On 25 October, together with Wemos, PHM Uganda, Minority Rights Group, ISER, Human Rights Watch, and Akina Mama wa Afrika, we co-hosted the panel “How does health financing affect access to healthcare,” at the World Bank’s Civil Society Policy Forum (CSPF) in Washington, D.C. Matt McConnell, researcher in the Economic Justice and Rights Division of Human Rights Watch moderated the panel.

Our deputy director, Camila Maia, presented research conducted with the Mouvement Ivoirien pour les Droits Humains (IMDH) in Ivory Coast. It revealed that 40% of healthcare is privately delivered, with 92% of these centers operating illegally. Payment was often required before treatment, contradicting local laws and medical ethics. The public sector also faced high out-of-pocket costs, insufficient staffing, and inadequate infrastructure, and it was heavily reliant on foreign aid. This situation, linked to IMF-imposed austerity measures in 2024, violates human rights due to chronic underfunding.

Denis Bukenya from PHM Uganda highlighted how debt servicing and fiscal policies impact Uganda’s health budget. He critiqued the global health framework for prioritising powerful states’ and corporations’ financial interests over people’s health, and the World Bank’s focus on Public-Private Partnerships (PPPs) amidst austerity measures.

Andes Chivangue from N’Weti addressed Mozambique’s debt, which stands at 32% (primarily external), constraining resources for public services.

The event stressed that governments should allocate at least 5% of GDP or 15% of their budgets to public healthcare. Data from Human Rights Watch showed that around 80% of the global population lives in countries that do not meet these benchmarks, with African governments spending just 7.4% on average in 2021. This is less than half what they committed to spending in the Abuja Declaration of 2001. It is also due to debt payments and austerity measures imposed in debt restructuring programs. 

Addressing this situation requires increasing public revenues through progressive tax reforms, including adopting a new UN Framework Convention for Tax Cooperation.