The trend in health financing on the continent is not encouraging. We saw this in brief on the first part of this post where we looked at health expenditure comparisons on the continent. Information on country, regional and continental progress that is produced and actively disseminated by structures and platforms at these levels is also difficult to find.As we have noted on other issues we have covered, it is critical for Africa to produce, package and actively share information on socioeconomic issues it is facing. The continent can not be dependent on institutions beyond its borders to generate on understand of the state of our problems.
Regional data on total Government spending per capita in dollars (weighted) how that East and West African country Governments are spending between $8 and $9 per head, Central African Governments are spending about $20 per head; while the corresponding amount for North African Governments is over $40 and Southern African ones over $140. - Health Financing in Africa, Special Summit of African Union on HIV/AIDS, Tuberculosis and Malaria (2006).
Why are countries not investing and financing health adequately? Our thinking is that the process of costing for national health delivery is still a challenge. There are still many puzzle pieces that are missing for the costing process to be smooth. We examined before the lack of human resource for health. Other challenges also include insufficient infrastructure and health commodities availability. Costing in these circumstances using the same approaches as elsewhere in the world may very well yield flawed results.
But we believe many of these countries have the financing to meet 'universal access to health' commitments. What is required is for deliberate decisions to be taken to favor increases in health financing. For example the regions highlighted in the quote above; many countries in these blocks have extensive access to sources of financing in the form of minerals and an increasing tax base (both local and foreign). But mismanagement of resources, corruption and unfair speculation by the outside world on natural resources has diminished the revenue margins these countries work with. So if you are already working with an inadequate income, the focus will remain on spreading the revenue across all sectors and as a result, health indicators will remain unfulfilled for decades to come.
For the moment, debate will remain on whether the spending threshold set by WHO is appropriate in the different contexts it is applied, least of all Africa. What is clear here is that immediate, deliberate and adequate action to properly finance the health sector on the continent needs to be taken now. Africa cannot take advantage of its changing position in the global market if we can not at least put up the money to take care of our people's health. The continent needs to do the work; needs to do the math and establish the minimum standards with appropriate context and take action.
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