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We, the Ministers responsible for Finance and Ministers responsible for Health in the EAC Partner States assembled here in Arusha City, the United Republic of Tanzania, today the 23rd June, 2016, for the High Level Ministerial Dialogue meeting on Sustainable Financing for Health and HIV & AIDS Coverage;

Noting that the Treaty for the Establishment of the East African Community provides for the promotion of the management of health delivery systems and better planning mechanisms to enhance efficiency within the Partner States;

Further noting that significant strides have been made in the development of policies to enhance cooperation in health and observing that Sustainable Development Goals (SDGs) 3 target 3.8 on achieving Universal Health Coverage (UHC) including financial risk protection, access to quality essential health care services and access to safe water, effective, quality and affordable essential medicines and vaccines for all;

Acknowledging that Universal Health Coverage is only achievable if there is strong focus on sustainable and reliable financing;

Acknowledging that to date almost all Partner States still experience challenges in operationalising the Abuja Declaration of allocating 15% of the government budget to Health and that the combined health and HIV resource gap remains high.

Cognisant that in the EAC Region only about 65% of health care financing comes from domestic sources (i.e. Governments, Private Sector and out of pocket spending) and 35% from external funding.

Recognizing the population dynamics in the region that create vulnerabilities to health and HIV;

Concerned about the out of pocket expenditure in the EAC region that ranges from 10% to 30% which, for some Partner States, is above the recommended WHO threshold of 20%, and leads to impoverishment of families, hinders access to health services and contributes to observed poverty levels in the region;

Noting that the diminishing funding for HIV and AIDS programming at Partner State and regional level has contributed to not achieving the set Millennium Development Goals (MDG) targets,

Concerned that dependency on external funding in HIV is quite high and that the expected decline in that support over the coming years is expected to affect all EAC countries to a significant extent;

Recognising that health is wealth and that investing in health yields dividends constitutes a fundamental goal of economic growth and development;

We, the Ministers responsible for Finance and Ministers responsible for Health on this 23rd day of June 2016 hereby commit ourselves to the following;

1. adopt an EAC Framework of Action on Sustainable Financing with recommended strategic actions, encompassing the three policy options among others, namely;

a) reprioritisation of public spending towards health to reach 15% recommended in the Abuja Declaration;

b) increased tax administration efficiency in the Partner States and earmark taxes to increase financing for health and HIV; and

c) increased efficiency of health and HIV service delivery to bridge the resource gap;

2. conduct efficiency audits in the health sector to inform our policies on efficiency improvement in delivery of quality health care;

3. implement mechanisms to strengthen health regulatory authorities to ensure delivery of quality health care in pursuit of Universal Health Coverage;

4. design and implement innovative financing mechanisms to ensure sustainable access and optimal utilisation of quality healthcare services;

5. promote the use of Information Communication Technologies (ICTs), research and evidence to inform the development of health and HIV investment cases that will enable advocacy towards Universal Health Care (UHC) Financing;

6. promote multi-sectoral synergies including Public Private Partnerships at national and sub national level to leverage additional health and HIV financing in the Partner States; and

7. support and participate in convening of the 1st EAC Summit on Investment in Health with the aim of attaining health related Sustainable Development Goals (SDGs) by 2030 in all Partner States.


Signed on this 23rd Day of June 2016 at Arusha, United Republic of Tanzania.


Hon. Minister Responsible for Finance Republic of Burundi

Hon. Minister Responsible for Health Republic of Burundi

Hon. Minister Responsible for Finance Republic of Kenya

Hon. Minister Responsible Health Republic of Kenya

Hon. Minister Responsible for Finance Republic of Rwanda

Hon. Minister Responsible for Health Republic of Rwanda

Hon. Minister Responsible for Finance The United Republic of Tanzania 

Hon. Minister Responsible for Health The United Republic of Tanzania

Hon. Minister Responsible for Finance Republic of Uganda

Hon. Minister Responsible for Health Republic of Uganda

East African Community
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