With no money, African states told to bank on disease prevention

From left: Dr. Claudia Shilumani, Director of External Relations and Strategic Management at Africa CDC, Dr. Sabin Nsanzimana, Rwanda's Minister of Health, Dr Githinji Gitahi, Group CEO of Amref Health Africa and Dr Chikwe Ihekweazu, acting regional director, WHO region during the ongoing AHAIC 2025, in Kigali Rwanda. March 3, 2025 [Mercy Kahenda, Standard] Kenya and other African nations have been urged to urgently invest in disease prevention and prioritize healthcare needs amid a freeze on foreign aid. Preventing diseases and outbreaks has been recognized as the most practical approach, as countries grapple with financial challenges. Global and African health leaders made this call, stressing the need for self-sufficiency in disease prevention and increased healthcare investment to fill the gap left by donor funding cuts, following a halt ordered by former U.S. President Donald Trump. Dr Githinji Gitahi, Group CEO of Amref Health Africa, warned that disproportionate funding for tertiary care leaves millions without access to essential health services. "It is now time to go back to basics. Because you do not have money to treat people, you have to avoid diseases, and if you wait, you will not achieve it," said Gitahi. The Amref boss spoke during the ongoing Africa Health Agenda International Conference (AHAIC) 2025, in Kigali, Rwanda, where global and African health leaders have convened to find solutions for tackling pandemics, climate-driven health threats, and declining health aid through homegrown strategies and strategic investments. This is happening at a time African countries are already grappling with impact of freeze on foreign aid, likely to result in looses made in elimination of diseases mostly malaria, HIV/AIDS and Tuberculosis (TB). Gitahi noted that no amount of efficacy will enable African states get enough money to handle healthcare system. "We must rethink and go back to the basics. The basics is to ask ourselves how many diseases can be prevented to avoid them," said Gitahi. Gitahi called for a bold policy shift to address fundamental health determinants such as clean water, sanitation, food security, and immunization. "We must ensure access to clean water, sanitation, food systems, and immunization for everyone. Achieving this requires bold decisions by policymakers to restructure the current system and refocus on primary healthcare," added Gitahi. He emphasised that the only way to build sustainable health systems amid shifting geopolitics is by redirecting investments to Primary Healthcare, where at least 80 per cent of the population seeks care. "For decades, we have called for prioritizing primary healthcare, as outlined in the 1978 Alma-Ata Declaration. We need to go back. When we receive funding, it is often directed toward tertiary care, yet we continue to mop the floor instead of fixing the leaking tap," said Gitahi. "African countries are waiting for the floors to get wet so they can mop, instead of fixing the leaking tap," he reiterated. Dr Chikwe Ihekweazu, Acting WHO Regional Director for Africa, reaffirmed WHO's commitment to working alongside African governments to address funding gaps, particularly in areas previously supported by USAID and other donors. "We need to map funding gaps and collaborate closely with African governments to find sustainable solutions. The focus must shift toward internally driven strategies while remaining open to strategic partnerships," said Dr. Ihekweazu. He highlighted Rwanda as a model for strong domestic health financing and called for greater investment in health systems, emphasizing the need to leverage private-sector expertise to complement public healthcare efforts With strategic investment and governance, African nations can effectively fund their health priorities. This requires prioritizing internal revenue generation for healthcare, reducing out-of-pocket costs, and expanding universal healthcare coverage." Rwanda is among the countries actively exploring internal health financing solutions, marking a significant step toward reducing dependence on foreign aid. Dr Sabin Nsanzimana, Rwanda's Minister of Health, reaffirmed the country's commitment to building a resilient and sustainable healthcare system, emphasizing that health is the foundation of national development. Nsanzimana stressed that Africa must take ownership of its healthcare future by reducing dependency on external aid and strengthening local healthcare capacity not just focusing on funding received, but also ensuring the efficient use of resources to improve health outcomes. "By prioritizing homegrown solutions, fostering innovation, and taking full ownership of our health systems, Africa can secure a healthier and more sustainable future for all," he concluded. "For Rwanda, we are working to finance our health system in a clear and structured manner-understanding what needs to be done, identifying funding sources, and ensuring that resources are directed toward effective solutions to meet healthcare needs," Nsanzimana explained. He further emphasised the role of innovation, including Artificial Intelligence (AI) and digital health solutions, in building resilient, high-quality, and accessible healthcare systems "We do not need to copy and paste solutions that do not work for us. In Rwanda, Community Health Workers (CHWs) are doing a great job, managing 70 per cent of malaria cases nationwide. It's about making healthcare simple and cost-effective, not just how much we invest," said the Rwanda minister. Rwanda continues to invest in health infrastructure, technology, and strategic partnerships to drive self-sufficiency and efficiency. The conference is taking place amid significant risks to African communities and healthcare systems. Dr. Claudia Shilumani, Director of External Relations and Strategic Management at Africa CDC, strongly urged Africa to assert its health sovereignty, emphasizing that self-sufficiency is key to securing the continent's health future. "If we prioritize self-sufficiency in healthcare developing, producing, and distributing our own vaccines, medicines, and medical technologies. We must also invest in a robust African health workforce to drive this vision forward," said Shilumani. Dr. Shilumani commended Rwanda's leadership in exploring internal health financing solutions, recognizing it as a major step toward reducing dependence on foreign aid. "Africa must lead its own health agenda by investing in homegrown solutions, mobilizing domestic resources, and fostering innovative public-private partnerships," she added. Meanwhile, Dr. Ihekweazu highlighted that Tuberculosis (TB) programs have been among the most affected by the reduction in U.S. government funding, underscoring the urgent need for alternative financing strategies. The U.S. had been procuring and supplying essential TB commodities, including drugs and sample transportation for testing-services that have now ceased. Gitahi noted that several health programs previously funded by the U.S. government have since stopped, increasing the risk of disease outbreaks and surges. "What makes me sorrowful is the impact on communities that depended on this support. This is what worries me the most," Gitahi lamented. The conversation on alternative funding models continues at the ongoing AHAIC 2025 conference in Kigali, Rwanda. Experts have called on governments, private sector players, and civil society organizations to make bold commitments that will shape Africa's health landscape for generations to come. With healthcare systems already strained by recent mpox and Marburg outbreaks, rising climate related diseases, and dwindling international health aid, the conference running from March 2 to 5, 2025, under the theme "Connected for Change: Addressing Socio-ecological Dynamics of Health" serves as a critical platform for driving African-led health solutions and forging sustainable partnerships.

With no money, African states told to bank on disease prevention

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