The Abuja Declaration was adopted by African heads of state on 27 April 2001 in the Nigeria’s capital. After more than two decades, leading countries like Ghana and Nigeria remain far from meeting these targets, according to a joint statement by Public Services International (PSI) and its affiliates. 

This underfunding to the health unions is identified as the root cause of the continent’s health workforce crisis and crumbling public health services. The Unions link the persistent budget shortfalls directly to the escalating migration of doctors, nurses, and midwives. 

Under-resourced systems lead to poor infrastructure, inadequate staffing, unsafe working conditions, and uncompetitive wages, pushing skilled professionals to seek employment abroad. The Union also criticised austerity measures promoted by institutions like the International Monetary Fund (IMF) for exacerbating health worker shortages. “Increased pressure on the fragile public health services that currently serve our growing populations is a direct result of this under investment,” the unions said. 

To reverse this trend, the unions’ primary demand is for African governments to urgently recommit to the Abuja Declaration. They asserted that sustained, significant public investment is the non-negotiable foundation for building resilient health systems. The call for budget allocation is part of a broader demand for investment in public health. The Unions urged governments to halt health sector privatisation and outsourcing, which undermine decent work and equity. 

They also call for investment in public health training institutions and continuous professional development, the implementation of living wages and transparent pay structures to close gender pay gaps. 

They also called for mobilisation of domestic resources through fair taxation and reducing harmful tax incentives to reclaim public money for public services. The Unions noted that the 15 per cent budget commitment was not just as a financial target, but as an essential step towards retaining health workers, achieving universal health coverage, and fulfilling the fundamental right to health for all.