Open letter reminding government of its commitment of allocating 15% of domestic budget to health by 2015

The Budget Tracking Working Group which includes Save the Children, World Vision, Budget Advocacy Network, Health Alert, MamaYe and WASH Consortium recognizes efforts made by government to increase health expenditure this year.

11th July 2013,Open letter reminding government of its commitment of allocating 15% of domestic budget to health by 2015To: Dear Minister of Finance – Dr. KaifalaMarah,Cc: President of the Republic of Sierra Leone – Dr. Ernest Bai KoromaThe Budget Tracking Working Group which includes Save the Children, World Vision, Budget Advocacy Network, Health Alert, MamaYe and WASH Consortium recognizes efforts made by government to increase health expenditure this year. Yet, as the Heads of States prepare to gather in Abuja this July 14th& 15th 2013 to discuss and review the commitments they made 12 years ago to spend 15% of their total annual budget on health by 2015, we are concerned by government’s fluctuation in keeping this commitment. In 2010 the government of Sierra Leone committed 7.4%, in 2011 there was an increase to11% , in 2012 that percentage decreased to 7.4% and for this year (2013) government promised 10.5% to health spending. However, more than 6 months into this year and less than 2% of these funds have been released into the health care system. This is compounded with factors like allocated funds not reaching to where they are most needed on time. In order to ensure good health care for the people of Sierra Leone, it is imperative that government exercise consistent commitment as well as timely and full disbursement of funds as required.In the recent Supplementary budget reading giving in parliament on Thursday July 4th, health was noticeably missing as an area of attention and although other areas that funds are directed towardsare of importance, but the wellbeing of the people of Sierra Leone should be a key priority as we work towards achieving national prosperity. Currently, looking at the budget allocation to health (10.5%) for this year, only $10 is been allocated for health care for each Sierra Leonean. The World Health Organization (WHO) recommends a spending of $54 per person, which they have determined is the minimum amount needed in order to provide basic health services. We are falling short of this minimum requirement in a BIG way. Good quality and well developed sanitation services are essential if Sierra Leone is to grow and prosper. For every $1 invested in Sanitation, on average $9 is returned in increased productivity. Waiting for disease to strike put lives at risk, divert valuable resources to band aid solution and limit the long term growth of the sanitation sector. One of the factors leading to last year cholera outbreak is the lack of adequate investment in sanitation in Sierra  Leone and such outbreak will continue to occur unless the government invest in the whole sanitation system i.e. Waste management, infrastructure   construction, collection and transport, treatment and disposal. In 2012, the government committed to spending 1 percent of its GDP on sanitation by 2015, double the target set in the eThekwini   Declaration, with clear timetable for how this target will be reached. However, the government is starting from an incredibly low base. In 2010, the sanitation allocation as a percentage of GDP was only 0.027 percent. It experience decreases over the next two years dropping to 0.018 percent in 2012.  In 2013, allocation to sanitation as percentage to GDP was 0.019 percent.  Key askØ  Guarantee that 1 percent of GDP is allocated to sanitation in the 2015.  There should also be a separate sanitation budget line in the Ministry of Health and Sanitation, with the local council budget line for sanitation expanded beyond solid waste to broader sanitation activitiesØ   Ensure district development plans and budgets prioritise sanitation, starting from the CLTS programme, but also look beyond to how citizens can move up the sanitation ladderThis African Union Special Summit, The Abuja Declaration heads of state meeting will provide a window of opportunity for the leaders of Sierra Leone to keep promises for health. It will be a great opportunity to not only recommit towards meeting the 15% target, but to also ensure adequate increase in the per capita spending on health. In our country today, 5 of our women die every day from causes related to pregnancy and child birth. Too many of our babies die; we lose 11,000 newborns each year. This amounts to one newborn death every 47 minutes. It does not have to be this way. Ensuring our clinics are safe for our mothers and babies requires more funds be allocated to maternal and newborn health, and this in turn will encourage increased use of our clinics. Despite Sierra Leone been the fastest growing economy in the world, its spending on health remains amongst the lowest in the world. The Budget Tracking Working Group will continue to work with government and serve as a reminder to government of its financial commitment to health, in addition to timely disbursement of funds. Sincerely,The Budget Tracking Working Group.

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