African leaders are pressing for increased domestic financing, expanded local production of medicines and vaccines, and stronger health systems as international aid to the continent declines. This shift follows a reduction in external assistance from major donors, including the United States and European countries, which has heightened concerns about Africa’s ongoing reliance on foreign support.

Official development assistance has long been a critical funding source for sub-Saharan Africa’s health sector, but bilateral aid to the region decreased by approximately 26 percent last year, according to the International Monetary Fund (IMF). While some countries such as China and Gulf states have increased their aid contributions, these efforts have not fully compensated for the overall reduction. The resulting funding gaps have impacted essential sectors including health, education, and humanitarian services.

Mahmoud Ali Youssouf, chairman of the African Union Commission, emphasized the need for stronger domestic resource mobilization, broader vaccine and treatment production, and the removal of barriers to intra-African trade to enhance the continent’s health sovereignty. He highlighted ongoing initiatives such as the African Medicines Agency and expanding vaccine manufacturing capacity as foundational steps toward greater self-reliance in health.

“African health sovereignty starts with effective national health systems,” Youssouf said, urging governments to ensure that health policies lead to tangible improvements for their populations.

Aboubakri Diaw, chief of staff at the United Nations Economic Commission for Africa, described Africa’s health sector as facing both a financing and “confidence gap.” He called for the development of credible, phased health investment plans capable of attracting a mix of public, development, and private funding. Diaw advocated for a paradigm shift in how health spending is viewed, suggesting it should be seen not merely as social expenditure but as a productive economic investment integrated into national development plans and fiscal frameworks.

Ethiopia’s Health Minister Mekdes Daba Feyssa stressed that sustainable health systems must prioritize primary healthcare, communities, and health workers. She also pointed to technology’s role in measuring health outcomes and digital transformation as a means of ensuring equitable access for both rural and urban populations. Additionally, she underscored the importance of enhanced disease surveillance and emergency preparedness to improve timely responses to outbreaks.

Mohamed Janabi, the World Health Organization’s regional director for Africa, advocated for strengthening the continent’s centers of excellence and retaining health resources within Africa, noting that approximately $7 billion annually is spent on 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 bears more than a quarter 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, a dependency that leaves it vulnerable to external shocks and highlights the urgency of efforts to build resilience through health self-reliance.