Achieving universal health coverage (UHC) for communicable diseases in Africa will hit a snag unless more efforts are put in both government action and funding, according to a new report.

The report, dubbed ‘Universal Health Coverage: A Framework for Action in Africa’, also reveals that total health expenditure that grew rapidly over the last two decades in Africa was mainly driven by out of pocket spending by households and development assistance, about half of which was allocated spending on HIV/AIDS.

Over the same period, total government expenditure decreased in half of the countries despite commitment to the Abuja target of 15 per cent government expenditure by 2014.

The report was launched at the sixth Tokyo International Conference on African Development, TICAD that ended last week in Nairobi, Kenya.

The report was launched by the World Bank and the World Health Organisation (WHO), together with the government of Japan, Japan International Cooperation Agency (JICA), the Global Fund, and the African Development Bank.

It provides a big-picture view of universal health coverage in the region and identifies key areas critical to achieving better health outcomes, such as financing, service delivery, targeting vulnerable populations, mobilising critical sectors and political leadership.

Despite such bottlenecks, the continent registered improvement in coverage using insecticide treated bed nets for children, improvement in maternal and child health services, antenatal care and child mortality.

Meanwhile, to achieve the 2030 Sustainable Development Goal of universal health coverage, the World Bank and the Global Fund to Fight AIDS, TB and malaria committed to invest $24 billion in Africa over the next three to five years.

The commitment was made ahead of the two-day TICAD meeting.

Rwanda’s Global Fund financing is based on the interventions stipulated in the strategic plan, according to Dr Jean-Pierre Nyemazi, the permanent secretary at the Ministry of Health.

He told The New Times Friday that government would make a five-year plan basing on that.

"Already, we are half way from the previous funding because in different areas such as HIV, TB and malaria, progress has been registered. If you look at malaria, the prevalence keeps changing that is why when it goes up or down, we keep adjusting our interventions,” he said.

Speaking ahead of the Nairobi conference, Jim Yong Kim, the president of the World Bank Group, said the fund would be strategic investment to ensure that African countries become more aggressive.

"African countries can become more competitive in the global economy by making several strategic investments, including investing more in their people, their most prised resource. A critical part of this commitment is to accelerate progress on universal health coverage — ensuring that everyone, everywhere has the opportunity to live a healthy and productive life,” he said.

Japanese prime minister Shinzo Abe highlighted the need for countries to strengthen responses to public health emergencies, and crisis preparedness.

Dispensing the funds 

The government of Japan will support the World Bank and WHO’s annual report to track UHC progress in Africa.

The World Bank and WHO also agreed to hold a high-level annual meeting in Tokyo in 2017 on monitoring progress toward UHC in Africa. 

Through its International Bank for Reconstruction and Development and International Development Association windows, the World Bank Group expects to contribute $15 billion in the next five years to investments that are critical to UHC, including early childhood development, pandemic preparedness, crisis preparedness and response, according to a statement.

The commitment assumes a successful IDA 18 replenishment. 

The Global Fund’s $9 billion commitment for 2017 through 2019 includes $6 billion of investments in programmes that treat and prevent HIV, TB and malaria while $3 billion of investments in systems for health such as strengthened procurement systems and supply chains, improved data quality and data management systems, and strengthened human resources for health.

The commitment assumes a $13 billion Global Fund replenishment to start in September 2016. 

Mark Dybul, the executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said prevention of such diseases is needed to reduce the burden on health systems.

Although the evidence is clear that investing in health pays dividends for countries, Dr Margret Chan, the director General of WHO pointed out that, challenges remain in the delivery and financing of health care.

editorial@newtimes.co.rw