The 50th Anniversary of the AU: Time to Recommit to the Promises of Abuja

"I do believe that a new Africa is unfolding before our eyes. The African Renaissance is now at hand. It is within reach. It is embedded within the honest and seeking minds of the young, the professionals, the activists, the believers in our continent."

Ellen Johnson Sirleaf
President of Liberia

The past decade has seen remarkable transformations across the African continent--an expression of hard earned progress and promise even in the midst of a global financial crisis. This is an era of unprecedented economic growth, socially sustainable gains and strong African leadership. Today, almost every country in Africa has a success story to tell, and Africa's prospects have never looked brighter. The continent is realizing its potential and improving the lives of its people.

Yet despite promising progress, challenges remain implementing previous African Union decisions and declarations on health. As Africa's leaders gather in Ethiopia to celebrate the African Union's 50 year anniversary, this is a strategic point for citizens to urge leaders to recommit to key health commitments, especially the Millennium Development Goals and the 2001 Abuja Declaration.

In September 2000, 189 heads of state adopted the Millennium Declaration, designed to improve social and economic conditions in the world's poorest countries by 2015. Subsequently, a set of eight goals were devised, drawing on the Millennium Declaration, as a way of tracking progress. Three of these relate specifically to health; two more have health components. In April 2001, heads of state of African Union countries met in Abuja and set a target of allocating at least 15% of their annual budget to improve the health sector, and urged donor countries to scale up support. Despite tremendous progress fighting AIDS, TB, malaria, reproductive health, maternal and child mortality, and human resources for health, most AU countries are not on track to achieve the health MDGs. Part of the explanation is a lack of financial resources, as many nations are challenged to raise adequate funds to provide quality services that deliver results. This was a problem the Abuja Declaration was supposed to address.

According to the World Health Organization, 27 countries have increased the proportion of total government expenditures allocated to health since 2001. Seven countries reduced their relative contributions of government expenditures to health during the period. In the other twelve countries, there is no obvious trend upwards or downwards. Meanwhile, six countries: Rwanda, Botswana, Niger, Malawi, Zambia and Burkina Faso have passed the 15% mark. This achievement has been the result of the hard work of governments, health care providers, and communities all over the continent over the last decade. And African leaders must show their commitment by bridging the resource gap with strong political leadership, leveraging the strong economic growth, and by adopting innovative funding opportunities. These include meeting the Abuja target of investing 15% of government resources in health.

At this AU Summit, not only advocates but every African must demand that unmet health MDGs are prioritized in the report of leaders on the post-2015 Development Agenda. The 50th anniversary meeting in Addis Ababa is a pivotal time to remind our leaders about their commitments.

The Director-General of the World Health Organization, Dr. Margaret Chan, pointed out last year that as external funding for Africa's health declines, the commitment of domestic funds for health and their wise use are critical. Many donors are in doubt whether African leaders have actually committed themselves to the Declaration. Governments must demonstrate dedication to health by devoting an increasing share of their own resources to the health sector. In 2008, Nobel Peace Prize winner Archbishop Desmond Tutu stated The African Union Abuja 15% pledge is one of the most important commitments African leaders have made to health development and financing, and our leaders should strive to meet this pledge before another 10 years pass.