Background

Current macroeconomic challenges, high and evolving disease burdens, and a reliance on external funds demand an urgent acceleration of domestic health financing across Africa. While the 2001 Abuja Declaration set an ambitious target for governments to allocate at least 15% of their annual budget to improve the health sector, domestic resources for health remain insufficient. This hinders the fight against high burden diseases, jeopardises and puts at risk the sustainability of hard-won gains, and leaves millions without access to essential care. Overall health expenditure has significantly increased over time, but funding from domestic sources has not increased commensurately. Therefore, while Africa celebrates considerable strides in health outcomes, inadequate domestic investments limit the flexibility of national health systems to address pandemics, NCDs, other emerging threats and threatens to dim the continent's ability to sustain healthcare advancements. As a result, new preventable diseases continue to claim lives, pushing millions into poverty due to crippling healthcare costs. Africa's future hinges on the health of its people, yet the continent continues to record high numbers of deaths and suffering. To build a sustainable future, the African Union has again committed to prioritizing domestic health sector investments through the 2019 Africa Leadership Meeting declaration. Meeting the ALM commitments will save millions more lives, break the cycle of poverty by protecting families from financial ruin occasioned by high out of pocket spending, and drive economic development.

Civil Society Organizations (CSOs) play a vital role in advocating for increased health financing in Africa. They shape policies, monitor implementation, and provide evidence-based recommendations to improve outcomes. CSOs champion the attainment of Sustainable Development Goals (SDGs) by advocating for improved resource allocation, prioritization, and utilization for essential health programs, including community health, primary healthcare, maternal and child health, TB, HIV/AIDS, and malaria. Their efforts facilitate public participation, research, program monitoring and evaluation, and social accountability, leading to more effective health resource allocation and use. However, Africa's health financing landscape remains challenged by factors like duplication of coordination structures, poor policy development and implementation, reliance on donor funding, and misappropriation of resources. To address these obstacles, CSOs are scaling up their health financing advocacy through the Joint Learning Agenda (JLA). Led by WACI Health and Impact Santé Afrique, the JLA receives support from the Global Financing Facility (GFF), the Global Fund, the Partnership for Maternal, Newborn & Child Health, Gavi, and UHC 2030 and national partners.

In its initial phase, the JLA successfully trained 40 participants across 20 countries in health financing advocacy, building a pool of experts to improve health initiatives at various levels. Additionally, it expanded the knowledge base of 400 civil society representatives in health financing, fostering a ripple effect in advocacy efforts. Through the second phase, participants applied their skills practically through customized capacity building, technical assistance, and grants.

Workshop Objectives

Considering the high demand from JLA participants, and following recommendations from the independent evaluation, JLA partners will convene all country trainers in a workshop to review progress,share knowledge, and discuss challenges and opportunities, to further consolidate and amplify civil society advocacy for health financing and UHC in the region. More specifically, the workshop aims at gathering actionable inputs from diverse stakeholders to effectively plan and launch the next phase of support in advancing CSO advocacy for health financing and contributing to increased domestic resource mobilization (DRM) for UHC.

It is therefore important to build on what JLA has achieved, address challenges and build stronger collaboration and advocacy with other stakeholders in the region. To do this, it is prudent that we take stock of what has been achieved, understand how change in this space happens, and identify the support that CSOs need to achieve further impact in the region and the next steps for this network. It is also critical that CSOs understand partner perspectives to help the latter meet their accountability objectives while supporting CSOs more comprehensively.