Can Africa Fund Its Own Public Health Future?

Africa faces a critical juncture in its public health journey as the continent grapples with reduced international support. With the United States signaling plans to exit the World Health Organization (WHO) and scale back funding for programs like PEPFAR (President's Emergency Plan for AIDS Relief), the African Union's Africa Centres for Disease Control and Prevention (Africa CDC) is urging nations to prioritize domestic health financing.

Image Source: Africa CDC

For decades, African public health systems have heavily relied on external aid to combat diseases such as HIV/AIDS, malaria, and tuberculosis. However, this dependency poses significant risks, as donor priorities shift and global funding dwindles. The U.S. exit from WHO and reduced AIDS program support highlight the urgent need for self-reliance in health financing. Africa CDC has emphasized that sustainable healthcare systems can only be built through robust domestic investment, calling on governments to allocate at least 15% of their national budgets to health, in line with the 2001 Abuja Declaration.

Image Source: Africa CDC

Domestic funding is not just a matter of independence but also efficiency. By managing their own health budgets, African nations can design programs tailored to local needs, ensuring resources reach the most vulnerable populations. For instance, strengthening local vaccine production and disease surveillance systems can reduce reliance on international supply chains, which proved unreliable during the COVID-19 pandemic.

However, achieving this vision is not without challenges. Many African countries face fiscal constraints, high debt burdens, and competing priorities, making it difficult to allocate sufficient resources to health. Corruption and inefficiencies within health systems also hinder progress, requiring transparent governance to ensure funds are effectively utilized.

Despite these hurdles, there are reasons for optimism. Initiatives such as the African Medicines Agency and increased intra-continental trade through the African Continental Free Trade Area (AfCFTA) offer opportunities to pool resources, improve collaboration, and bolster health infrastructure. With strategic investments and political will, Africa can build resilient health systems that serve its people, regardless of shifting donor landscapes.

The question is no longer whether Africa can afford to fund its public health future, but whether it can afford not to. The path forward demands bold leadership, innovation, and a commitment to putting health at the center of Africa's development agenda.