Wean Yourself Off Donor Dependence – African Leaders Told

Panellists at a high-level meeting on sustainable health financing have urged Africa to urgently shift from donor dependence to strong domestic investment as the surest pathway to health sovereignty, resilient systems and long-term development.

They stressed that with nearly 70 per cent of health financing in many African countries still coming from external donors, governments remain constrained in decision-making and vulnerable to global funding shocks, putting their populations at public health risk.

The call was made by the Head of the Interim Secretariat of the African Medicines Agency, Benjamin Djoudalbaye; Chief Executive Officer of the Africa Public Health Foundation, Dr. Ebere Okereke; and Chief Executive Officer of the South African National AIDS Council, Dr. Tendisi Ndungu. They spoke on the sidelines of the 23rd International Conference on AIDS and STIs in Africa (ICASA), ongoing in Accra.

Hosted by the AIDS Healthcare Foundation (AHF), the discussion was held on the theme: “Regional Health Leadership and Sustainable Financing in Africa.”

Admitting that Nigeria was still off-track in meeting the Abuja Declaration target of allocating 15 per cent of national budgets to health, Dr. Okereke said the country was expanding budgetary allocations at federal and state levels to drive its health agenda.

She disclosed efforts aimed at strengthening Nigeria’s national health insurance scheme, which currently covers just about 10 per cent of the population, while integrating key health programmes for greater efficiency. She also outlined initiatives to boost local pharmaceutical production through partnerships with private investors and manufacturers from China and India, as well as tackling the massive migration of health workers through expanded training and recruitment.

According to her, retaining health workers and producing medicines locally are essential foundations for sustainable health financing.

Sharing South Africa’s progress in moving from declaration to action, Dr. Ndungu revealed that nearly 80 per cent of the country’s HIV programme is now funded domestically — a clear shift toward locally driven health financing. She explained that South Africa is embedding health investments within broader economic growth strategies by strengthening primary healthcare, advancing universal health coverage and investing in local manufacturing to safeguard against global supply chain disruptions.

“Declarations inspire, but actions transform,” she said, emphasising that Africa must invest in its people as its most valuable asset.

For his part, Dr. Djoudalbaye highlighted the potential of diaspora remittances to serve as a major funding source for health if properly harnessed. He commended countries such as Ghana and Rwanda for reforming and strengthening their domestic health financing systems, indicating they were worth emulating.

As part of efforts to build Africa’s health sovereignty amid the decline in global aid, the Africa CDC launched a two-phase health financing strategy in April 2025. The first phase involves piloting innovative domestic financing tools in 30 countries, including government levies, mobile health taxes, solidarity contributions and stronger accountability systems.

The second phase aims to scale up these successful models so that at least 20 countries can finance 50 per cent or more of their health budgets domestically by 2030.

BY ABIGAIL ANNOH

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