Wearing different political hats, meeting as a group, plotting Africa’s health future and setting targets while ensuring that they are met is a potent formula that could change Africa’s health fortunes.
Coming from diverse backgrounds, but facing similar health problems in their backyards, Africa’s health ministers share a related view. They need to build a coalition to secure Africa’s health security, and the Africa Centres for Disease and Control Prevention (Africa CDC) is an appropriate ally.
When forty-five African health ministers and over 100 key stakeholders sat down on February 13, 2025, in Addis Ababa, to discuss pressing health challenges and strategies for strengthening health leadership on the continent, under the flagship Ministerial Executive Leadership Programme (MELP), the desire for strengthened collaboration with the Africa CDC in refining political strategies came out strongly.
The urgency of shaping resilient health systems in Africa and underscoring the three foundational pillars of the MELP initiative: reimagining primary health care, advancing UHC, and fostering multi-sectoral collaboration in emergency response, was highlighted by Africa CDC’s Director General, Dr. Jean Kaseya, who got the discussion off the ground.
“Ministers of health are at the forefront of shaping national policies and influencing political will. Let’s use our deliberations at this forum to position health as a matter of economic and continental security, leading us to increase and sustain domestic financing for health. We cannot continue to outsource our health priorities to external funders,” said Dr. Kaseya, emphasizing that PHC is not just about delivering basic services but about creating robust systems capable of addressing long-term health threats.
Against the backdrop of a 40% increase in disease outbreaks in Africa between 2022 and 2024, he said, creating self-sustaining systems that endure both ongoing and unforeseen crises on the continent is important.
To put the problems in Africa into perspective, Dr. Ngashi Ngongo, Principal Advisor and Incidence Manager, Africa CDC, presented data on the alarming rise in outbreaks across Africa, again noting that the number of outbreaks has more than doubled from 2022 to 2024.
He said many countries were experiencing multiple concurrent outbreaks, which were placing severe strain on national health systems.
At the mercy of recurrent outbreaks, Dr. Silvia Lutucuta, Minister of Health, Angola, suggested that health security cannot function in isolation and that a multi-sectoral approach is crucial for effective outbreak response and prevention.
Dr. Lutucuta pointed out that environmental factors, cross-sectoral coordination, and community engagement must be prioritized alongside medical interventions to strengthen public health resilience.
She noted how Angola responded to the cholera outbreak in January 2025, citing the need to bring care closer to the people. “This involved decentralizing epidemic response centres which ensured that community-based facilities could treat cases locally instead of relying solely on centralized hospitals, empowering local healthcare workers and community responders to detect and manage cholera cases at the earliest stage and strengthening surveillance networks to monitor the spread of cases in real time and direct resources to high-risk areas,” she said.
Dr. Lutucuta envisaged an epidemic response in which the health sector adopts a One Health approach: joining hands with the environmental sector, sanitation authorities, and local governance structures as part of the solution.
A country’s ability to respond to health crises depends on the strength of its pre-established governance structures and strategic preparedness, said Dr. Mitoha Ondo’o Ayekaba, Minister of Health, Equatorial Guinea, adding that response effectiveness is directly tied to how well a system is organized before a crisis occurs.
Dr. Ayekaba highlighted a common pitfall in emergency response, failing to contextualize strategies to the unique realities of a country’s health system and stressed that simply adopting global best practices without local adaptation can be ineffective, as each country has distinct healthcare challenges, political structures, and community engagement dynamics.
He illustrated this point with the lessons learned before and during COVID-19, explaining that before the pandemic, his country had already begun strengthening its health system by decentralizing healthcare structures and addressing the gaps between central administration and local service delivery. This proactive operationalization of health districts proved critical when COVID-19 hit, enabling a rapid and coordinated response, he said.
Building resilient health systems also resonates with Professor Muhammad Ali Pate, Nigeria’s Coordinating Minister of Health. Strong political commitment is the backbone of any successful health initiative, he said sharing key lessons from the COVID-19 pandemic. Health systems must be agile; they must be designed to respond swiftly to emerging threats, he said.
This flexibility, adaptability and cross-sectoral collaboration are essential in building resilience. Fostering partnerships across sectors; governments, NGOs, the private sector, and communities, can ensure that health systems withstand shocks. He also emphasized the gravity of equity in service delivery, noting that health disparities have worsened during pandemics and ongoing outbreaks like mpox and Marburg.
In terms of political commitment, Professor Pate said it is the backbone of building any successful initiative as it encompasses not only the allocation of resources but also the creation of policies that prioritize health.
Strategies such as advocacy for integrated health policies, community engagement, investment in health workforce and leveraging technology are pertinent for ministers to showcase the potential of political will, he shared with his peers.
For Professor Pate, resilience in health systems means not only enduring shocks and public health threats but thriving amidst them, however, it will require sustainable financing, innovative solutions and a robust emergency response framework and other commitments.
At the heart of any response is health financing, but with foreign development investment in Africa plummeting from $80 billion in 2021 to a projected $24 billion in 2025, Africa is at a crossroads. Dr. Ngashi noted that funding decline is largely due to major donors, including the US, Switzerland, Italy, France, and Sweden, scaling back bilateral financial support for African health systems.
Africa’s health challenges are also compounded by fragility, insecurity and political instability, said Dr. Ngashi. He said many of the countries facing frequent outbreaks are also experiencing armed conflicts or political unrest. He cited the Democratic Republic of Congo (DRC) as a case study, where conflict in the eastern region led to the rapid spread of Mpox due to population displacement and health system collapse. He emphasized that Primary Health Care plays a crucial role in health security, contributing to five keyways.
Community engagement should involve strengthening community-based health responses and awareness through Community Health Workers. Many diseases are preventable, and Primary Health Care can reduce the burden of outbreaks. Primary Health Care ensures marginalized populations have access to care, preventing outbreaks from escalating. Investing in Primary Health Care yields a tenfold return, making it the most cost-effective way to improve health outcomes. Many outbreaks originate from zoonotic diseases, emphasizing the need for integrated One Health approaches.
Dr. Mekdes Daba, Ethiopia’s Minister of Health, called for bold investments in the health workforce, pointing to Ethiopia’s commitment to training more healthcare professionals and strengthening frontline health services. “This commitment was brought to the fore by the identified vulnerabilities in our health system which further highlighted the indispensable role of a well-trained and adequately supported health workforce,” said Dr. Daba.
She said investing in Ethiopia’s health workforce goes beyond a budgetary consideration and is rather an ethical imperative backed by political will, unity and passion to improve and revolutionize the health system at the national level.
Dr. Pierre N’gou Dimba, Minister of Health, Côte d’Ivoire, highlighted taxation-based financing models aimed at expanding health insurance coverage to informal sector workers, sparking discussions on the feasibility of implementing similar models in other African nations. He noted that 40% of the population in Côte d’Ivoire’s still lacks coverage due to persistent challenges such as collecting premiums from informal workers, and that the tax-based financing is expected to ameliorate the situation.
Dr. Joy Phumaphi, former Minister of Health of Botswana, provided actionable recommendations for African health ministers in light of the US government’s reduction in global health funding. She warned that only 25% of the committed funding for malaria programs has been released, potentially leading to 35–40 million additional malaria cases due to disruptions in supply chains. She advised health ministers to engage directly with US ambassadors to ensure remaining health commodities are released. She encouraged utilization of emergency response funds allocated for disasters, as the current situation constitutes a crisis. Another option is to leverage International Development Association (IDA) funding from the World Bank for urgent health system strengthening and consider integrating vector-borne disease control into climate change adaptation programs to broaden access to funding.
Dr. Phumaphi echoed calls for mobilising domestic health budgets, adhering to the 2001 Abuja Declaration target of 15% of national budgets for health and engaging the private sector by creating innovative financing models where companies contribute to health system funding. “Relying on external aid is no longer sustainable, and African nations must prioritize self-sufficiency in health financing,” she said.
Dr. Mitoha warned that strategic organization in health is as important as funding, noting that having money without a clear strategy is a risk rather than an advantage. He explained that poorly structured health systems waste resources, delay responses, and ultimately worsen health crises.
Unless proposed policies and initiatives are implemented, they will take Africa nowhere, said Dr. Raji Tajudeen, Acting Deputy Director General and Head, Division of Public Health Institutes and Research, reminding the ministers of the need for concrete follow-up mechanisms to translate commitments into measurable actions.
