Africa charts new course to fund public health as foreign aid wanes

ETHIOPIA – With donor support dwindling and disease threats rising, Africa is rethinking how it funds its health security.

The Africa Centres for Disease Control and Prevention (Africa CDC) is spearheading a continent-wide shift toward domestic investment and innovative financing to safeguard decades of public health progress.

The move comes in response to a dramatic 70% drop in Official Development Assistance (ODA) to Africa over recent years.

For decades, ODA played a critical role in expanding immunization programs, reducing under-five mortality by half, and delivering lifesaving antiretroviral therapy to over 18 million people. It also enabled rapid response to epidemics, including Ebola in West Africa.

But as international support shrinks, health threats are growing. Between 2022 and 2024, Africa reported a 40% spike in public health emergencies, driven by infectious disease outbreaks and climate-related shocks such as floods and heatwaves.

“We’re grappling with rising debt burdens and a heavy reliance on imported medical countermeasures,” said Dr. Jean Kaseya, Director General of Africa CDC. “This puts the continent in a precarious position.”

To address this, Africa CDC is rallying African Union (AU) Member States behind a new three-pronged health financing plan.

The first pillar is increasing domestic health budgets. Currently, only two countries meet the Abuja target of allocating 15% of national spending to health.

Dr. Kaseya is urging others to follow suit, supported by national strategic and costed health plans to align external resources more effectively.

The second pillar introduces new funding mechanisms like the Africa Epidemics Fund, launched in February 2025.

Africa CDC is also exploring innovative tools such as an airline levy or regional solidarity tax to ensure sustainable, predictable funding for emergency response.

The third strategy is expanding partnerships with private sector and philanthropic organizations.

This includes building infrastructure for local vaccine production, strengthening digital health systems, and operationalizing the African Pooled Procurement Mechanism to improve access to essential supplies at lower costs.

To activate this ambitious plan, Africa CDC is seeking USD 43 million to support technical assistance, develop financing models, and pilot new initiatives like the airline tax.

Recent high-level diplomatic engagements in the U.S., Norway, and Denmark have helped garner political support, even as fresh financial commitments remain under discussion.

In Washington, Dr. Kaseya met with U.S. lawmakers, USAID, the CDC, and top foundations including Gates and Rockefeller, emphasizing the global value of resilient African health systems.

“Africa’s health security is global health security,” said Dr. Kaseya. “Our ask isn’t charity — it’s co-investment in a shared future.”

Dr. Ngashi Ngongo, Africa CDC’s Incident Manager for Mpox, echoed this sentiment. “We’re not standing still. We’re turning funding shortfalls into momentum for lasting change. This is a moment to innovate, not retreat.”

Support from African leaders is growing. President João Lourenço of Angola and Ethiopian Prime Minister Abiy Ahmed both voiced strong backing for Africa CDC’s new direction at the AU summit in February. “We must elevate Africa CDC as a continental health leader,” Prime Minister Abiy urged.