Key messages:

• Devoting 15% of domestic public funds to the health sector is necessary - both to address the health and health care needs within east and southern Africa (ESA) and to ensure progress towards building a universal and comprehensive health system
• The target of 15% is not unrealistic – it is very much in line with levels of public spending in other countries around the world
• Achieving the 15% target demands that public funds not be consumed by debt servicing, so rapid implementation of debt cancellation is critical
• The 15% is understood to mean domestic public spending on health, excluding external funding. It should be regularly monitored and publicly reported by governments
• Even if countries achieve the 15% target, for many there will still be a substantial gap in funding for health services. More resources flow out of Africa than into the continent, so sustainable health financing demands global solidarity. OECD countries should meet their commitment to contribute 0.7% of their GNP as official development assistance (ODA).
• Increased spending on health services should not be at the expense of spending on other social services.

What is the Abuja target?

In 2001, in Abuja Nigeria, Heads of States of the African Union (AU) member states committed to allocating at least 15% of annual government budgets to their health sectors. At the same time they called upon donor countries to complement their efforts to mobilise resources domestically by fulfilling their commitment to devoting 0.7% of their GNP as ODA to developing countries and cancelling Africa’s external debt in favour of increased investment in the social sector.

The Abuja target, thus, consists of three components; African countries should:

• mobilise domestic resources for health (15% now);
• unencumbered by debt servicing (Debt cancellation now); and
• be supported by ODA (0.7% GNP to ODA now).