Africa’s health system is in crisis, driven by declining donor aid, rising debt, and persistent inequities in global health financing.

The concerns were highlighted at a webinar, “Africa Leadership for Health Sovereignty,” convened by AIDS Healthcare Foundation (AHF) Africa, AFRICA REACH, and WACI Health.

Dr Penninah Iutung, Executive Vice President of AHF, said the global charity-based health model had failed the continent.

“The continent cannot beg its way out of a US$43 per person health financing deficit. When countries prioritise debt servicing over life-saving medicines, it ceases to be an economic issue and becomes a moral indictment,” she explained.

Dr Iutung urged African leaders to negotiate collectively on debt restructuring and health financing, warning that inaction would entrench a system in which Africa imports nearly all its vaccines and “100 per cent of its poverty.”

She noted that foreign aid to Africa’s health sector was expected to fall by about 70 per cent, amid a debt crisis in which at least 34 African countries now spent more on debt servicing than on citizens’ health.

Dr Iutung noted that despite carrying roughly 23 per cent of the global disease burden, Africa accounted for just one per cent of global health expenditure.

“The continent faces an estimated annual health financing gap of US$66 billion, while African countries borrow at interest rates exceeding 10 per cent, compared with two to three per cent for high-income countries,” she said.

Madam Rosemary Mburu, Executive Director of WACI Health, said Africa had adequate domestic resources to fund health but suffered weak prioritisation and accountability.

“Urgency is non-negotiable,” she stressed, calling on governments to align procurement policies with local manufacturing initiatives so African producers can compete.

She said that Africa imported about 99 per cent of its vaccines, a vulnerability worsened by currency devaluations and high production costs.

Mr Martin Matabishi, AHF Africa Bureau Chief, warned that chronic underfunding now threatened national and continental security.

“If leaders choose to pay creditors before doctors, they are choosing fragility over the future,” he said.

Mr Matabishi called for enforceable health financing mechanisms, stronger public financial management, and enhanced parliamentary oversight.

He also urged the urgent operationalisation of the African Medicines Agency (AMA) to harmonise regulations, support local pharmaceutical production, and create a viable continental medicines market.

In a communique read by Tolessa Olana Daba of AIDS Healthcare Foundation Ethiopia, the coalition called for a unified African position to renegotiate debt and financing terms, alongside rapid action to achieve supply sovereignty through functional continental regulatory systems.

Dr Julius Simon Otim, Senior Health Officer, Medicines & Food Safety, East African Community (EAC) Secretariat, advocated a shift from state-centred to people-centred health sovereignty that prioritises equity and human rights.

“Africa is not short of policies or frameworks. What is missing is political will and implementation,” he said.

The coalition stressed that decisions taken at the AU Summit would determine whether Africa continued to rely on fragile external aid or moved towards sustainable, self-reliant health systems.

Auto dealers respond to 15% price cut announcement