The prolonged global financial crises coupled with the devastating effects of climate change have aggravated poverty and famine in Africa, making it more difficult for most African countries to keep their commitments to the Plan of Action of the International Conference on Population and Development (ICPD PoA). In an attempt to address those challenges, the African Union has undertaken a number of measures including adopting the policies and strategies such as the Plan of Action on Sexual and Reproductive Health and Rights known as the Maputo Plan of Action.

It should be recalled that 179 governments at the ICPD Conference (the Cairo Consensus as it was called) adopted a twenty-year action program for sustainable growth, the education for girls, gender equality, maternal and infant mortality reduction, among others. The ‘Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) which recognizes the need to meet the daunting challenges of maternal mortality in most African countries, is part of the implementation of the Maputo Plan of Action (Maputo PoA) which aims to achieve universal access to comprehensive sexual and reproductive health and rights in Africa by 2015.

The Heads of State and Government, in Banjul in July 2006, adopted the African Youth Charter, to ensure the constructive involvement of youth in Africa’s development agenda by engaging States Parties to broaden communication channels and strengthen dialogue about youth-related, among other issues. Also in the 2007-2015 Africa Health Strategy, African governments have emphasized the need to contribute to the improvement of the health of the African people and to ensure access to essential health care services for all Africans, especially the poorest and most marginalized, by 2015. This falls under the Millennium Development goal (MDG) to facilitate the scaling up of health interventions in member states through regional and intergovernmental bodies.

Indeed, fifteen years after the ICPD Program of Action was adopted for the provision of universal education, and for ensuring universal healthcare, including family planning, assisted childbirth and prevention of sexually transmitted diseases, there is still a significant gap between sexual and reproductive health needs among young people in Africa and the education and services provided. "There are continents where women give birth and it is a pleasant experience because they are bringing life. In our continent, women also bring death to themselves and their children," admits AU Commissioner for Social Affairs, Bience P. Gawanas.

Maternal mortality in Africa remains the highest in the world, and despite the support to ICPD PoA by some countries, the threat to cultural fundamentalism, discrimination, stigma against infected people and violence continues to grow. According to UNICEF, more than 500,000 women die in childbirth or from complications during pregnancy each year, the majority of them from Africa.

Despite the efforts of African countries, civil societies and international agencies, including the ICPD initiatives in tackling social problems in Africa, the continent still loses more than 8 million lives per year due to malaria, tuberculosis, HIV and AIDS infection, child mortality and maternal death, according to published reports by the UNFPA.

Attaining the MDGs by 2015 in Africa must involve, among others, a strong campaign for local health development and financing, based on increasing the efficiency of domestic health financing, advancing government investment in health systems, demonstrating dignity for women, promoting gender equity by investing in reproductive and sexual health, increasing the health budget on gender in support of the AU Campaign on Accelerated Reduction of Maternal Mortality (CARMMA), and ensuring equitability in the geographic distribution of access to health.

AU Role:

African countries have responded to the call for global action for sexual and reproductive health and rights underscored at the ICPD conference held in Cairo in September 1994 by endorsing the implementation of time-bound programs. Since 2006 they have adopted similar continental initiatives such as the Program of Action on Sexual and Reproductive Health and Rights known as the Maputo Plan of Action, and produced a Continental Policy Framework; produced the Africa Health Strategy; African Regional Nutrition Strategy, among other policy documents. The efforts were endorsed by the AU leadership.

During the 2nd Pan-African Forum on Children and Youth held in Cairo, Egypt from October 29-November 3, 2007, to review progress towards achieving the implementation of the 2001 Declaration and Plan of Action on Children, participants adopted a resolution calling for accelerated action on the implementation of a plan for the promotion of maternal, infant and child health and development. Recognizing that poor maternal, infant and child health problems continue to confront the continent and undermine development efforts, and that reducing child mortality, improving maternal health and combating chronic diseases such as HIV/AIDS, malaria, and tuberculosis are key indicators for monitoring socio-economic development in African countries, the African Union has taken bold steps toward addressing those issues.

The AU mandated its Chairperson to undertake vigorous advocacy to mobilize resources and, galvanize political will among industrialized nations to advance maternal, infant and child health and development on the continent. A case-in-point was the advocacy campaign at the G8 Hokkaido Toyako Summit in Japan in 2008 and the TICAD IV, where serious challenges to the achievement of the MDGs were discussed including widespread poverty, inadequate access to education and the scourge of infectious diseases. Participants welcomed TICAD IV’s promotion of the concept of “human security”, which underscores freedom from fear and emphasizes the protection and empowerment of individuals and communities. African Heads of State and delegates from 51 African countries joined representatives of 34 other countries, the private sector, academic institutions, civil society organizations from both Africa and Asia as well as 75 international and regional organizations, noted the continuing commitment of development partners and the international community to the promotion of African development.

Recently, the African Union teamed up with AU member states, the Regional Economic Communities (RECs), UN agencies and other organizations and launched the CARMMA—the Campaign on Accelerated Reduction of Maternal Mortality in Africa, under the theme Africa Cares: No Woman should Die While Giving Life. The event took place during the 4th Session of the AU Conference of Ministers of Health (CAMH4) in Addis Ababa, Ethiopia, May 7, 2009. In fact, CARMMA is an outgrowth of key priority areas embedded in the 2005 AU Policy Framework for the promotion of sexual and reproductive health and rights in the Maputo Plan of Action that African Ministers of Health approved in Maputo, Mozambique in September, 2006.

The African Union Commission, in collaboration with the UNFPA, UNICEF, WHO has launched CARMMA in Ethiopia, Mozambique, Malawi, and Rwanda. CARMMA is expected to be launched in all African countries. Ghana, Nigeria, Senegal, Chad and Tunisia have been selected to launch CARMMA through February, 2010. The countries were selected for joint AU, UN and government launching based on a number of criteria that include identifying countries having one of the highest maternal mortality rates and lowest gender development indexes; having strong political commitment through resource allocation and leadership; regional balance; and strong UNFPA offices with the resources to actively support country-driven efforts in accelerating maternal mortality reduction.

The Way Forward

In fact, the Department of Social Affairs of the African Union Commission has recognized the need to engage the public and the private sector in the campaign against the aforementioned challenges by requesting that a communication and advocacy strategy and information products be designed on the Maputo Plan of Action and CARMMA with a view to disseminating health-related information across the continent, galvanizing support for CARMMA, and bringing greater awareness to the affected public.

The AU welcomes the world wide support demonstrated through programs and initiatives to mobilize resources to meet the challenges germane to the promotion of maternal, infant and child health, survival, protection, development and participation, and reaffirms previous commitments towards the promotion of maternal, infant and child health development.