Reshaping Africa’s Health Financing and Targeting Autonomous Governance for Sustainable Growth

Opinion Piece: Healthcare Landscape in Africa Beyond Aid by Dr. Mary Moussa

The recent suspension and re-evaluation of USAID funds across Africa’s healthcare programs, have sent shockwaves through the continent’s health systems. The decision woke the continent as it was dreaming about global solidarity towards international health security.

USAID's funds have been critical in the support towards Africa’s most essential healthcare services, from disease prevention and treatment to health system strengthening and emergency response, especially in countries where resources and funds haven't been able to meet the need. The abrupt withdrawal of USAID 's resources exposes Africa’s vulnerabilities and dependence on external funding, leaving millions of Africans at risk and reversing hard-earned gains in public health.

Don’t put all of your eggs in one basket, but in this case even the basket is not ours!

As people try to analyse the situation and put together emergency measures and actions to mitigate the negative effects of the USAID -halt, ?it is also important to acknowledge and support the decision to rescind the stop order on essential medicines, as lives are at stake and a sudden halt in supply would have had devastating consequences.

However, the USAID ban serves as a wake-up call: There should be no debate about the necessity of donor funds scaling down over time as self-reliance and ownership of healthcare financing should be within nations themselves, however we urge for a gradual and strategic withdrawal of foreign aid.

The reality remains that Africa cannot continue to rely on foreign donor-funded programs to sustain its health systems.

Now is the time for a bold and coordinated shift toward self-reliance, financial prioritization and ownership of Africa’s healthcare systems.

The Role of Africa CDC in Strengthening Health Systems as a Pan African Autonomous Agency

The Africa Centres for Disease Control and Prevention (Africa CDC )has been at the forefront of strengthening continental health security and pandemic preparedness. The organization has demonstrated its ability to coordinate African-led responses, from Covid-19 to mPox, proving that homegrown solutions are not only possible but necessary. Now more than ever, Africa CDC must be empowered and supported to guide a continental strategy for health resilience, ensuring that foreign funding uncertainties do not disrupt critical disease control efforts.

African governments must work closely with Africa CDC to develop sustainable public health financing models that prioritize domestic investment in Africa’s health security infrastructure.

The African Union (AU) political will and guidance should direct the health ministries across the member states to empower Africa CDC with technical assistance and resources. All member states must invest substantially larger sums in health to avoid catastrophic consequences that results from a weak health system that has been reliant on external funds for way too long.

The African Union, Africa CDC, and regional economic blocs must take a strong lead in setting the agenda for sustainable health financing and implementation.

The Private Sector as a Strategic Partner to Address the Aid Freeze

The private sector is and has always been a core component to navigate risks in uncertain times. The private sector has an unprecedented opportunity to step up as a key player in providing innovative solutions to provide better access, more affordability and increased quality in terms of delivering healthcare on the continent.

Multinationals, African owned businesses and investors must recognize their social responsibility is beyond diversity, equity and inclusion. It is more of strategic economic investment that contributes to social and economic growth.

Enter the market fiercely, show goodwill, earn the trust of governments as a trustworthy ally, the private sector when guided by national priorities represents a committed and reliable partner targeting long term sustainable solutions.

The African Governments Role in Ensuring Sustainable and Viable Private Sector Offering

Governments play a leading role by either maintaining status quo or engaging in accelerating partnerships such as public-private partnerships (PPPs). A successful PPP can provide a viable model to finance and sustain health infrastructure, and improve service delivery.

Governments across Africa need to actively work towards creating an enabling policy and regulatory environment that encourage private sector participation and innovation. This includes streamlining licensing and accreditation processes to offer a foundation for ripe and investment ready markets .

In addition clear tax incentives, regulatory reforms, and risk-sharing provide a better environment for increased private sector involvement.

Owning Our Healthcare Systems from Design to Practice

We can’t afford not to invest heavily in health.

Throughout my years of practice and involvement in the health sector, I have often heard experts repeatedly demand that Africa must treat health not as an expense, but as an investment for economic stability and growth. Countries across the world prioritize healthcare financing as they target the direct returns in increased workforce productivity, job creation, and human capital development, etc.

But for our continent it’s not merely a choice, with all the pandemics, breakouts and other health emergencies related to climate and environmental changes or natural disasters.

To reduce dependency on foreign aid, a necessary step, though undoubtedly a challenging one, African governments must:

1. Mobilise domestic resources
2. Allocate a greater share of national budgets to health
3. Develop innovative financing mechanisms
4. Setup national social insurance
5. Explore sustainable funding models
6. Encourage local manufacturing and reduce reliance on imports
7. Ensure uninterrupted access to essential medicines
8. Create economic opportunities

Our governments need to intentionally deepen Private Sector Engagement – Governments must work with businesses to co-create healthcare solutions, from financing infrastructure to driving digital health innovations.

A Defining Moment for Africa

The USAID funding crisis is a defining moment for Africa—one that calls for strategic and meaningful collaboration between governments, regional institutions, and the private sector.

Reducing imminent risks and building a self-reliant, healthier Africa is not just a moral obligation but an economic necessity. We need to take charge of our own health and it seems that we need to do that now!

Taking control of our own health financing and delivery, will provide an opportunity to design solutions that are innovative and culturally relevant with possible tremendous costs reduction.

We have been given an opportunity to step up and build strong home made solutions that safeguard lives, drive economic growth, and shape a sustainable and prosperous future for the continent.

Now we have been given no choice but to change the narrative, to act, not just to fill funding gaps, but to reshape Africa’s healthcare systems for generations to come.