Africa pushes for health self-reliance as aid shrinks

African leaders are calling for greater domestic financing, local production of medicines and vaccines, and stronger health systems as cuts to international aid expose the risks of Africa's continued dependence on external funding.

The push comes as African countries grapple with shrinking external health assistance from major donors such as the United States and Europe, rising pressure on public finances and persistent gaps in access to medicines, vaccines and specialized care.

Official development assistance has been a pillar of financing for sub-Saharan Africa, but bilateral aid to the region fell by about 26 percent last year as traditional donors reduced funding, according to the International Monetary Fund.

Although countries such as China and the Gulf states have increased aid to the region, it could not make up for the decrease in funding, resulting in a wide gap in funding for crucial services in Africa such as health, education and humanitarian support, the IMF said.

Mahmoud Ali Youssouf, African Union Commission chairman, called for stronger domestic financing, expanded production of vaccines and treatments, and the removal of barriers to intra-African trade to strengthen the continent's health sovereignty.

He said initiatives such as the African Medicines Agency and growing vaccine manufacturing capacity are helping create the foundations for greater self-reliance in health.

"African health sovereignty starts with effective national health systems," he said, urging African countries to move and ensure that health policies translate into tangible improvements for people.

Aboubakri Diaw, chief of staff at the United Nations Economic Commission for Africa, said Africa's health sector faces not only a financing gap but also a "confidence gap", adding that countries need to develop credible and sequenced health investment proposals capable of attracting public, development and private financing.

He urged governments to shift from viewing health as recurrent social expenditure to treating it as a productive economic investment, with health priorities integrated into national development plans, macroeconomic forecasts and medium-term expenditure frameworks.

Ethiopian Health Minister Mekdes Daba Feyssa said sustainable health systems must put primary healthcare, communities and health workers at the center of transformation.

Technology could help measure health outcomes and financing could sustain services, but a stronger health workforce is essential to improving care quality, she said.

Digital transformation should benefit people in remote communities as much as those living in cities, while stronger disease surveillance and emergency preparedness would help countries respond more quickly to outbreaks, she added.

The World Health Organization's regional director for Africa, Mohamed Janabi, said the continent must strengthen its own centers of excellence and retain more health resources within Africa, noting that African countries spend nearly $7 billion a year referring patients abroad for specialized care.

"Our vision is simple: strengthen Africa's centers of excellence, connect African patients to African expertise and keep Africa's investments working for Africa," he said.

Africa carries more than 25 percent of the global disease burden but accounts for less than 3 percent of global health expenditure. The continent produces less than 2 percent of the medicines and vaccines it consumes, leaving it vulnerable to external shocks.