1. MEETING OF MINISTERS OF HEALTH AND
FINANCE ON DOMESTIC FINANCING FOR
HEALTH
AU Roadmap on Shared Responsibility
and Global Solidarity for AIDS, TB and
Malaria response in Africa (2012-2015)
Dr. MARIE-GORETTI HARAKEYE
African Union Commission

2. leaders demonstrated strong commitment to stop HIV/AIDS,
TB and Malaria as exemplified by several continental, regional and
international decisions and commitments
AU Commitments on AIDS, TB, Malaria (2000, 2001, 2006, 2010, 2013)
Efforts were intensified and partnerships increased as a result
significant progress has been recorded, the triple challenge is abating
January 2012 : Decision on the revitalization of AIDS WATCH AFRICA:
African High Level Advocacy &Accountability Platform to Combat
HIV/AIDS, TB and Malaria
AWA targets expanded to include TB and Malaria, continent-wide
(AU) Assembly Decision No: Assembly/AU/Dec.413 (XVIII), requested
the African Union Commission (AUC) “to work out a roadmap of shared
responsibility to draw on African efforts for a viable health funding
with support of traditional and emerging partners to address AIDS
dependency response
2
African

3. AU Roadmap Principles and goal
• The Roadmap presents a set of practical African-sourced
solutions for enhancing Shared Responsibility and Global
Solidarity for AIDS, TB, and Malaria responses in Africa.
• The overarching goal of the AU Roadmap is to support African
countries to exercise leadership to meet AIDS, TB, malaria
targets by 2015 and source African solutions to ensure
universal access to health-related services for all those in need
on a sustainable basis. The AU Roadmap builds on a number of
AU initiatives (e.g. Africa Health Strategy and Abuja
Declaration)
• :

4. The Roadmap: three action pillars
2
Access to medicines –
local production and
regulatory harmonisation
3
Leadership, governance and
oversight for sustainability
4
1
More diversified, balanced
and sustainable financing
models
Priority actions
 Develop financial sustainability plans
with clear targets
 Ensure development partners meet
commitments and align with Africa’s
priorities
 Maximise opportunities to diversify
funding sources and increase
domestic resource allocation
 Invest in leading medicines
manufacturers – focusing on AIDS,
TB and malaria
 Lay foundations for a single African
regulatory agency
 Acquire essential skills through
technology transfers and south-south
cooperation
 Incorporate TRIPS flexibilities and
avoid "TRIPS-plus" measures in
trade agreements
 Use strategic investment approaches
for scale-up of basic programmes
 Support communities to claim their
rights and participate in governance
of the responses
 Ensure investments contribute to
health system strengthening
 Mobilise leadership at all levels to
implement the Roadmap

5. Key High Level Meetings related to the AU
Roadmap
• July 2012: Ministerial dialogue on value for money on
sustainability and accountability with a call to reduce aid
dependency
• September 2012: The UNGA high level side event in September
2012 event generated broad political consensus around a novel
approach to development cooperation to support
implementation of the AU Roadmap and to achieve, by 2015,
the MDGs targets .
• 29 November 2012: The United States upheld their
commitment to the Shared Responsibility-Global Solidarity
agenda for AIDS ‘PEPFAR Blueprint launch: Creating an AIDSfree Generation’.
• May and July 2013 : AWA Action Committee meeting of HSOG
and the Abuja AU Special Summit.

6. Diversified, balanced and sustainable
financing
• Most African countries have recognized the need to diversify and
expand the sources of funding for health generally and for HIV
responses specifically to reduce their dependence on a few
external funders.
• Measures taken include quantifying the country-level funding gap
(eg. financial gap analysis for malaria for 2013 – 2016 done by all
malaria endemic countries), identifying policy options to increase
resources, increased financial commitment by the private sector
and inclusion of health, malaria and HIV services in different
forms of health insurance and other health financing schemes.
• Member States encouraged to develop financial investment plans for
health, including AIDS, TB and Malaria, showing how national
programme costs will be covered with domestic and external funding
and annual increases in share of domestic funding

7. 7

8. Key suggested actions for
Pillar 1
Action
National Level
•
•
•
•
•
Analyzing the costs of the three diseases
Develop a sustainable financial plan based on
evidence based strategies
Building a picture of ‘returns on investment’
Identify innovative sources of domestic funding
Work with development partners to ensure they meet
their funding commitments
Regional Level
•
Facilitate sharing of ideas and lessons learned on
diversifying and innovating funding
Continental Level
•
Monitor and report on progress of member states on
biennial basis
8
Level

9. Commitment by the HOSG for Global Fund
Replenishment
• There was strong support from Heads of State Champions
(Nigeria, Tanzania, Kenya, South Africa, Senegal, Côte
d’Ivoire, Ghana, Rwanda, Malawi, Liberia, Ethiopia,
Mozambique) who have called for a fully-funded Global
Fund replenishment at bilateral meetings with donor
Heads of State, at international events (TICAD V, May 2013
AU Summit (AWA), Abuja + 12 Special Summit), UNGA and
in their communication with donors.
• The Heads of State and Government through the renewed
commitments of Abuja Declaration 2013 urged all
stakeholders to take action in support of achieving the
USD fifteen (15) billion replenishment target of the Global
Fund In this context, call upon Development Partners to
adhere to the 0.7% target of GDP for the contribution to
the Global Fund to fight AIDS, TB and Malaria

11. Scanning the environment:
Health Financing
• GF: Priority has to be given to Global burden of HIV/AIDS, TB
and Malaria, as well as the ability to pay.
• Even if countries provide the maximum ‘fair share’ domestic
financing of their Health especially ATM programs, many of
them, particularly low-income, high burden countries, will
continue to need substantial external support for some time.
• More investment on health is required as Africa seeks to
eliminate ATM (2030 ). This is also compounded by emerging
dynamics including that AIDS is increasingly classified as a
chronic disease.
• GF/UNAIDS/UNDP/RECS/CSOs committed to continue
partner with AU to accelerate the implementation of the AU
Roadmap in up to 2015

12. RECOMMENDATIONS
• AU Member States need to assess prospects for future
external aid, and their own domestic fiscal space.
• Need for Predictable international donor funding as
well as increased domestic investment and innovative
financing that can tap into new resources.
• Need for Timely investment, Combat the emergence of
MDR and XDR TB cases which can cost up 100 times
more. Same issue with the ARV third line high costly and
quite inaccessible in many African countries.
• We must put energy in getting results as the war is won
not when pledges come in, but when new cases of Aids
decline and all those eligible for treatment receive it;
when malaria is eliminated and Tuberculosis under
control.
• Share country experiences, best practices and challenges
in implementing the 3 pillars of the Roadmap

13.
1.Increase of investment plans for AIDS, TB and Malaria to close
1.Increase of investment plans for AIDS, TB and Malaria to close
the GAP by 2015 and ensure the sustainability of the national
the GAP by 2015 and ensure the sustainability of the national
response
response
2.At least one new revenue stream for domestic financing in
2.At least one new revenue stream for domestic financing in
operation by 2015
operation by 2015
3. Increase in ‘on budget’ spending between 2013 and 2015 for
3. Increase in ‘on budget’ spending between 2013 and 2015 for
the three diseases
the three diseases
1.Donors meet 100% of their commitments for 2015 financing.
1.Donors meet 100% of their commitments for 2015 financing.
13
Proposed benchmarks for diversified,
sustainable and balanced financial
models

14. «
GETTING MORE HEALTH FOR MONEY IS CRITICAL FOR
SUSTAINABILITY AND HOLDS US ACCOUNTABLE FOR RESULTS.
AFRICA’S TIME IS NOW A ND OUR PEOPLE CAN NO LONGER
AFFORD TO WAIT FOR HEALTH, WELL BEING AND
SUSTAINABLE DEVELOPMENT
H.E PRESIDENT ARMANDO GUEBUZA, MOZAMBIQUE
THANK YOU