Health for All, Not for Some: Revamping the Global Health Architecture for Equitable Access

The global health landscape is at a pivotal moment, where Africa’s collective voice is pushing for a redefined, equitable health architecture. At the Africa Health Agenda International Conference (AHAIC) 2025, a critical plenary session titled Health for All, Not for Some examined how Africa can assert its role in shaping global health policies, financing models, and partnerships to achieve sustainable, inclusive health systems.

Challenging the status quo in Global Health Equity

The Lusaka Agenda, a framework for advancing health equity in Africa, was a focal point of the discussion. It underscores key areas such as regional manufacturing, research and development, sustainable domestic financing, and equity. Speakers emphasized that traditional donor-driven health systems have perpetuated dependency, urging a shift toward African-led solutions.

Dr. Ruth Nigatu, Strategy Alignment Consultant at the Global Financing Facility in Ethiopia, highlighted the need for structural reforms in global health financing. She called for a stronger African negotiating presence in global health decision-making, including seats in the governing boards of various institutions. She emphasized that equity must be at the center of reforms. This includes reducing financial fragmentation, supporting African health institutions, and enhancing accountability and transparency across the continent.

Unlocking Sustainable Financing for Africa’s Health Systems

Sustainable domestic financing was another critical theme. Africa’s health systems have historically been underfunded, with only 3.8% of the global health budget allocated to low- and middle-income countries. Addressing this requires innovative financing strategies that include domestic investments and private-sector partnerships.

Maturin Tchoumi, Area Head for Africa at Roche, stressed that investing in health should be seen as an economic imperative, not a cost. He pointed to Cameroon’s efforts in reducing the cost of breast cancer treatment as an example of how governments can strategically invest in health services to ensure affordability and access. He also underscored the need for local vaccine manufacturing capabilities to reduce dependency on external supply chains. “We need to start thinking of sustainable financing strategies such as having local manufacturing in Africa, localization agenda of the vaccine in Africa. How will Africa be part of health science? we need to have a few capabilities to manufacture vaccines in Africa. We have to do it now” Said Tchoumi.

Dr. Seth Berkley, Adjunct Professor at the Pandemic Center, Brown University, reinforced the importance of preventive care, particularly through vaccines. He highlighted the need for African leaders to improve financial accountability and reallocate resources towards Primary Health Care (PHC), where 80% of health outcomes are determined.

African countries must also take the lead in influencing health financing priorities, ensuring that investments align with the region’s most pressing health challenges. This requires a shift from passive participation to active engagement in global health policy discussions.

Strengthening Africa’s Role in Global Health Governance

For Africa to achieve self-reliance in health, it must solidify its voice in global health governance. Dr. Magda Robalo, President and Co-Founder of the Institute for Global Health and Development, emphasized the urgency of African nations negotiating as a united block in global health forums. She called for a fundamental shift in mindset, moving away from fragmented approaches towards collective advocacy for African health priorities.

Similarly, Dr. Ngozi Erondu-Manyonganise, the Technical Director of Global Institute for Disease Elimination (GLIDE) argued that Africa’s debt burden significantly impacts its ability to finance health systems. She called for debt restructuring and reimagined partnerships that prioritize African-led health solutions.

Moving Forward: Key Takeaways

The plenary session clarified that Africa must take proactive steps to reframe the global health architecture in its favor. Three actionable recommendations emerged:

1. Enhance Domestic Health Financing: Governments must increase budget allocations to health and explore sustainable financing mechanisms such as taxation on unhealthy products, strategic public-private partnerships, and innovative funding models tailored to Africa’s unique needs. Strengthening financial accountability will be key to ensuring long-term success.
2. Invest in local manufacturing and research: Strengthening Africa’s end-to-end research and development capacity, along with scalable local pharmaceutical and vaccine manufacturing, is not just necessary but urgent. Building regional innovation hubs and leveraging African expertise will be crucial in reducing reliance on external suppliers and achieving true self-sufficiency.
3. Unify Africa’s negotiating power: African nations must leverage their collective strength in global health decision-making, advocating for policies that reflect the continent’s priorities. A cohesive, well-coordinated African bloc will be better positioned to drive structural reforms in global health governance, ensuring equitable access to funding, technologies, and medical innovations.

In conclusion, the time for Africa to take ownership of its health future is now. The momentum must translate into policy action, investments, and a collaborative push for equitable health access for all. As Dr. Mercy Mwangangi put it, “If you imagine less, then less is what you undoubtedly deserve.” Africa must imagine and demand more to secure a just and sustainable health system for its people.

By: Dr. Samuel Muhula, Sechelanji Nambela Mulenga, Christine Muya and Dr. Mercy Mwangangi