MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
African record is abysmal.
At the conclusion of the African Summit on HIV/AIDS, TB and Other
Related Infectious Diseases in April 2001, African leaders adopted the now-famous Abuja Declaration, pledging to allocate at least fifteen percent of
their annual budgets to the health sector.141 But the rhetoric has not been
matched with action. As of 2008 only eight countries—Botswana, Burkina
Faso, Democratic Republic of Congo, Djibouti, Liberia, Rwanda, Tanzania,
and Zambia—have met the target, out of the fifty-three (now fifty-four)
nations that make up the region.142 Even Nigeria, the host of the Summit,
remains far from the target, at 6. 4 percent.143
It is very tempting to blame this budgetary gap on a resource deficit, as is
usually canvassed by government officials. Nonetheless, since the pledge
relates to proportionality of spending, specifically the percentage of national
budgets allocated to health versus other sectors, not dollar amount, the
temptation must be resisted. Thus, one may conclude, and rightly so, that
the failure of most African countries to comply with the Abuja Declaration
is simply evidentiary of lack of commitment to the needs of the population
– one of many in a long list of manifestations of bad governance that stands
in need of remedy at polling booths.
I. Judicial Passivity
Although the court system offers a potent route for remediating the
unacceptably high rate of morbidities and mortalities resulting from
pregnancy in Africa, judicial passivity or timidity effectively forecloses this
avenue. Judicial reticence, even in the face of injustice, is not new.
If you read the great cases of Ashby v. White, Pasley v. Freeman, and
Donoghue v. Stevenson you will find that in each of them the judges were
divided in opinion. On the one side there were the timorous souls who
were fearful of allowing a new cause of action. On the other side there
were the bold spirits who were ready to allow it if justice so required. It
was fortunate for the common law that the progressive view prevailed.144
141. Organisation of Afr. Unity (OAU), Abuja Declaration on HIV/AIDS, Tuberculosis
and Other Related Infectious Diseases, para. 26, Apr. 24-27, 2001, OAU/SPS/ABUJA/3.
This pledge was reaffirmed at the Gaborone Declaration and the Maputo Plan of Action. See
Afr. Union (AU), The Maputo Declaration on Malaria, HIV/AIDS, Tuberculosis and Other
Related Diseases, para. 2, July 12, 2003, Assembly/AU/Decl. 6(II) 2; AU, The 2nd Ordinary
Session of the Conference of the African Ministers of Health, Oct. 10-14, 2005,
CAMH/MIN/Draft/Decl. (II).
142. WORLD HEALTH STATISTICS 2011, supra note 47, at 128–134.
143. Id. at 132.
144. Candler v. Crane, Christmas & Co [1951] 2 KB 164 (Denning, L.J., dissenting).