When the African Union (AU) Heads of State committed to allocating at least 15% of annual government budgets to their health sectors In Abuja, Nigeria in 2001, they also called on high income countries to fulfil their own commitment to devote at least 0.7% of their GNP as ODA to developing countries and to cancel Africa’s external debt in favour of increased investment in the social sector.

The Abuja target, thus, consists of three components; African countries should:

- mobilise domestic resources for health (15% now);

- unencumbered by debt servicing (Debt cancellation now); and

- be supported by ODA (0.7% GNP to ODA now).

After the significant fall in public sector funding of the health sector funding associated with structural adjustment programmes and market reforms, most African countries clearly need to increase public sector investment in health. Poorer groups have considerably worse health than the better off and economic growth and achievement of the Millennium Development Goals (MDGs) in the region is seriously undermined by the prevalence of HIV and AIDS, TB, Malaria and other diseases. Eleven of the 16 countries in east and southern Africa spend in their public sectors less than the US$34 needed for the most basic interventions for these conditions, let alone the US$80 needed for more comprehensive health services. Very few East and Southern African (ESA) countries have health care spending levels anywhere near this amount, and there are thus major unmet health needs. Ten of the sixteen countries in the region, if they met the Abuja target, would, however, increase their public financing to health above the level of US$34/capita needed for the basic health programmes.