Africa’s top public health institution is planning to tap more funds from domestic sources to protect the gains made over the past two decades in epidemic preparedness and response, following a steep decline in external support.
Since the decline of Official Development Assistance (ODA) to Africa by 70% over the past few years, one thing has become abundantly clear: there is a gap in health funding, putting pressure on already fragile health systems.
Historically, ODA has been instrumental in achieving a 50% reduction in under-five mortality between 1990 and 2019, expanding routine immunization coverage, and supporting HIV/AIDS prevention and treatment programs that now provide antiretroviral therapy to over 18 million people across Africa. It also enabled rapid responses to major health crises, such as the Ebola outbreak in West Africa.
The contraction in funding coincides with a rise in disease outbreaks. Between 2022 and 2024, the continent witnessed a 40% increase in reported public health emergencies. Concerns also persist about the return of viral haemorrhagic fevers such as Ebola and Marburg, while climate shocks — ranging from floods to heatwaves — are fueling new health risks, often in regions least equipped to respond.
“We are also facing a number of issues in terms of debt servicing and dependence on imported medical countermeasures. Combining these two factors, Africa is facing a major risk,” said Dr. Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention (Africa CDC).
The situation poses a broader challenge within Africa’s health security architecture, but work is ongoing to reverse the funding uncertainty. Africa CDC has mobilized African Union Member States toward a new era of health investment. Dr. Kaseya proposes a three-pronged strategy to enhance sustainability and reduce reliance on external donors, outlined in a new paper.
He is calling on African Union Member States to increase their domestic funding for public health. Only two countries currently meet the Abuja target of allocating 15% of national budgets to healthcare. Domestic commitment is essential to safeguarding health systems against the volatility of international funding, he notes. “We need to have a costed strategic plan and a national financing plan. We need to push for more alignment of external resources,” said Dr. Kaseya.
Second, Africa CDC is pursuing new financing models. These include the Africa Epidemics Fund, whose operational framework was launched in February 2025, as a pooled resource for emergency preparedness and rapid response. The agency is also exploring mechanisms such as an airline tax or regional solidarity levies to provide a more predictable stream of funding for outbreak management.
Third, Africa CDC is seeking greater collaboration with philanthropic organisations and the private sector. The aim is to attract long-term investment into critical infrastructure, including local vaccine production, digital health systems, and logistics networks. As part of this effort, Africa CDC is implementing the African Pooled Procurement Mechanism to lower costs and increase access to essential health commodities across the continent.
To support the mobilization of domestic funding and the pursuit of new financing models, Africa CDC is requesting USD 43 million. The fund will enable the successful execution of the plans to ensure measurable progress toward sustainable health financing across the continent.
“A detailed budget has been developed for each pillar of support, covering technical assistance for the development of costed national health plans, the establishment of the AU-led monitoring dashboard, implementation of the pilot airline tax, and the design and scaling of innovative and blended financing mechanisms,” says the paper on health financing.
Galvanising broader support, Dr. Kaseya recently led a high-level diplomatic mission to the United States, Norway, and Denmark. In Washington, D.C., he and his team met with U.S. lawmakers, USAID, the U.S. Centers for Disease Control and Prevention, and major philanthropic institutions, including the Gates and Rockefeller Foundations. These engagements focused on reaffirming Africa CDC’s central role in global health security and appealing for continued support despite ongoing budgetary pressures in donor countries.
“An investment in Africa’s public health is an investment in global stability,” said Dr. Kaseya during his visit to the U.S. “Africa’s progress cannot be reversed by temporary budget constraints in partner countries.”
What may seem like a major setback could, in fact, be a defining opportunity, says Dr. Ngashi Ngongo, Principal Advisor to the Director General and the Continental Incident Manager for Mpox.
“Africa CDC is leveraging global funding cuts to champion sustainable health financing — fueling domestic investment, unlocking innovative funding streams, and building resilient systems for Africa’s future,” says Dr. Ngongo.
In Europe, discussions with government and development officials in Norway and Denmark highlighted a shared interest in strengthening health systems. While new financial commitments have yet to materialise, both countries signalled strong political support for Africa CDC’s long-term objectives.
During the trip to Norway, Dr. Kaseya signed a new Memorandum of Understanding between the Africa CDC and the Kingdom of Norway focused on building capacity, enhancing data for decision-making, and leveraging DHIS2—an open-source software platform for the collection, reporting, analysis, and dissemination of aggregate and individual-level data—for national and regional disease surveillance.
Throughout these engagements, Dr. Kaseya emphasised that Africa is not seeking charity but partnerships. “We are asking for solidarity and co-investment,” he said. “What we are building is a firewall that protects not only Africa but the world.”
Dr. Ngongo adds that it really doesn’t help to complain. “We have to be proactive in terms of thinking that, if this is the new normal — if that is the direction the world is taking — how do we remain fit in that context? What are the adjustments we need to make on our side to turn this challenge into an opportunity for Africa? That’s the angle we have taken: to turn what may seem like a setback into an opportunity. This is why we’re moving ahead with a new strategy — one that prioritises increased domestic resource mobilisation, explores innovative financing like solidarity levies and sin taxes, and brings in private sector investment. We see this not only as a challenge, but also as a moment to reshape the future of health financing on the continent.”
Africa CDC’s efforts to build a strong war chest to fund responses to outbreaks and fight diseases across Africa received a boost from two African Heads of State on March 14.
President of Angola, João Manuel Gonçalves Lourenço, took over the rotating African Union (AU) chairmanship at the opening of the 38th Ordinary Session of the AU Assembly of Heads of State and Government on February 15.
“I strongly commend the remarkable efforts of the Africa CDC in advancing the continent’s public health agenda, tying it closely to economic growth and job creation, and ensuring the safety and well-being of all Africans,” President Lourenço said.
Africa CDC plays a key role in strengthening Africa’s capacity to respond effectively and rapidly to emerging health threats, he said.
“The fundamental role that this institution has played has set a commendable standard in disease surveillance, prevention, and control, contributing immensely to continental and global health security. I reaffirm my commitment to providing continuous and sound support to Africa CDC, empowering you to fully discharge its essential mandate,” President Lourenço said.
Ethiopian Prime Minister Abiy Ahmed, who also visited Africa CDC on the same day, called on AU members to intensify their collective support in elevating the Africa CDC as a premier public health institution. “It is incumbent upon us to strengthen this institution in collaboration with partners. I call upon fellow African leaders to join efforts in establishing our continental public health agency as a premier institution, fully committed to advancing health across the continent,” Prime Minister Abiy Ahmed said.
