Has the Abuja Health Declaration been killed before it turned 24?

Author presenting the key note gala dinner presentation

This key note gala dinner presentation was made to the “Health & Illnesses in Africa and the African Diaspora” University of Texas 24th Annual Africa Conference on Saturday 30 March 2025.

I approached this year’s Annual Africa conference dinner with an element of anxiety that guests would probably be dealing with postprandial somnolence or “food coma” and unable to take another speech. You all seem somewhat alert, so let me launch straight in. Thank you, Prof Toyin Falola, for the coordination of the 24th Annual Africa Conference and for the invitation to speak tonight. I note with some admiration that the UT tradition of Annual Africa conferencing is as old as the Abuja Declaration.

Four days ago, The United States President’s Emergency Plan for AIDS Relief lapsed without re-authorisation. Overseas health assistance funding has declined by 70 per cent. Debt servicing obligations exceed external financing flows to Africa while Africa remains 90 per cent dependent on imported drugs and technology. At 7-10 per cent, African private corporate investment remains minimal. Most Africans make out of pocket payments of 35 per cent, double that recommended by WHO.

Public health-care financing is at crisis point, once more.

In just 29 days, the world marks 24 years of the Abuja Health Declaration of African Heads of State and Government. The Declaration committed to eliminate AIDS, Tuberculosis and Malaria in Africa by 2030. Rather than, the elimination of the triple threat, we must face for the reality that without a radical intervention by African Governments, private and civic sectors, we face one of the sharpest reversals of the last two decades.

Unless we can compel a sense of urgency within Africa, the gains made in disease control as well as maternal and child health will soon be history. Unless we can collectively act to increase domestic investment, plug corruption loopholes and challenge external health policy conditionality that advises our governments to raise taxes and reduce access, we could see 2-4 million deaths annually.

Allow me to pivot from the direction this dinner speech is taking lest I cause dyspepsia or that familiar discomfort that leads to belching and nausea.

The idea that African governments should budget 15% of their expenditure to healthcare and rich countries would support by contributing 0.7 per cent of their GDP to global health and development was radical in its time. During a time when structural adjustment programs severely reduced healthcare access for millions, providing free public health services was viewed as poor governance.

The timing of this year’s conference health theme, therefore, could not have been better.  Let us recall this evening, the courage of that young Sierra Leonian Dr. Milton Margai in the 1950s, that Angolan doctor and first President Augostino Neto, that Mozambiquan nurse and first President Samora Machel in the 1970s or today’s Ugandan Dr. Kizza Besigye who continues against great odds, to champion open and accountable democracies that care for their people.

Let us draw from our ancestors and current leaders’ courage again to forge a new way through disease for our people. Let us insist that the world remains aware that preventative diseases stalk our most vulnerable. Let us persist in demanding that health remains a human right. Let us resist any actions that will weaken or destroy public healthcare now or in the future.

Millions depend on our courage and creativity right now. I honor you all, those here and the millions of healthcare workers on the front-line. Continue to stand for a world in which childbirth or falling sick should not be a death sentence for any human being.

Thank you.