African Activists Call on Leaders at the 2009 World Economic Forum on Africa to Prioritise Health Financing and Close the Resource Gap to Secure Universal Access to HIV and TB Care
At the start of the World Economic Forum (WEF) in Cape Town from 10 – 12 June, a coalition of African HIV and TB activists demands that the region’s leaders guarantee the right to health, ensure that it is financed as a priority, and mobilize the additional resources needed to secure universal access to TB/HIV prevention, treatment and care.
Without adequate financing, promises for access to disease prevention, treatment and care ring hollow, and our communities will continue to be devastated by preventable and treatable illnesses. The theme of the WEF is “Implications of the Global Economic Crisis for Africa”. For people living with HIV (PLHIVs) in the African region, the implications of the economic crisis are clear: 70% of the 1.9 million who are receiving antiretroviral treatment (ART) may see their access to treatment threatened in the next 12 months due to the economic crisis, according to a recent World Bank report.
For the 3.9 million African PWHIVs who are still in need of treatment, despite global commitments to universal access by 2010, the likelihood of accessing ART is now slipping even further out of reach. The situation is equally dire for maternal and child health, with regional maternal mortality rates having decreased by less than 5% from 1990 levels - far short of the Millennium Development Goal aim of a 75% reduction by 2015.
The demands for resources to fight HIV and TB in Africa are not arbitrary or exaggerated. The availability of resources for HIV/TB is the key determinant of whether or not the right to life for millions of Africans will be realized. TB is a leading cause of death in many countries in the region, especially among people living with HIV, and claims more than half a million African lives every year. All HIV-related deaths are estimated at 1.5 million a year.
Failure to invest adequately in managing TB and HIV not only implies a disregard for the lives of people with these diseases, but also further burdens the continent with the social and economic consequences of the unmanaged epidemics. A 2007 World Bank paper estimated that the economic cost of not treating TB in Africa would be US$ 519 billion, more than twenty-five times the cost of managing TB adequately in the same period. Several studies have also demonstrated convincingly that treating HIV timeously reduces its transmission significantly, and as such is a valuable preventive measure that could ultimately save governments billions of dollars.
As financial resources become increasingly scarce, it is more imperative than ever for regional leaders to ensure that their priorities are in line with the needs of the people they serve. In 2001, African heads of government stated that “We are fully convinced that containing and reversing the HIV epidemic, tuberculosis and other infectious diseases should constitute our top priority for the first quarter of the 21st century”.
Numerous other regional and international commitments have echoed this conviction and recognised the importance of increased investment in combating HIV and TB in Africa, but much of this rhetoric has not translated into action. “Expert” dialogue at the global level has now started to turn against HIV-specific funding, arguing that it has weakened health systems, despite the fact that there are millions of people who are living today only because billions of dollars were invested in ART.
We refuse to have this progress undone. As world leaders gather in Cape Town to discuss the economic crisis and to “develop a new roadmap for Africa’s future”, activists around the region will be watching the outcomes of this meeting for evidence of political commitment to the rights of people living with HIV and TB on the continent, and will mobilize to ensure that these rights are protected.
The future of the continent is bleak if the health of the continent is not secure, and the health of the continent cannot be secure unless we address the challenges posed by HIV and TB. Great strides have been made in the response to these co-epidemics in Africa – but the battle is far from over, and the casualties continue to rise.
We demand that regional and global leaders recognize and respond to this reality by:
- Honouring their existing commitments, including:
o The 2001 Abuja Declaration in which African heads of state pledged to devote 15% of national budgets to health;
o International agreements to committing 0.7% of high-income countries’ revenue to Overseas Development Assistance (ODA); and
o The pledge to ensure universal access to TB and HIV prevention, treatment and care; and
- Closing the gap for health resources through:
o Discouraging fiscal policies that prevent increased social spending in low income countries;
o Committing 15% of middle- and low- income countries’ total revenue (excluding grants) to health;
o Ensuring that 15% of ODA, or 0.1% of high-income countries’ revenue, is devoted to health;
o Adopting and accelerating the implementation of a global currency transaction levy as recently proposed by France, which has the potential to generate an extra 30 – 60 billion dollars annually for global health; and
- Improving transparency and accountability in the allocation and expenditure of resources for health, including stemming illicit capital flight from low income countries.
Paula Akugizibwe (ARASA): +27 83 627 1317
Rebecca Hodes (TAC): +27 79 426 8682