Olayide AkanniJournalists Against AIDS ( JAAIDS)

Nigeria

Olayide.akanni@nigeria-aids.com

In the wake of the September 2000 Millennium Summit, the leaders of African Union Member States assembled in Abuja, Nigeria in 2000 and 2001, and adopted the ◦ Abuja Declarations and Frameworks for Action on

Roll Back Malaria, and on HIV and AIDS, tuberculosis and other related infectious diseases.

The primary objective of the Abuja Declarations and Frameworks was for Africa to collectively and individually work towards arresting and reversing the staggering rate at which these diseases were eroding prior progress made in socio-economic development.

Africa Summit on Roll Back Malaria held in Abuja on 25th April 2000

Key outcome documents included the Abuja Declaration on Roll Back Malaria in Africa as well as the Framework for Monitoring the Plan of Action http://www.rollbackmalaria.org/docs/abuja_declaration_final.htm

44 out of the 50 countries affected by Malaria attended the Summit

Through the Declaration, African heads of state committed to:

Halve malaria deaths by 2010, provide financial resources and

incentives to access goods and services, and support malaria research.

April 25 was declared African Malaria Day

Personal responsibility & leadership

Comprehensive multi-sectoral response

Mobilize internal and external resources

Spend at least 15 per cent of national budgets on health

Better care and support of PLWH

Improve the availability of medical products and technologies

Support the development HIV vaccine

Endorsed establishment of AWA

Endorsed Global Fund launch

Heads of States and Govt of AU met in Abuja 2nd – 4th May 2006

Reviewed progress made since 2001 Call emphasizes the following key areas:

◦ Rededication by African Heads of State and Governments to 2000 and 2001 Abuja Declarations and Plans of Action

◦ Leadership at National, Regional and Continental levels

Resource Mobilization◦ To mobilize local resources for sustainable and

predictable financing including implementation of the Abuja declaration call for 15%

◦ To negotiate for debt cancellation and availability of grants at national and regional levels( Paris Club Debt Cancellation/Reallocation to MDGs)

Protection of Human Rights Adapting national legislation to take cognisance

of HIV and TB issues specifically stigmatization and discrimination( National Anti Stigma Bill pending assent)

Poverty Reduction, Health and Development

To ensure the integration of HIV and AIDS, TB and Malaria programmes into Poverty Reduction Strategies and Programmes and country programmes ( SEEDS, NEEDS, Vision 2020)

Strengthening Health systems◦ To meet WHO Standards for Doctors and Nurses (

WHO recommends 1 doctor to 600 patients, Nigeria has 1 doctor to 3500 patients)

Prevention, Treatment, Care and Support

To invest heavily in evidence-based prevention as the most cost-effective intervention with focus on young people, women, girls and other vulnerable groups

Access to Affordable Medicines and Technologies

Research and Development Implementation Partnerships Monitoring, Evaluation and Reporting

“We call upon the respective national, regional, continental and international partners including NGOs to”:

Intensify their efforts more than ever before for the fight against HIV and AIDS, Tuberculosis and malaria.

In this connection, they should develop and implement well coordinated and harmonized frameworks which will provide concrete results.

Support the mobilization of additional resources for prevention, care and support and treatment-related activities;

Facilitate through enhancing their monitoring role, the operationalization of commitments at all levels

Effectively implement the AU Commission HIV and AIDS Strategic Plan and AWA Strategic Framework 2005-2007;

Promote regional integration and collaboration in the areas of Disease Control

Ensure that HIV and AIDS Tuberculosis and Malaria are catered for in the NEPAD Health Strategy;

Ensure that malaria prevention and control is accelerated with the goal to eliminate malaria in Africa by 2010 using all available control strategies

Coordinate in broad partnership with Civil Society and the private sector, the effective implementation of the Abuja Call and report annually to the AU Assembly

Conduct Consultative Reviews of Progress after two years (2008) and five years (2010) on Status of Implementation

Priority Areas formed the basis of the review

Data sources reviewed included:◦ 2008 and 2009 Progress Reports on the status of

implementation on the Abuja Call to the AU organs, which were based on annual country reports on the three diseases.

◦ Biennial country progress reports for the United Nations Declaration of Commitment on HIV and AIDS and annual country reports for monitoring the health sector response towards Universal Access for HIV prevention, care,

◦ WHO Annual TB Country Reports

Although progress has been recorded in the Priority areas :◦ Few countries have addressed health in their

central development frameworks◦ Most countries have not adopted or are not

applying policies, legislation protecting human rights

◦ Monitoring and evaluation systems are weak in many countries making reporting difficult

◦ Health financing: Although available resources have generally increased, this has been mainly from international sources. Most countries have not yet established sustainable

financing mechanisms for services or regular supplies

Extend the “Abuja Call for Accelerated Action towards Universal Access to HIV and AIDS, TB and Malaria Services” for the period 2010-2015 to enable further implementation of the commitments and to coincide with the target of the MDGs

Strengthen advocacy and resource mobilization for the 3 diseases

Support implementation of country road maps towards Universal access by 2010 and beyond

Prepare another Progress Report by 2013

Progress Report considered at the Abuja +12 Summit held July 12 -17th 2013 in Abuja

Key findings◦ For the 2010 -2012 Report, only 12 of the 53 member

states presented data to the AU Commission◦ Only 5 out of the AU members have reached the 15%

budget threshold commitment made in 2001◦ Only 54% of those eligible for antiretroviral treatment

on the continent have access◦ Only 10.9 % of children under 5 received timely

malaria treatment based on national guidelines◦ Emergence of MDR TB has become a growing concern

To address the issues of Sustainable Financing, a key element in addressing the 3 diseases, the AU members states have come up with a Roadmap on Shared Responsibility and Global Solidarity for the AIDS, TB and Malaria Response in Africa

It aims to :◦ Leverage the resources, activism and momentum

of AIDS, TB and Malaria response◦ Mobilize for progress across health and

development ◦ Utilize African sourced( home grown) solutions

MPoA seeks to take the African continent closer to its goal of universal access to comprehensive sexual and reproductive health services by 2015.

It is a short-term plan for the period up to 2010, only recently extended to 2015. The plan is built on the following action areas:

◦ Integrating of Sexual and Reproductive Health (SRH) services into PHC

◦ Repositioning family planning developing and promoting youth-friendly services

◦ Eliminating unsafe abortion◦ Encouraging quality safe motherhood◦ Mobilizing resources ◦ Ensuring commodity security◦ Monitoring and evaluation.

The Plan is premised on SRH in its fullest context as defined at ICPD/PoA 1994, taking into account the life cycle approach. These elements of SRHR include:◦ Adolescent sexual and reproductive health (ASRH)◦ Safe motherhood and newborn care;◦ Abortion care◦ Family planning; prevention and management of

sexually transmitted infections including HIV/AIDS; prevention and management of infertility

◦ Prevention and management of cancers of the reproductive system

◦ Mid-life concerns of men and women; health and development;

◦ Reduction of gender-based violence; interpersonal communication and counseling; and health education.

The ultimate goal of this Maputo Plan of Action is for African Governments, civil society, the private sector and all development partners to join forces and redouble efforts, so that together the effective implementation of the continental

policy including universal access to sexual and reproductive health by 2015 in all countries in Africa can be achieved◦ $3.5 billion is required for sexual and reproductive

health services for Africa in 2007 and a total of $16billion through to 2010

◦ Strategic action areas also include Indicators for Monitoring Progress

The Plan recognizes the importance of creating an enabling environment and the role of men and the community towards women’s empowerment◦ Repositioning family planning as an essential part of the

attainment of health MDGs◦ Addressing the sexual and reproductive health needs

of adolescents and youth as a key SRH component◦ African and south-south co-operation for the

attainment of ICPD and MDG goals in Africa◦ Increase domestic resources for sexual and

reproductive health and rights, addressing of the human resource crisis

◦ Adopt a multisectoral approach to SRHR◦ Foster community involvement and participation

The AU will, among other things, play advocacy role, resource mobilisation, monitoring and evaluation, dissemination of best practices and harmonisation of policies and strategies

RECS will, provide technical support to Member countries including training in the area of RH, advocate for increased resources for SRH harmonise the implementation of National Action Plans, monitor progress, identify and share best practicesMember States will adapt and implement the Action Plan for the

operationalisation of the Continental SRHR Policy Framework. They will also put in place advocacy, resource mobilisation and budgetary provision as a demonstrationof ownership and monitoring and evaluation. They will also invite civil society and the private sector to participate in national programs.

Partners In line with the Paris principle ( Declaration) multi-lateral and bi-lateral organizations; international and national CSOs and other development partners will align their financial and technical assistance and cooperation plans with national and regional needs and priorities for implementation of the plan of action

Despite several socioeconomic strategies in Africa, the burden of disease has continued to undermine efforts at development.

 African Union ministers of health have decided to harmonize all the existing health strategies to create a formidable front in the fight against disease by implementing the Africa Health Strategy with regional economic communities, other regional entities and member states◦ Health Ministers met in Johannesburg, South Africa

April 9 -13 2007◦ Theme : Strengthening of Health Systems for Equity

and Development in Africa

The strategy acknowledges that the burden of disease has stifled Africa’s ability to realize global objectives such as the Millennium Development Goals. (MDGs)

Mission : ‘To build an effective, African-driven response to reduce the burden of disease and disability through strengthened health systems, scaled-up health interventions, inter-sectoral action and empowered communities

This burden has been compounded by :◦ high maternal and infant mortality◦ low life expectancy◦ poor education of children and women.

The strategy aims to prevent avoidable disease and reduce disability and death in Africa by strengthening healthcare systems.

The strategy outlines the integrated approach countries should take towards the ultimate objective of socioeconomic wellness.  

Sound data is crucial to success; monitoring and evaluation are spelled out in detail in the strategy. It assigns definitive roles to major partners, including the African Union, regional economic communities, member states and civil society

Health is a human right Health is a developmental concern requiring a

multi sectoral response Equity in health care is a foundation for all

health systems Evidence is the basis for sound public health

policy and practice Respect for culture and overcoming barriers to

accessing services Prevention is the most cost effective way to

reduce the burden of disease

Governance Policies and Legislation, Organization,

Performance Resources, Financing, Resource Allocation Social Protection, Human Resources Commodity Security and Supply Systems Health Systems Operations African Traditional Medicine Participation Community Involvement and

Empowerment Strengthening Partnerships Health Information and Research Surveillance, Emergency Preparedness

Community members are often perceived as consumers and yet are a potential resource that could be tapped into so as to strengthen health systems. Countries and the regions need to have strategies of empowering and involving communities to ensure ownership and sustainability of programmes.

Community participation should not be limited to cost sharing only but should also include other aspects like report problems in the health systems

“Each country should plan their framework for community participation in the health system and create an enabling environment for this to take place.

Countries should design and implement a plan for achieving health literacy and community empowerment to realise the full benefit that this offers for health.”

The Africa Health Strategy supports broader issues that are undermining health including poverty, HIV/AIDS, marginalisation and displacement, poor governance, socio-political instability, economic underdevelopment, lack of infrastructure (energy, transport, water and sanitation), low educational levels, agricultural vulnerability, environmental degradation and gender inequality

Ministers of Health will seek to participate in their countries poverty reduction strategy and economic empowerment processes to encourage health promoting options and development for the poorest and most marginalised people and will engage with other sectors to promote decisions and actions that work in favour of health.

The AU should organise a meeting of stakeholders to develop an action plan for the overall implementation of this Strategy

Regional Economic Communities will, among other things, provide technical support to Member countries including training in the area of health systems strengthening, advocate for increased resources for health systems strengthening, harmonise the implementation of national Action Plans, monitor progress, identify and share best practices.

Civil Society : These include NGOs, Faith Based Organizations (FBOs), CBOs, Traditional leaders and healers as well as media organizations. Member States will should civil society and the private sector to participate in national programs

For additional information contact :

Journalists Against AIDS ( JAAIDS) Nigeria14Fadare Street, End of Kayode StreetOgba, Lagos Email : jaaidsng@nigeria-aids.com jaaidsng@gmail.com

Website : www.nigeria-aids.org