The continued care of many people taking antiretroviral therapy in Africa is under threat as donors are retreating from funding AIDS programmes. Many countries in Africa do not have elaborate budgets for their health programmes. Almost 90% of some African countries’€™ health budgets are funded through donor finances. Yet, African leaders accept that health is a critical component for the survival of their countries. At a meeting in Abuja, Nigeria, one decade ago they promised to increase their budget allocations for health to 15%. For many countries, health budgets have increased to about 12% since then. A human rights activist from Zambia, Daniel Libati, says leaders have shown their political will to take health seriously, but cautions that political will on its own does not pay for health.

‘€œThe political will should be able to be matched with the need that’€™s on the ground and that matching comes in as far as resources are concerned. We look at the resources which our government itself is actually contributing to antiretrovirals and TB drugs, compare it to what our co-operating partners, that is, the donors are contributing, you come and realise that the co-operating partners are putting more into the basket than our government’€, Libati says.

South Africa is one of the countries that are not yet spending 15% of their health budgets on health. But the country is credited for having substantially increased its health spending, particularly on HIV and AIDS care, as a country that has one of the highest numbers of people living with HIV. Deputy Health Minister, Dr Gwen Ramokgopa, says leaders have a responsibility to ensure that the right to health of citizens is fulfilled.      

‘€œThe AU has agreed that all countries in our continent should endeavour to spend, at least, 15% of their budgets on health. Leaders, have a responsibility to ensure that the purse of a country is distributed towards health as a right. Almost 90% of the health budget of some countries is from donors and that is not sustainable’€, Ramokgopa says.

Section 27’€™s Executive Director, Mark Heywood, says over 70 countries have incorporated the right to health into their national constitutions over the last 10 years, but have failed to fulfill their promises. Heywood said civil society has also not done enough to ensure that the right to health is honoured.

‘€œThe right to health has not been popularised and not been utilised sufficiently. The right to health has not been used as a mobilizing and campaigning tool and has not been used against States and against private players to the degree that it could have been. Many of the institutions that have been mandated to realise the right to health actually work against it and work for the status quo’€, says Heywood.    

Deputy Health Minister, Dr Gwen Ramokgopa, said the government has a role to be responsive to the needs of its population.

‘€œIf there is a specific problem, whether it’€™s HIV/AIDS, whatever it is, the State should be responsive’€¦ the resources, the efforts that are put into the processes that seek to relieve the population of that health problem should result in reduced burdens of those particular ailments’€.          

She also called on the international community to continue its relationship with countries such as South Africa to lend a hand.

‘€œThe international community should continue working with us to deal with the health challenges that are beyond our capability as a nation to deal with. The burden of HIV/AIDS and TB has grown to epidemic proportions and I’€™d like to acknowledge that, indeed, we have substantive international support in that regard, although we, ourselves, are contributing to the Global Fund because we know that there are countries that are less privileged than us’€, she said.

Ramokgopa also pointed out that the Constitution should be a guiding principle towards the realisation of the right to health. She commended civil society organisations such as the Treatment Action Campaign and the National Association of People Living with AIDS for using the principle to ensure justice for people with HIV and AIDS.

‘€œWe, as South Africans, should reflect on this Constitution as a mirror, should reflect on health as a right and determine how far we have gone, and also look at what else needs to be done and participate actively. The action of a number of progressive NGOs, inclusive of the TAC, inclusive of NAPWA and others have contributed as well in that specific area, particularly around HIV and AIDS, for the country to look at this matter differently from how it has been perceived before, and that has also assisted in terms of moving forward’€, Ramokgopa said.