protection is necessary. Our panel of speakers were hosted by our very own AfNHi Youth cohort member, Ituleleng Mothlabane, and featured a Kenyan clinical researcher Dr Charlene Biwott, and a medical doctor from Nigeria, Dr Progress Agbola. Key highlights of the panel conversation included discussions around the progress the HIV Vaccine development has made to date, amidst the urgent need that would be met by having a vaccine available in the near future.

CategoriesWACI Health News

Zero Malaria Campaign Coalition seeks to end disease

A deadly disease is stealing young futures in Africa and claiming the life of a child every 60 seconds – that is 1300 children dying every day.

Malaria continues to be a significant public health problem in Kenya. The entire population of Kenya is at risk from malaria, including those most vulnerable to the disease, specifically children and pregnant women.

Malaria not only impacts on health but has a crippling socio-economic impact. Every day, malaria hits the very poorest communities hardest. It keeps kids out of school, adults out of work, and communities stuck in a cycle of poverty they can’t escape.  Despite the challenges, this is one fight we can win. Malaria is preventable and treatable, we have more tools now than ever before to prevent, diagnose and treat it.

Enormous strides

Kenya has made enormous strides in the fight against malaria thanks to concerted national efforts by government, partners and communities; shrinking the malaria map, reducing deaths by 2 per cent and saving millions of lives.

The global fight against malaria national malaria fight is becoming the biggest public health success story in history and fighting against  malaria is ranked as one of the most cost-effective global health interventions and Kenya is determined to maintain momentum in spite of the effects of Covid-19.

The pandemic has pushed global health to the forefront of the international agenda, underlining the need to build strong national health systems capable of protecting citizens from infectious diseases and delivering healthy lives.

Source : Nation.africa

CategoriesWACI Health News

COVID 19 AND LACK OF FUNDING NEGATING GAINS HIV PROGRESS

Stakeholders have warned that COVID 19 disruptions are likely to set back efforts made in curbing HIV infections back to ten years or more. According to UNAIDS’ new report released in July 2020, while securing antiretroviral therapy has been steadily improving, the progress is inequitable. In its report, Seizing the moment, the World Bank warns that if we don’t act, even the gains made will be lost. To reach the Millions still left behind, nations must double down and work with more urgency.

Unequal progress

Prevention of new HIV infections in Africa is far behind the rest of the world. Nearly two million people were newly infected with the virus, more than three times the global target. Seizing the moment report shows unequal progress, leaving behind vulnerable people and populations. For example, infected key populations such as gay men and their partners, men who have sex with men, sex workers, drug users and people in prison, accounted for 62 per cent of these new HIV infections. Women and girls from marginalised communities face barriers to accessing reproductive health services, especially contraception and HIV services. Those living with HIV/AIDS face stigma. A total of 59 per cent of all new HIV infections in Sub-Saharan Africa in 2019 were among women and girls, with 4500 girls and young women between 15 and 24 years old becoming infected every week. Thus, a growing number of young women are getting HIV infection, despite only making up 10 per cent of the population in sub-Saharan Africa.

Exclusion, stigma and discrimination

Social inequity and exclusion, stigma and discrimination have proven to be significant obstacles in curbing the new HIV infections. At least 82 countries criminalise HIV transmission, exposure, or non-disclosure, 103 criminalise sex work, and 108 criminalise the use, possession, or consumption of HIV related drugs.

 

Progress in targets

There is, however, a significant reduction in HIV transmission levels where comprehensive HIV services are provided. In addition, combining proactive medical practices with social and economic support for young women in Eswatini, Lesotho, and South Africa has narrowed inequality gaps and driven down the incidence of new HIV infections. Fourteen countries have achieved the 90–90–90 HIV treatment targets (90% of people living with HIV know their HIV status, of whom 90% are on antiretroviral treatment and of whom 90% are virally suppressed), including Eswatini, which has one of the highest HIV prevalence rates in the world, at 27% in 2019, and which has now surpassed the targets to achieve 95–95–95. The expansion of antiretroviral therapy has saved countless lives.

 

However, in 2019, 690 000 people died of AIDS-related illnesses 2019, and 12.6 million of the 38 million people living with HIV did not receive life-saving treatment. Although progress has been made, it is masking the lack of progress and challenges that continue to persist, threatening the progress made during the past decade, with tragic consequences for people’s lives, economies, and health security. Again, Sub-Saharan Africa is most affected.

 

A case for biomedical research

Reducing new HIV infections need to be a deliberate act in Africa. It is imperative that the locally tailored, evidence-based, and community-owned programs be tailored to sustainably reduce new HIV infections.

In the just-concluded 5th Biomedical HIV Prevention Forum (BHPF) hosted virtually in South Africa which focused on Financing of HIV Prevention Research in Africa, findings revealed that most countries did not have funding for biomedical research, and where research happened, it was mostly donor-driven.

To achieve Africa free of New HIV infections (AfNHi)’s vision of ending new HIV infections in Africa, the BHPF aims at mobilizing scientific knowledge and building bridges between science and policy. In addition to mapping potential for collaborative national and regional activities within the AfNHi network, the forum looks to strengthen connections between policy and research through information exchange with HIV prevention advocates.

 

Reporting on the state of funding biomedical research in Africa, Dr Caleb Mulongo, in his research findings based on four countries; Kenya, Rwanda, Eswatini and Malawi noted that none of the four countries met the recommended allocation of two per cent of a country’s domestic budget to biomedical research.

 

While the Abuja Declaration targets that 15 per cent of the national budget be allocated to the health docket, none of the four studied countries (Kenya, Rwanda Eswatini and Malawi) met the target. The highest was Malawi with 11.5 per cent, with Kenya reporting the lowest allocation at less than seven per cent. Rwanda allocated about eight per cent while Eswatini allocated about nine per cent of their national budget to health.

When it comes to research allocation, Malawi set aside 1.06 per cent, which was the highest allocation from the studied countries. Eswatini had the least allocation, at 0.3 per cent.  Kenya allocated 0.79 per cent while Rwanda 0.27 per cent. It is evident low allocation in the health sector which is not adequate to support quality and universal coverage of health means there is very little if any funding to allocate to biomedical research.

More than underfunding

The mini-BHPF conferences held in Rwanda, Zimbabwe and Cote d’Ivoire, presented during the main BHPF forum had similar findings, that their respective countries had not prioritized biomedical research for preventing new HIV infections. More challenges beyond funding were nevertheless noted. There was a lack of expertise in writing proposals, those in charge do not know how to bind for funds to support their activities and where research was conducted, it was noted that because it was donor-driven, it did not particularly priorities local issues, but rather ran with the donors’ agenda.

 

Own the process

A challenge has been thrown to African governments to invest more in biomedical research for HIV prevention funding, as well as invest in making sure systems are in place for translating findings into actions. A case of Malawi was noted, whose National Research Council of Malawi (NRCM) is domiciled in the Office of the President. This positioning is thought to be responsible for the higher allocations in the Health docket, hence elevating research as a national priority.

 

Other stakeholders including advocates for change, Civil Society and communities, Researchers and Front-line providers were called upon to keep the momentum for biomedical research HIV prevention funding, by pushing for better allocations of funds, elevating the discussion to the national level where policymakers sit and as well as information sharing across the countries.

CategoriesWACI Health News

Speeding up Investments in Research and Development to Meet Public Health Needs

For over a decade, advocates for HIV prevention research have called for stronger political will and global solidarity towards a preventive vaccine and other prevention tools for HIV. COVID-19 has demonstrated how political will can help accelerate scientific breakthroughs. The COVID-19 vaccine is a case in point: science, political will and global solidarity came together to find a tool that has helped protect millions and could protect billions if inequitable access issues are addressed.

As advocates call for action, it’s clear that greater domestic investment in health research and development (R&D) will be critical for improving health, equity and development. However, despite a disproportionately high burden of disease, Africa still lags in health R&D to address the region’s health challenges. We attribute this in large part to inadequate funding among other factors.

A recent publication, ‘Situation analysis report on the mobilization of resources for health research and development’, commissioned by Africa Free of New HIV Infections (AfNHi)WACI Health and Coalition to Accelerate & Support Prevention Research (CASPR), examines the financing problem of health R&D in Africa. It reports on progress but finds efforts have fallen gravely short of the target, with serious implications. This report comes at an opportune time, as COVID-19 puts a spotlight on the importance of health R&D and the need for greater domestic leadership and international commitment.

Accounting for over 15 percent of the world’s population, the continent bears 25 percent of the burden of disease at the global level, produces only 2 percent of the world’s research and only accounts for 1.3 percent of publications on global health. As explored in the report, regional commitments have been made to increase government spending on health R&D. For instance, the 2008 Bamako declaration calls on African governments to allocate at least 2 percent of budgets of ministries of health to research. Similarly, the 2008 Algiers Declaration calls on African governments to invest at least 2 percent of their national health expenditures and at least 5 percent of their external aid in projects and programs that build capacity and advance health research. However, despite such commitments, such investment remains gravely low in Africa.

Source: Simpkins (2019); Analysis by AfNHi Consultant

Based on the map above, domestic funding is inadequate for sustained and impactful research in health as most governments are investing less than 2 percent of their GDP, yet several health problems demand more investigation, arising from specific conditions, such as HIV, Malaria, challenges to maternal health, that are so widespread that they undermine public health at large.

Financing for health, especially R&D, relies heavily on foreign aid. This presents opportunities and challenges. Foreign aid brings skills, technology transfer, infrastructure for research and other resources. But the challenges are important to consider. Foreign aid can put funder research priorities ahead of host country priorities. Foreign aid can also be tied to a lack of local ownership, exploitative research partnerships, focus on publications vs. investing in the capacity for sustained research and development, and undermining the independence and success of innovative domestic research institutions. In some countries where governments have committed significant investment for health R&D, it’s often not financial, and often not useful. For financial investments, for instance, in 2017, the SciDev.Net reported that Uganda committed 30 billion Uganda Shillings (about USD 9Million) to support innovation and technology, and the first round of grants would be given mostly to individuals who had products in place. But critical voices point out that giving these funds to individuals rather than institutions undermine efforts to develop a sustainable ecosystem for innovation, one that supports individuals and a system that nurtures them.

Some of the sharpest criticism among African scientists, ministers, advocates and other observers say research in Africa too often can be experienced by African scientists as extractive, a ‘slave model’, where foreign funders reap the benefit of African intellectual labour but leave behind few benefits for ordinary Africans. Researchers are sustained by their own governments to continue their work with salaries and operational costs. Those same researchers advance proposals to foreign donors, often in consortia, and may individually benefit from publications, promotion, peer recognition and presentations at international conferences. But the true impact of their labour—the field advances with new tools, products and interventions—is not felt at home. An African scientist quoted in Scidev.net noted “Maybe we should have an incentive system structured differently in research institutions. Innovation is a public good with commercial value and industrial application, but a publication has knowledge value. When we reach an extent where they will use the commercial output from innovators other than publication, we shall see more innovations come out.”

The Situation analysis report on the mobilization of resources for health research and development finds that Africa has made progress towards financing for health R&D, especially in the past decade, but many African countries still have significant gaps to address. Of all the sampled countries, the report showed that Malawi had the highest proportion allocated to research in general at 1.06 percent of GDP, while Kenya had 0.79 percent, Rwanda 0.66 percent and Eswatini 0.27 percent. The report has clear recommendations – for policymakers and civil society organizations to address the challenges.

The reports’ findings and recommendations call for:

a. Increased government funding for health and research, which signals government leadership and commitment, and encourages greater investment from domestic partners
b. Strengthening existing laws, regulations and policies and enacting new ones were needed to guide research
c. Increase the influence of research on government policy by locating research closer to political power and aligning research priorities between researchers and governments
d. Governments must lead and facilitate collaboration between government and the private sector to fund and conduct contextually relevant health research
e. Research in Africa must prioritize benefits to Africans in research and development Incorporate robust accountability structures for efficient use of research resources
f. Advocating collectively for an enabling democratic environment for effective research
g. Strengthen cross-sectoral partnerships among CSOs to advocate for health research and development
h. Strengthen the advocacy capacity of CSOs in health financing and health research

The following are key strategies that advocates should consider:

1. Demonstrate to governments how specific investments are cost-effective, bring health and socioeconomic benefits, and enable broader governmental objectives
2. Explains the consequences of not investing in health R&D, including a slowing economy, reluctance of business and funder entities to invest, a “brain drain” of science and medical professionals, and cascading losses of the R&D benefits to other countries
3. Choose a collaborative approach to ensure that key government officials and policymakers view advocates as assets, partners and problem solvers with whom relationships can be formed towards the realization of health objectives and the mobilization of resources
4. Partner with experts in disciplines such as economics, public finance, business and international development for the strongest possible advocacy for health R&D
5. Strengthen capacity to interrogate and track government funding and actual expenditure on health R&D

The report concludes that governments, among others, in low and middle-income countries (LMICs) must prioritize and ensure budgetary allocations to health R&D, beyond the non-financial investments. Budget commitments have the potential to attract additional investments by partners and demonstrate political will. It’s time to champion this work!