Even though Africa’s Health Agenda is closely aligned with the global health agenda, it faces distinct challenges that set it apart, including the ongoing burden of infectious diseases and rising Non-Communicable Diseases. Dr Githinji Gitahi, Group CEO of Amref Health Africa, made these strong submissions during the recent Africa Health Agenda International Conference (AHAIC) 2025 held in Kigali, Rwanda.
The conference’s theme, “Connected for change: Addressing Socio-Ecological Dynamics of Health,” is a strong call to action for African countries to collaboratively tackle the environmental threats and shifts in global health funding priorities impacting Africa’s health. The need for action has never been more urgent as the continent grapples with emerging health threats, and financial constraints. This year’s theme underscored the urgency of reimagining Africa’s health systems — moving from reactive to proactive approaches, from fragmented to integrated financing models, and from national silos to multilateral collaboration.
While diagnosing the challenges is a good first step, the convening emphasised finding bold, sustainable, and Africa-led solutions. Across various sessions, one message remained clear: health is an investment, not an expense. If Africa is to build resilient, equitable, and future-proof health systems, we must rethink how we finance health, prioritise prevention, and strengthen our capacity to develop medical countermeasures.
Opportunity in a crisis
Health financing in Africa is at a crossroads. Over the past two decades, donor support has been a crucial lifeline, funding everything from HIV/AIDS programmes to vaccine rollouts. However, the tide is shifting. With global economic downturns, donor fatigue, and shifting geopolitical priorities, Africa is seeing a decline in external health financing. The COVID-19 pandemic exposed the vulnerabilities of health systems that depend heavily on external funding, emphasising the need for sustainable financing mechanisms that are led and owned by African countries.
As the impact of the recent US funding freeze evolves, Dr, Gitahi noted that it’s important to centre the conversation around the communities served. “If we shift our mindset from the money that is leaving but, on the communities, we will start asking the right questions,” he said.
He emphasised that while aid and foreign corporation helps communities and advances the interests of donor countries, it shouldn’t be an entitlement.
What does this mean for Nigeria and other African countries? It means there’s a window of opportunity to own our problems while still exploring opportunities for collaboration. The conversation about declining development assistance is not new, even though no one could have predicted the speed and manner it happened.
Dr Chikwe Ihekweazu, Assistant Director General at the World Health Organization (WHO) and Acting WHO Regional Director for Africa and other experts at the convening, expressed optimism that the challenge might push African leaders to invest more in health and trigger solidarity between and within countries. Nigeria’s government is already rising to the challenge. Even though “no country can afford to outsource its responsibility to other parties,” as Ihekweazu noted, the instinct to set up a global collaboration to manage certain issues 75 years ago has not changed.
To emerge stronger from this funding situation, Africa must own its health agenda, leveraging tools like national health insurance schemes, taxation on unhealthy commodities, and blended financing models that engage the private sector. However, in doing this, it’s important to keep in mind that “it’s not about how you spend, but where and how you spend it,” that matters, according to Dr Sabin Nsanzimana, Minister of Health of Rwanda.
A prevention-first approach
The health systems in Africa have been structured around treatment rather than prevention for far too long. The burden of non-communicable diseases (NCDs), mental health conditions, and infectious diseases continues to rise, yet investments in prevention remain disproportionately low. The question is no longer whether prevention works; the evidence is overwhelming. Investments in primary healthcare, immunisation, nutrition, and health education yield far greater returns than the cost of treating preventable diseases. Dr. Gitahi mentioned that investing in these, including clean water for everyone, is important when you have little money. “We must prioritise prevention because health is made at home, and hospitals are garages for repair,” he said.
AHAIC 2025 called for a paradigm shift where governments embed prevention at the heart of health policies, ensuring that public health interventions receive the same level of commitment as curative care. This means scaling up community health programmes, integrating digital health solutions for early disease detection, and adopting policies that promote healthier lifestyles. Prevention is not just a health issue, it is an economic strategy that reduces long-term healthcare costs and enhances productivity.
Three considerations for strengthening Africa’s health security
As countries in Africa navigates an era of increasing health threats, from pandemics to climate-driven disease outbreaks, three priorities emerged from the AHAIC 2025 for ensuring health security and resilience:
Strengthening Medical Countermeasure R&D in the continent: Africa cannot afford to be a passive consumer of medical innovations. It must be a leader in research and development (R&D). The continent has witnessed significant progress, with countries like Kenya and Nigeria investing in medical countermeasure R&D. However, gaps remain in infrastructure, funding, and regulatory capacity. AHAIC 2025 highlighted the need to accelerate local production of vaccines, diagnostics, and therapeutics to reduce dependency on external markets. Innovative and Sustainable Health Financing: Financial sustainability remains a challenge. Traditional financing models are insufficient to meet Africa’s growing health demands. Governments must explore innovative solutions, such as social impact bonds, pooled regional funds, and strategic private sector partnerships. Leveraging innovative financing mechanisms will help Africa can build resilient health systems that withstand public health threats. Multilateral Partnerships: No Country Can Do It Alone: Health security is a collective responsibility. Borders must not be barriers, but bridges for collaboration. No single country can address pandemics, antimicrobial resistance (AMR), or emerging health threats in isolation. AHAIC 2025 reaffirmed the power of regional cooperation, emphasising that stronger multilateral partnerships across governments, private sector actors, and civil society are essential for shared health security. Rwanda’s success in addressing the Marburg virus outbreak is an important opportunity for regional organisations to connect the dots and learn from the science developed.
Africa’s health future depends on bold, coordinated action. It is time to break down silos, rethink financing strategies, and prioritise prevention. The road ahead will require innovation, investment, and unwavering commitment from governments, private sector leaders, and communities. Now is the time to act. Now is the time to invest in Africa’s health sovereignty.
