Africa Public Health Rights Alliance & the “15% Now!” Campaign

From TrustAfrica wiki - African Regional Organizations

Africa Public Health Rights Alliance and the “15% Now!” Campaign
International Office:
AFA, Unit 10 Aberdeen Centre
Highbury Grove
London N5 2EA

Tel: +44 (0)20 7424 5744
Fax: +44 (0)20 7424 5745

Email: info@credonet.org

Africa Office:
17-19 Allen Avenue
P.O Box 197 Ikeja, Lagos

Tel / Fax: +234 1 8197344

Email: africapublichealth@googlemail.com
Website under development

Honorary Chair: Archbishop Desmond Tutu, 1984 Nobel Peace Prize winner
Mr. Rotimi Sankore, Coordinator, rotimi@credonet.org
Mr. Dapo Awosokanre, Projects and Campaigns Manager, projects@credonet.org

Description

Launched on International Human Rights Day (10 December 2006), the Africa Public Health Rights Alliance (APHRA) is the first single-issue coalition of its kind to articulate public health for Africa as a rights and development issue.

APHRA is an initiative of the Centre for Research, Education and Development of Rights in Africa (CREDO-Africa) and brings together actors from key sectors of civil society. APHRA’s work is based on the premise that in order to exercise any other rights in a meaningful way, and contribute to Africa’s social and economic development, citizens of African countries need to be alive and well. As such, the Right to Health and to Healthcare is viewed as arguably the most crucial right of all—as articulated by both the constitution of the World Health Organization and Article 12 of the International Covenant on Economic, Social and Cultural Rights.

APHRA’s overarching objective is to engage the African Union, the Regional Economic Communities (RECs), their institutions, member countries, and the African public towards: promoting greater awareness and understanding of African health issues and; adopting comprehensive health policies based on a public health rights and development philosophy—and mobilizing resources for sustainable financing and implementation of health policies. APHRA also engages global stakeholders and actors including donors, the UN, EU and their institutions and international NGOs and organizations especially those concerned with health, social and economic development.

APHRA’s “15% Now!” Campaign is based on the fact that the lack of sustainable financing for public health and disease specific issues is the greatest obstacle to the delivery of comprehensive public health across Africa. The “15% Now!” campaign is based on effecting the unredeemed 2001 Abuja pledge of AU member states to allocate at least 15 percent of national budgets to health.

APHRA campaigns on the basis of specific advocacy targets. Within Africa, it aims to ensure:

• That the untenable loss of an estimated 8 million African lives every year to preventable, treatable or manageable diseases—led by HIV, tuberculosis, and malaria—is brought to and sustained at the forefront of the African and global agenda, and that similar focus is brought to bear on reducing maternal and child mortality through improved resource allocation to reproductive health.
  
• That African governments immediately work toward urgently implementing their 2001 Abuja Declaration pledge to dedicate 15 percent or more of annual budgets to health care within three years, and ensure that a commensurate percentage of this is dedicated to resolving the human resource/ health worker shortage.
  
• That the allocation and expenditure of this 15 percent or more of national budgets to health sectors be monitored by health care professionals and other civil-society stakeholders.
  
• That African governments, including the African Union and RECs, make the resolution of Africa’s health worker shortage and the adoption of a comprehensive preventive health care strategy their top public health care priorities, and in consultation with health workers and other civil-society stakeholders set measurable targets, especially for rapid and scaled up training and retention of all categories of health workers, including review and resolution of push factors that facilitate the exodus of health workers, such as working conditions.

Internationally, APHRA and its global partners want to ensure:

• That Northern and international public pressure is placed on International Finance Institutions, donor countries, and the International Monetary Fund in particular to ensure that conditionalities such as expenditure ceilings and other policies that hinder health sector training, employment, and development are immediately ended. In particular, ensure that any such policies that stand in the way of 15 percent or more of budgetary expenditure being dedicated to health care are ended.
  
• That Northern governments which benefit from, promote, and depend on “brain drain” to prop up their health care systems immediately cease any domestic policies that promote such, e.g., official overseas recruitment policies, and consider options, including increase domestic public expenditure for education in general and health care worker training in particular.
  
• That governments of countries that have benefited the most from the “brain drain,” together with African governments and African and international civil society, including health sector workers, examine ways to compensate Africa’s health care system for the damage their overseas recruitment policies have done.
  
• That G8 countries be held to account regarding their policies that undermine pledges to enable African countries meet the MDGs, in particular the three health-based MDGs.
  
• That the 2008 International AIDS Conference places commensurate emphasis and focus on concrete solutions to scaling up human resources and health care infrastructure, especially in Africa, and that African voices are provided with a platform.
  
• That key health intergovernmental organizations such as UNAIDS and its sponsoring agencies focus on and take practical steps toward supporting sustainable financing for Public Health, and the resolution of Africa’s human resource and infrastructure shortages within the next five to six years.

The thematic scope of APHRA’s campaign is comprehensive, spanning Public Health Policy; Mobilizing Greater Resources, Financing and Budgeting for Public Health and the following interlinked themes - Child Health and Mortality, Environmental Health and Sanitation, Gender Equality and Women’s Rights Issues especially Reproductive and Sexual Health/Rights, and Maternal Mortality; Ethical Research and Trials; Health Workforce Development; Human and Health Rights; Nutritional Health; Preventive Medicine; Refugees and IDP Rights and issues; and disease specific focus on HIV/AIDS, TB, Lung and Respiratory Disease, Malaria, and Neglected Diseases especially those that affect millions and exacerbate the big killer diseases such as Blindness or Sexually Transmitted Diseases.

The Alliance’s objectives are advanced through a wide range of methodologies that include research; information and statistics gathering and analysis for decision making; policy analysis and development; technical support; advocacy and campaigns; public awareness and education; information dissemination; enhancing media coverage of health issues; networking, constituency building and support; capacity building; training; leadership development; and combating stigma.

Track Record

In the short time it has existed, and through its “15% Now!” Campaign, APHRA has successfully engaged the African Union, Regional Economic Communities their member states and institutions and the African and international public.

It has played a leading role in reviving the African Union’s 2001 pledge, made in the Abuja Declaration on HIV/AIDS, Tuberculosis and Other Infectious Diseases, for member states to allocate at least 15 percent of national budgets to health care.

By crossing country level, regional and disease specific indicators, and through thorough research and advocacy, APHRA has created continental and international awareness of the scale of Africa’s health tragedy. It has drawn attention to the fact that each year between 2001 and 2006 Africa has lost more than 8 million people a year to 5 preventable, treatable and manageable diseases—maternal mortality, child mortality, HIV/AIDS, TB and malaria.

In addition APHRA has highlighted the link between the loss of 40 million lives in 5 years and a projected loss of 120 million or more lives by 2015 - to the 2015 target for meeting the MDG’s, arguing that unless AU member states start meeting their Abuja 15 percent pledge immediately, the sheer scale of the health challenges at hand will severely undermine Africa’s quest for social and economic development.

APHRA has campaigned successfully for the adoption of an Africa Health Strategy and intervened at the 2007 conference of African Health Ministers to ensure that the Health Strategy for 2007–2015 is based on a rights and development perspective. Some 80 percent of APHRA’s expert submissions and recommendations to the conference were adopted in the final draft of the Health Strategy.

Similarly, APHRA intervened at a Conference of African Ministers of Finance, Planning and Economic Development in Addis Ababa, Ethiopia, in April 2007, calling for a re-ordering of budget priorities from military, to an emphasis on social and economic development, including public health. Other APHRA highlights include awareness building and advocacy at the January 2007 World Social Forum and African Union Summits.

In the space of 6 months, APHRA now constitutes a broad-based Alliance of close to 40 organizations drawn from across thematic areas and social sectors. The incorporation APHRA and its “15% Now!” campaign as a not-for-profit entity is currently being finalized. APHRA’s governance structure is under development. It is composed of an Honorary Chair, Archbishop Desmond Tutu, 4 Patrons and Special Ambassadors (currently being finalized), and a 14-member advisory committee of leading health professionals and experts, policy experts, disease specific activists, gender equality and women’s rights campaigners, and human rights and development campaigners.

Challenges

As with coalitions of this kind, bringing together disparate actors and spanning countries and regions, ensuring effective secretariat capacity is a challenge that APHRA must overcome if it is to fulfill its potential and deepen its campaigning. This organizational fragility must be overcome both at CREDO, the coalition’s central hub, and in various temporary nodes at different times, depending on the location of key events and processes such as Ministerial and other intergovernmental meetings.

Ensuring that APHRA has the ability to mobilize quickly and campaign effectively in different spaces and scales implies a bigger budget and more predictable types of funding. Since its inception in December 2006, APHRA has raised approximately US$60,000 of mostly project-based funding, and also some in kind support. Contributors to the budget are CREDO-Africa itself (US$25,000 in core and $5,000 in in-kind support), the Open Society Initiative for Southern Africa (OSISA, $20,000 in project support for health advocacy, policy and awareness, $12,000 in-kind) and Open Society Initiative for West Africa (OSIWA, $15,000 in project support).

At present capacity shortfalls include lack of core funding for dedicated staff. Required staff and skills to cover Africa and International work includes: an overall Program Director; Health Policy Director; Advocacy and Campaigns Coordinator; Projects and Partnership Development Manager; Gender Equity in Health Officer; Research and Publications Officer; Finance Manager; Office and Administration Manager; and Projects Assistant.

Other capacity challenges include office and running costs—at present mainly provided by CREDO-Africa. Ideal funding support would be 40 percent Core and 60 percent project funding.

Opportunities

Private foundations have the opportunity to ensure the effective functioning and sustainability of a new and emerging African alliance that promises to break new boundaries and deepen citizen engagement on the Right to Health, especially at a time when there is a growing need for governments to be held accountable for norms and standards they have signed up to. Technical advice and institutional support to strengthen the campaigning hub and secretariat function holds the key to APHRA’s future survival and effectiveness. Support to strengthen the Alliance’s staffing, administrative, research, information dissemination and advocacy capacity is also needed. Core program funding would also make for more flexibility, faster mobilization and more proactive campaigning.