The foundations of healthcare systems in many African nations were established during the colonial era, often prioritizing resource extraction and strategic control over genuine public health needs. Post-independence, significant efforts were made to develop national healthcare systems, frequently reliant on external aid and influenced by donor-driven agendas. The rise of the African Union (AU) in the late 20th and early 21st centuries marked a crucial turning point, signifying a desire for greater continental ownership and coordination in addressing shared health challenges. Initiatives like the Accra Reset (2015) and the Lusaka Agenda (2001) laid the groundwork for a more integrated approach, recognizing the need for a unified front against disease outbreaks and promoting regional health cooperation. “Institutions here at the African Union are bringing together your collective strength in a way that wasn’t possible a generation ago”, the President noted, highlighting the emerging significance of bodies like the African Union Development Agency (AUDA), the Africa Centre for Disease Control and Prevention (Africa CDC), and the proposed African Medicines Agency. This shift represents a departure from traditional “aid-dependent” models, moving toward a system of mutual support and shared responsibility. Data from the World Bank indicates that Official Development Assistance (ODA) to health in Sub-Saharan Africa declined significantly after 2021, reducing from an average of $8.7 billion to approximately $5.2 billion, reflecting a broader shift in global priorities and resource allocation.
Key Stakeholders and Motivations
Several key stakeholders are actively shaping the trajectory of global health within Africa. The African Union, through the AU-CHA, plays a central role in coordinating responses to disease outbreaks, promoting health standards, and fostering regional trade in pharmaceuticals and medical supplies. Africa CDC, established in 2017, is rapidly gaining influence, leveraging its epidemiological expertise and surveillance capabilities to combat infectious diseases. Furthermore, key international partners like the UK, the United States, and the European Union, alongside multilateral organizations such as the World Health Organization (WHO) and the Global Fund, continue to invest in African health systems. Motivations vary. The UK, as outlined by its representative, seeks to support sustainable health systems while safeguarding global security, recognizing the interconnectedness of health and geopolitical stability. “Political commitment matters, but every country, including the UK, has to back it with resources and better financial management,” the representative emphasized, reflecting a recognition of the need for systemic change. The Global Fund’s focus on combating HIV, Tuberculosis, and Malaria remains a crucial component of the international health agenda, while the World Bank provides significant financing for infrastructure development and health system strengthening. However, a critical challenge lies in ensuring that these diverse interests align with African priorities and contribute to a truly collaborative partnership.
Recent Developments and Emerging Challenges
Over the past six months, several developments have underscored the urgency of the situation. The Africa CDC has intensified its surveillance efforts, particularly in response to a marked increase in disease outbreaks, including a 40% surge in reported outbreaks between 2022 and 2024, as highlighted by the CDC’s own data. Climate change and its associated shocks – droughts, floods, and extreme weather events – exacerbate existing vulnerabilities, threatening health systems and disrupting supply chains. Furthermore, decreasing external aid, coupled with rising populations and increasing healthcare demands, presents a significant financial challenge. “Disease outbreaks in Africa increased by 40% between 2022 and 2024,” the Africa CDC reports, demonstrating a growing strain on resources. The fragmentation of global supply chains, exposed during the COVID-19 pandemic, necessitates greater regional self-sufficiency in pharmaceutical manufacturing and medical equipment. Innovative initiatives like the Institut Pasteur de Dakar’s genomics surveillance program exemplify a shift toward localized capacity building. Recent discussions surrounding the proposed African Medicines Agency signal a desire for greater control over pharmaceutical production and regulatory oversight, a key step towards continental health sovereignty. The UK’s recent co-leadership of the G7-Global South-led Global Health replenishment, alongside Ghana, reflects a recognition of the need for new financing mechanisms and a more equitable distribution of resources.
Future Impact & Insight
Short-term (6 months): Continued efforts by the AU-CHA to strengthen disease surveillance, build local capacity, and coordinate responses to outbreaks will be critical. The UK’s focus on technical assistance and knowledge sharing, particularly through partnerships with institutions like the Africa CDC, will play a vital role. However, the ongoing decline in ODA and the impact of climate change pose significant headwinds.
Long-term (5-10 years): A more resilient and self-sufficient African health system is achievable, but dependent on sustained investment, technological innovation, and effective regional collaboration. A fully functional African Medicines Agency would be a game-changer, reducing reliance on external suppliers and fostering local pharmaceutical industries. The UK’s role should evolve from a donor-driven approach to a strategic partner supporting the AU-CHA’s ambitions. A key consideration will be navigating the evolving geopolitical landscape, ensuring that health security remains a priority amidst increasing competition and potential instability. “Unity should not be a slogan; it must be the strategy…a global partnership of the willing, based on a shared vision and mutual respect”, President Mahama urged, a sentiment crucial for the future of the continent’s health architecture.
Call to Reflection: The Comoros address presents a compelling vision of partnership and shared responsibility. However, realizing this vision requires a fundamental shift in mindset—from viewing African health challenges solely as humanitarian crises to recognizing them as integral components of global security and prosperity. The question remains: can the UK, and other international partners, fully embrace this perspective, and are African nations prepared to lead the way in shaping a new era of global health governance?