In Africa, the twin effect of poverty and low investment in health has led
to an increasing burden of diseases notably HIV/AIDS, malaria, TB, high
maternal and child mortality and morbidity, and non-communicable diseases.
This is challenging the achievement of the health Millennium Development Goals (MDGs) in the region. The current per capita expenditure on health in most countries of the region is below $10 per capita compared to $34 as recommended by the Commission on Macroeconomics and Health. The Abuja Declaration of 2001 proposed that 15 percent of public expenditure be allocated to the health sector. Progress towards this target has been slow and health spending continues to be seen as ‘consumption’ rather than ‘investment’. By 2005, only a third of the African countries had allocated 10 percent or more of their national budgets to the health sector, while another 38 percent had allocated 5-10 percent and the remaining 29 percent had allocated below 5 percent1. During 2005 – the year of development – the G8 and the World Summit accordingly recognized the need for increased development aid to African countries.

A series of High Level Forums held between 2003 and 20063 reviewed how
to accelerate progress towards the health MDGs and identified critical upstream
policy-level constraints that need to be urgently addressed. To support African
countries, most health partners agree that multilateral and bilateral assistance
will remain an important source of funding to health development for a long
while. The WHO through its “Strategic Orientations for WHO Action in the African Region, 2005-2009”, the World Bank through its poverty reduction strategy initiatives, and UNICEF through its child survival initiatives have all expressed their commitment to strengthening partnerships for scaling up essential services such as HIV/AIDS, TB, Malaria, maternal and child health and health systems strengthening, and tackling the determinants of health.