The ministers’ consensus is particularly significant in view of the need to ensure the effective integration of socio-economic, demographic and health factors into broader development strategies and solidify sustainable health financing systems.

They share a common objective of seeking maximum impact for the money spent on health services. They also agree to intensify dialogue with their technical and financial partners in order to enhance sustainability and accountability in the health sector. With this, Africa will be moving closer to universal health coverage and better health outcomes. 

It is commendable that the finance and health ministries have a common platform that supports health investment in Africa. The link is crucial if we are to achieve the target of ‘more money for health, and value for money.’

Clearly, health services in Africa need more money to achieve better health outcomes. Per capita investment in many countries is low, with 32 countries investing less than the $44 per capita recommended by the High Level Task Force on Innovative Financing. This includes 12 countries in which per capita investment is as low as between $2 and $10.

For many African countries, the debate on budget allocation has been focused on allocating a percentage of the total budget. But this needs now to emphasize actual per capita investment, based on the needs and requirements of each country.

Many aspects of social development contribute to health. Investing in education has a huge impact on health outcomes. For instance, investing in the training and retention of health workers is crucial to reducing maternal deaths. Similarly, investing in the social determinants of health, especially clean water, sanitation and hygiene, improve the efficiency of health.

In 25 African countries, between 20 per cent and 70 per cent of the population have no access to improved water sources. In mostly the same 25 countries, between 52 per cent and 91 per cent of people have no access to improved sanitation. Increasing funding for water-, sanitation- and hygiene-related diseases contributes to overall health development.

When it comes to maternal mortality, experts have found that a reduction in maternal deaths can increase average life expectancy by as much as four per cent increase in GDP. All of these point to the significant effect that ongoing investment in comprehensive health services has, including sexual and reproductive health.

But it is also clear that there is a need for more value for money. Globally, a lot of money is wasted through inefficiency. The 2010 World Health Report estimates that 20 per cent to 40 per cent of all health spending is wasted through inefficiency.

Yet the level of inefficiency in Africa is already high. More than half of total health spending is paid out of pocket by African households. And in many cases, health expenditures are not directed to core aspects that achieve maximum returns.

A number of questions could help to unpack the idea of value for money. For instance, what proportion of health allocation goes to direct service delivery rather than to administrative costs? What percentage of health allocation goes to tertiary health care rather than direct service delivery at the community health level? What is the funding ratio of direct operational and non-operational costs? Are government health investment plans building institutional capacity and equity?

The answers to these questions will help determine whether or not we are getting more value for health investment.

Ensuring maximum investment and return on investment for health is no longer an option. It must be a way of life in Africa’s health care systems. With the reduction of development aid to Africa, there is a need for increased domestic spending and greater domestic accountability.

That is why the ten-point way forward produced at the conference by the ministers of finance and health will require consistent action and the concerted effort of all partners for its realization. It must not be allowed to become just another declaration from a major regional meeting.

We need to get the best from health for Africa’s population, especially for the most vulnerable and the most in need – women and children. The outcome of the Ministers of Finance and Health Conference therefore represents a tipping point for better health outcomes in Africa.

Through the consistent action of all players from the public and private sector, academia, civil society, media, bilateral and multilateral development partners globally and, of course, the ministers of finance and health, we can indeed achieve the desired health outcomes for Africa’s population.