By Sharon Atieno
Despite African countries not meeting the Abuja declaration commitment of allocating 15 percent of national budgets to health, dwindling donor funding is worsening the situation.
A World Health Organization (WHO) report shows that about 150 million Africans are pushed into or deeper into poverty due to high out-of-pocket health spending.
It is against this backdrop that experts at the Evidence for Development (Evi4Dev) conference called for innovative approaches to increase domestic health financing to achieve universal health coverage.
Calling on African countries to transition to domestic resource mobilization, Dr. Jackson Otieno, Senior Policy Analyst, African Institute for Development Policy (AFIDEP), noted that the sector is heavily donor-dependent.
He observed that Development Assistance to Health (DHA) in 2020 alone accounted for more than 20% of total health spending in 24 African countries and even surpassed government expenditures in 10 countries.
“Innovative health financing models remain unexploited,” Dr. Otieno said, adding that there are numerous approaches that African countries can implement, such as health taxes, debt swaps, impact bonds, as well as public-private partnerships.
Dr. Daniel Mwai, Presidential Advisor on Health Financing in Kenya, pointed to the fragmentation of services and vertical health programmes are key barriers to efficient health financing.
“We can cut the cost of healthcare in Africa by 40% if we reorganise and plan well in its delivery,” Dr. Mwai stated, calling for integration and multi-skilled healthcare workers. He also urged countries to focus on preventive healthcare compared to curative healthcare.
Dr. Patrick Zimpita, Principal Secretary for Economic Planning and Development in Malawi, warned that rising debt is squeezing development budgets.
“There is a need for budget reform transformation as most African countries spend 70% of their budgets on current expenditures, while 30% on development expenditure, while 80% of this [development expenditure] is donor funded,” Dr. Zimpita said.
Kwame Owino, CEO of the Institute of Economic Affairs (IEA-Kenya), emphasized the need for fiscal discipline and efficient resource utilization in Africa’s healthcare systems.
“Citizens across East Africa are reaching their limits, the protests last year in Kenya were a clear sign. We must get the most from the taxes by prioritising high-impact public goods and reducing wastage through corruption. Governments must spend conservatively in areas with the greatest public demand,” he said.
According to Prof. Victor Murinde, Executive Director, African Economic Research Consortium, new technology can be leveraged to reduce inefficiencies in the health sector.
“There is need to unlock the potential of new technology. The adoption of AI, big data and machine learning is key in identifying best practices and reducing inefficiencies,” Dr. Murinde said.
Prof. John Ele-Ojo Ataguba, Executive Director, African Health Economics and Policy Association (AfHEA) noted there is need to think of health as an investment.
“People who want to invest struggle to invest in health because they see it as a sector that is not productive. Perhaps it is time for us to think. Think hard in terms of creating investment cases for investing in health,” he urged. “Investments in health don’t go down the drain because we’re looking at human capital, building up people who are productive to make sure the economy runs.”
The experts called for homegrown solutions, stronger stakeholder engagement, and strategic investments in health-focused technology and financing models. As countries face pressure to deliver quality healthcare amid shrinking budgets, experts agreed that bold reforms, partnerships, and innovation should take centre stage.
The conference was convened by the African Institute for Development Policy (AFIDEP), Science for Africa Foundation and African Union Development Agency (AUDA-NEPAD) in Nairobi, Kenya’s capital.
