African Health Workforce Compact, March 2025

Introduction

The African Health Workforce Compact (hereinafter “the Compact”) is a comprehensive, multi-stakeholder, evidence-informed initiative dedicated to supporting African Union Member States in their efforts to strengthen their human resources for health capacity. The Compact builds upon the work of the Africa CDC Framework for Health Workforce Development 2020–2025 and supports the African Union (AU) Agenda 2063 through the development of a sufficient, motivated, and well-trained health workforce capable of delivering essential health services across the continent.

This Compact has been developed to implement the Decision of the Assembly of Heads of State and Government during its Thirty-Fifth Ordinary Session held in Addis Ababa, Ethiopia from 5–6 February 2022 (Assembly/AU/Dec.4(XXXV) of 2022), which called on AU Member States to accelerate investment in health workforce development and mandated Africa CDC to champion this continental drive.

The Compact also builds upon, and reflects upon, the following:

• A Communiqué of African Union Heads of State and Government during a high-level side event “Reimagining Health Workforce Development for Africa’s Health Security” held on the margins of the 77th United Nations General Assembly on 19 September 2022. The communiqué called upon:

  • the AU to establish a health workforce task team to implement a compact for health workforce development;
  • Africa CDC to design, develop, and facilitate adoption of a comprehensive metrics framework for health workforce in Africa; and
  • AU Member States to collaborate through compacting.

• The Africa Health Workforce Investment Charter, endorsed in January 2023, which calls for accelerated and sustained investments in health workforce development through inclusive, multi-stakeholder processes (Principle 1.1) and the formulation and implementation of national health workforce investment compacts (Principle 3.1).
• The Abuja Declaration on HIV/AIDS, Tuberculosis and Other Related Infectious Diseases (OAU/SPS/ABUJA/3), 27 April 2001, which states:
  “WE COMMIT OURSELVES to take all necessary measures to ensure that the needed resources are made available from all sources and that they are efficiently utilized. In addition, WE PLEDGE to set a target of allocating at least 15% of our annual budget to the improvement of the health sector.”
• The aspirations of Agenda 2063 that African people have a high standard of living, and quality of life, sound health and well-being;
• Historic injustices through the COVID-19 and MPOX public health emergencies and injustices imposed on Africa such as slavery, colonisation, depletion of natural resources, and considering the firm will of African peoples for self-determination and the economic integration of Africa, and Africa CDC’s New Public Health Order;
• The impact of pandemics and public health emergencies on African health, economies, security, and safety, and the need to create a robust and well-qualified health workforce to ensure the highest attainable standard of health;
• The importance of international security, democracy, human rights, gender equality and the rule of law, for the development of health workforce across the continent.
• Aspirations of Universal Health Coverage (UHC), i.e. that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.

This Compact seeks to address the critical challenges that we face as African Member States in the self-sustainability and development of our health workforce. To address these challenges and align with the priorities of Member States, the Compact will detail strategies for coordinating health workforce efforts across Africa, supporting training initiatives for key prioritized cadres, and mobilizing resources to strengthen the continent’s health workforce. The Compact will be evaluated using a robust monitoring and evaluation (M&E) plan.

The work of the Compact will be implemented through a defined governance structure led by AU Member States, via the Africa CDC and its Governing structures, and operationalized through the formation of a Health Workforce Task Team (HWTT). The Africa CDC, as the Secretariat of the Task Team, shall ensure a rotating membership of health workforce directors from Ministries of Health, representatives from other relevant Ministries such as Ministries of Finance, Education and Civil Service, as well as membership from multilateral development banks, development partners, civil society, RECs, professional associations, and other relevant partners. The membership shall be periodically revised to ensure relevance and engagement. The HWTT shall ensure that strategic decisions align with Member State priorities, help coordinate work across the continent, and bring expertise and oversight to the work of the Secretariat.