Communiqué of the 1st Amref Health Africa International Conference, Safari Park Hotel Nairobi, November 24 – 26, 2014, Organized in Collaboration with the World Health Organization

Theme: From Evidence to Action – Lasting Health Change in Africa

 

Preamble

We, the organizers, keynote speakers, scientists and researchers, leaders from governments, multilateral agencies, the private sector and civil society, representatives of development partners, delegates, participants and the media, came together in this inaugural Amref Health Africa International Health conference to:

  • Share cutting edge research on health and health systems in Africa
  • Identify and discuss priorities in addressing Africa’s health in the post-2015 agenda
  • Bring together stakeholders to reflect on home-grown solutions to health system challenges in Africa
  • In the past three days, we have had rich sharing and discussion around the deep knowledge shared by keynote speakers, the findings of researchers, and the experience and skills of the private sector in innovation to find solutions to improved service delivery in Africa.

Dr. John Nduba, Amref Health Africa

We Note That

  • Africa has made progress in improving the health of her peoples in the MDG era, but that this progress has been inadequate to achieve the MDG targets for health.
  • Serious challenges in health persist in relation to the health of women and children, communicable diseases and infectious diseases that have long been eliminated or mitigated in other continents.
  • Africa additionally faces an emerging health burden from non-communicable diseases (NCDs).
  • More than one-third of African children are stunted due to chronic malnutrition, which seriously reduces their future economic productivity. This is a root cause of Africa’s under-development as malnutrition reduces national GDP by up to 3%.
  • In some countries, up to 40% of healthcare expenditure is out of pocket
  • The majority of African countries have not honoured their commitment to allocate 15% of their recurrent budget to health as per the Abuja Declaration of 2001.
  • Foreign aid to Africa has in most cases displaced national investment in the health sector, leading to unsustainable interventions with little local ownership. 
  • For every dollar committed to health, only 20% goes to real health interventions while 60% goes to buying equipment and services that do not meet the health needs of the people.
  • Africa’s health systems remain weak and fragmented due to decades of under-investment, weak leadership and management that do not respond adequately to the health needs of Africans in the era of Universal Health Coverage.
  • Predominant health approaches have to-date focused on tackling diseases at the expense of health system strengthening.
  • Africa allocates insignificant amounts of funding to research, far below the recommended 2% of GDP. Consequently, Africa lacks home-grown evidence-based solutions to her own problems.
  • Health policies are not based on translation of local knowledge
  • Africa has 11% of the world’s population, accounts for 24% of the global disease burden, but has only 3% of the world’s health workers struggling to cope with the health needs of Africans.
  • Further, the world has the evidence necessary to bring about lasting health change with proven interventions, but this evidence is not applied adequately in Africa to address the unacceptable levels of inequity pertaining to the health status in Africa, even as the world moves on from Millennium Development Goals to Sustainable Development Goals to be adopted in September 2015.


We Resolve That

  • All stakeholders in health in Africa must stop “business as usual” development and adopt evidence-based action in order to create lasting health change in Africa. We must break the silos and work together.
  • Africa must have more than one Sustainable Development Goal for health. The persistent inequalities in health status require great focus on strengthening health systems (SDG 1) that respond to the persistent challenges in Maternal Health, Child Health, Major Communicable and Infectious Diseases, and Non-Communicable Diseases. Nutrition is such a serious multisectoral issue that it requires its own SDG in the post-2015 era, and the third health SDG should address the neglected health problems of young and aging African populations.
  • Community participation and ownership should be the foundation of the six Health Systems Strengthening building blocks.
  • Community Health Workers must be made a part of the formal health workforce in African countries rather than being seen as a stop-gap solution.
  • African governments and the private sector must work together to invest in systems of production of human resources for health, taking maximum advantage of current technologies like e- and m-learning to lower the cost of training.
  • Accountability, efficiency, value for money, and transparent tracking of health expenditure must become standard principles in utilization of health care resources by both state and non-state health stakeholders.
  • African governments must put in place enabling policies, invest in quality health services, and show greater political will to address the root causes of ill health and galvanise other stakeholders to contribute towards sustainable universal health care coverage.
  • African governments should enact polices that adopt task shifting to address the shortage of human resources for health.
  • African governments must urgently create the policy framework, legislation and investment to rapidly improve the health research output in the continent.
  • Implementers, researchers and policy makers must create the platforms that ensure that research is translated into evidence-based policy-making and action to improve health in Africa.
  • African governments should create policies to facilitate networking of African researchers to generate evidence from research for practice and policy change.
  • Non-governmental organizations must advocate with the key stakeholders to focus attention continuously on translation of evidence to investment decisions for sustainable health systems in Africa.