Abuja AIDS Summit - promises, promises?

African leaders meeting last week at a special summit on HIV/AIDS, tuberculosis and malaria, in the Nigerian capital, Abuja, threw down a challenge to their governments by setting bold new targets to be achieved by 2010. At the end of the gathering to review progress in implementing the 2001 Abuja Declaration on AIDS, TB and Malaria, a major resolution was passed, declaring that at least 80 percent of those in need, especially women and children, should have access to HIV/AIDS treatment, including antiretroviral (ARV) drugs, care and support. Civil society organisations welcomed the "ambitious continental targets", but it remains to be seen whether these will be met, particularly when considering how little progress has been made in implementing goals set in 2001. Of particular concern is that leaders reiterated their commitment to devote 15 percent of their national budgets to improving the health sector, while the African Union (AU) found that Nigeria, Burundi and Ethiopia scored worst in this respect, having set aside only four, three and two percent of their annual budgets respectively for health. Only a third of African countries spend 10 percent of their budget or more on health, according to an AU report. "It is really unfortunate that most countries have not reached this objective - it's proof of a lack of political will," director-general of the African Council of AIDS Service Organisations (Africaso) Tadinane Tall, told PlusNews. "The 15 percent target set in 2001 was insufficient to address the challenge with which Africa is confronted, but it was a starting point," Tall added. Richard Feachem, head of the Global Fund to fight HIV/AIDS, TB and Malaria, commented, "Most of the African States do not take the health sector as seriously as they should - this is the reason they are lagging behind the 15 percent target." African countries also pledged that at least 80 percent of pregnant women would have access to medication for preventing mother-to-child transmission (PMTCT) by 2010, and at least 80 percent of target populations would have access to voluntary testing and counselling services. The leaders also called on civil society to "enhance their monitoring role" in implementing the commitments of the Abuja Declaration and increase their efforts in combating the three diseases. A number of measures were adopted to ensure that these commitments are met this time around, which include putting in place mechanisms for reviewing progress at regional level by 2008, and monitoring progress by African countries towards reaching the target of allocating 15 percent of their national budgets to health. Dr Chrispin Kambaili, Medical Director of the International AIDS Vaccine Initiative (IAVI) Kenya Regional Office, warned: "It will not be good enough that, like before, we would be unable to meet the new targets, some of which may not have taken into consideration our ability to deliver. There will be a need for regular monitoring, so that we don't have to gather again in 2010 to bemoan our inability to meet the new targets." Nevertheless, experts at the summit acknowledged that some progress had been made in Africa, including an improvement in access to ARVs from one percent in 2003 to 17 percent in 2005.