BACKGROUND: AFRICA LEADERSHIP MEETING – INVESTING IN HEALTH DECLARATION

The African Leadership Meeting (ALM) on “Investing in Health” held in February 2019 adopted a declaration (Assembly/ AU/Decl.4 (XXXII)) aimed at increasing domestic health financing to strengthen health systems and achieve quality assured Universal Health Coverage (UHC) in Africa. The ALM declaration was grounded on the Agenda 2063 and the Africa Health Strategy 2016-2030 that prioritises “sustainable and predictable financing as essential to building viable health systems”. The declaration also builds on the Abuja 2001 political commitments by African Union (AU) Member States to allocate at least 15% of the national budgets to health.

Under the ALM declaration, Africa’s Heads of States and Governments committed to:

• Increase domestic investment in health. Heads of State to review progress annually against the benchmarks of the Africa Scorecard on Domestic Financing for Health.
• Convene African Ministers of Finance and Health every 2 years to discuss health financing and to review progress against benchmarks.
• Complement the Africa Scorecard with a domestic health financing ‘Tracker’ that will guide health financing reforms and track country progress in implementing these enablers.
• Establish regional health financing Hubs in each of Africa’s five regions to facilitate peer-to-peer learning by providing practical & technical expertise to support countries to implement these reforms and to coordinate alignment of partner efforts to Africa’s priorities.
• Attract further private capital into the health sector by creating conducive investment climates and increase Member State stewardship of private sector support so that such efforts strengthen public health systems and expand access to health services.
• Increase the coherence of investment through improved alignment of multilateral, bilateral and private sector efforts to the priorities of the continent.
• Improve public financial management (PFM) capacity to help improve tax collection and/or increase the proportion of tax revenue collected as a percentage of GDP, through equitable and efficient general taxation and improved revenue collection, and strengthen the capacities of Ministries of Finance and tax revenue authorities to achieve this.
• Digitize the Africa Scorecard on Domestic Financing for Health so that the data used to review performance is more widely disseminated.
• Enhance national health financing systems, including exploring options to reduce fragmentation, explore national health insurance (where appropriate), strengthen capacity to purchase services effectively and improve prevention, cost-effectiveness and efficiency.
• Reorient health spending and health systems to target the diseases and conditions across the lifecycle that have the greatest impact on mortality and human capital development with the mix of interventions that will deliver the greatest impact in combatting them.

The implementation of the ALM declaration is structured into the four components as shown below: The trucker which monitors progress all the four components of ALM; health financing with a focus on domestic allocations to health, private sector engagement in health and the advocacy and communication component. The AUC and AUDA-NEPAD are collaborating with wide range of partners, including Regional Economic Communities and development partners in the implementation of ALM declaration.