READY Movement: On the frontline to ensuring young people are not left behind in UHC

By Ready Movement
20 Mar 2019

Early this March (5-7th), Cedric Nininahazwe from Y+ and Tinashe Rufurwadzo from Africaid travelled to Kigali, Rwanda, the land of a thousand hills and joined over 1000 health advocates from over 40 countries at the 2nd Africa Health Agenda International Conference (AHAIC).

As the momentum grew at the Africa Health Agenda  youth pre-conference and main conference, young advocates who took part at the conference thought it was a great time to chit chat and catch up with their colleagues from various countries. The situation was totally different for Cedric and Tinashe, READY Movement Advocates – it was not business as usual as they continuously reflected on the worrying realities facing the African health sector, notably,

  • Eighteen years on, despite the progress made in healthcare provision across the continent, only a handful of African countries are financing their healthcare as per the 2001 Abuja Declaration. The declaration calls for the 55 African Union member states to allocate at least15% of the annual state budget to healthcare.
  • 66% of people living with HIV globally are living in sub-Saharan Africa.
  • Three in four new HIV infections are among girls aged 15–19 years.
  • UNAIDS 2018 data shows that progress in reaching the 2020 targets is slowing down and time is running out. Recent data still indicates that AIDS-related illnesses remain the leading cause of deaths among adolescents in our region.
  • UNICEF estimates that almost 80 adolescents will die daily by 2030 without additional investment.

“Umuntu ngumuntu ngabantu” is a Zulu proverb which translates to, ‘a person is a person through other people’. The proverb speaks to the interconnectedness and responsibility that we all have for each other and also sends an important message that the success of the UHC in Africa is dependent on the collaboration of all key stakeholders as per the 2019 AHAIC conference theme, “2030 Now: Multi-sectoral Action to Achieve Universal Health Coverage in Africa”.

So what is the link between adolescents, HIV treatment and universal health coverage?

Africa has a youthful population with almost 70% of the population being under the age of 25 years. A 13-year-old adolescent girl in 2019 will be 24 years old in 2030 and will be part of the over 50 percent youthful population that is expected to power Africa to economic prosperity. Africa stands to benefit from the unfolding demographic dividend only if, adequate investments in health, education, family planning, human capital development, and job creation are put in place.

If we fail, the youth bulge will be another case of missed opportunity, leaving many behind as widespread unemployment, high maternal mortality, poverty, HIV related deaths and other forms of socio-economic challenges will plague us according to the World Bank.

According to Dr Githinji Gitahi, CEO of AMREF Health Africa, “ We should bring the youth at the centre not only to participate but to lead. The youth own the continent, now and the future.”

UHC has a direct impact on Africa’s youthful population’s future. When the youth have access to health services, they can be more productive and active contributors to their families and communities. Affordable healthcare protects them succumbing to ill-health due to lack of funds to buy medicine or pay for critical care or from being pushed into poverty when they have to pay for health services out of their own pockets.

“Young people are no longer taking the back seat and waiting to be invited to give views or take part in decision making, they are demanding for it. As young people, we know, it is our right to take part in policy making, it is our right to give input to matters that affect us”, said Evalin Karijo, one of the youth representatives at the AHAIC conference.

Achieving UHC requires not only donor support but also increased commitment and financial support from African governments to ensure the vulnerable and marginalised groups such as the adolescents, youth, LGBTI, migrants and sex workers are not left behind and can access health services.

What did we learn at AHAIC 2019? As young people, what do we want to see?

Our learnings during the Africa Heath Agenda Youth pre-conference and main conference will form part of the discussion points to be presented to a High-level United Nations meeting on UHC in New York this September.

  1. Nothing about us without us: The building of a UHC 2030 Youth movement will ensure that young people across Africa are fully engaged and actively contributing towards reaching UHC in their countries by 2030.

 

2. Adolescents and youth living with HIV experience many challenges while accessing care. They experience stigma and discrimination in health facilities, asked how they got HIV and told not to be having sex. Judgmental attitudes by health workers put youth living with HIV off going to the health facility. They are judged for being young and living with HIV and sometimes also because they may be selling sex, using drugs or identify as a sexual minority.

3. Policy has so much jargon. The youth need to be more proactive in building their capacity in all matters relating to health and development. This will give them more bargaining muscle as they will be considered as equals and not as learners during important decision making discussions.

4. Most African countries are yet to fulfil the 2001 Abuja Declaration in which African Union member states pledged to increase their health budgets to at least 15% of the state’s annual budget.

5. African countries must act with speed and maintain a sense of urgency to sustain gains made by investing in healthcare infrastructure to ensure that adolescents have access to differentiated HIV treatment programmes.

6. Achieving a high level of viral suppression among adolescents and youth on ART is critical for achieving the third 90-90-90 goal by 2020. The principle behind UHC is that everyone receives needed health services without financial hardship.

 

There is no “one-size-fits-all” approach to achieving universal health coverage. It is crucial to meaningfully engage adolescents and young people in policy development and implementation,  we will not achieve UHC if young people who make up the bulk of  Africa’s population are left behind. As our eyes are on the UHC political declaration , we urge member states to think about the future they want for Africa as we are the present and future of Africa.

In conclusion, it is our right! We as the youth of Africa demand for accessible, affordable and friendly health services and we will hold you accountable for our future.