Increased investment in health systems is critical for ending AIDS, TB and eliminating Malaria. Member States should therefore ensure that all pillars of their health systems discussed below operate optimally. Member States should foster synergies in the health system pillars to attain equity, efficiency, access including coverage, quality including safety, and sustainability. 

Leadership, country ownership, governance and accountability

While Africa has achieved significant progress in responding to the three diseases in the last 15 years, political commitment needs to remain a key priority. Governments should reinforce leadership, ownership, integration, governance and management of disease programmes to promote accountability. Coordination and planning within national, regional and continental platforms should be strengthened through a multi-sectoral approach. 

Universal and equitable access to prevention, diagnosis, treatment, care and support

Universal health access is a fundamental human right and should be equitably accessible and affordable. While talking into consideration structural and operational barriers to achieve universal access, countries should accelerate the implementation of comprehensive policies, multi-sectoral approaches and strengthened health systems to protect the poor and the vulnerable. Member States should accelerate efforts toward universal and equitable quality health services including social protection for people of all ages. Countries should address cross border barriers related to the three diseases to ensure universal access to services.

Access to affordable and quality assured medicines, commodities and technologies

The pharmaceutical industry in African countries is not fully developed and is highly heterogeneous with a wide range of quality standards and regulations to which firms adhere. In order to strengthen and sustain the African pharmaceutical industry, African Union Member States should prioritise investment, regulatory harmonisation, creating an enabling environment for local production, and addressing weak market integration. Member States should build in-country essential skills in manufacturing and management through technology transfers and south-south and north-south cooperation. Regional Economic Communities should serve as regional platforms for information sharing and for implementing the AU ̳Model Law . This includes enforcement of standards, building capacity and promoting greater regional legislative and regulatory harmonisation.

Health financing

Various commitments by African governments including the Abuja Declarations have recognized the need to invest in health for sustainable development. In order to achieve the Agenda 2063 and SDGs health outcomes, Member States should fully implement their costed National Strategic Plans for the three diseases to ensure efficient utilisation of the allocated resources. Countries should endeavor to increase domestic funding to Health through innovative financing mechanisms, increased allocations to national and district health programmes, private sector involvement and other potential sources of funding for the domestication and successful implementation of the Catalytic framework.  African countries should continue to champion true transformation and paradigm shift towards optimal domestic financing for health and diversifying sources of financing.

Community participation and involvement

Community-based strategies have the potential to improve access and utilisation of comprehensive services that result in improved quality of life. Member States increase efforts to empower communities as agents of change for their own health. African countries should support the development of community driven systems to expand health service delivery in particularly hard-to-reach areas in the context of leaving no one behind. Member States should integrate and mainstream community health systems into the national system. 

Research and development & innovation

Health research provides the tools and evidence for effective policy and decision making at all levels. African countries should intensify research aimed at strengthening preventive and curative measures to curb the spread of the three diseases in line with the Abuja +12 commitments. African countries should increase investments in research and innovation  to address the health needs of the continent. Governments should strengthen collaboration with universities and research institutions to enhance innovation and evidence informed policies and programmes.

Promotion of human rights and gender equality

Inequalities based on gender and vulnerable populations are widespread in many African countries despite various efforts to address the situation. African countries should foster respect, promotion and protection of human rights with particular focus on women and girls. Governments should accelerate efforts to address all forms of violence, stigma, discrimination, social exclusion and ensure access to services for key populations  and vulnerable groups.

Multi-sectoral collaboration and coordination

Strong partnerships and collaborative initiatives for health and development influenced by the spirit of shared responsibility and global solidarity have resulted in significant progress in AIDS, TB and malaria responses. However, there is need to harmonise priorities of recipient countries with those of donor countries to avoid conflicting focus in programme implementation. Member States should champion all-inclusive partnerships in areas of programming, management and equitable access to health. More emphasis is needed in strengthening partnership with the private sector with a particular focus on public private partnerships. Strengthening South-South cooperation and alliances towards ending the three diseases remains critical.

Strategic information

Accountability mechanisms are critical to ensure that AIDS, TB and malaria related commitments and results are realised. Strengthening national data management systems, civil registration and vital statistics at various levels is a prerequisite for measuring results and improving equity in health. Governments should strengthen evidence informed mechanisms in response to the three diseases at various levels.