African leaders, policymakers, and development partners have called for a fundamental shift in how healthcare is financed across the continent. They urged governments to prioritize domestic resource mobilization, strengthen accountability, and embrace innovation to build resilient health systems. This critical appeal was made at a High-Level Interactive Policy Dialogue held in Accra on Monday, July 20.
The dialogue, jointly organized by the African Renaissance Trust and the Jakaya Mrisho Kikwete Foundation, formed part of activities leading up to the African Union Extraordinary Summit. This summit will focus on ending AIDS by 2030, addressing preventable maternal deaths, and strengthening health systems. The event's theme, "Advancing Africa's Health Agenda through Domestic Financing, Accountability and Strategic Innovations," explored how African governments can bridge the gap between political commitments and implementation through sustainable financing and stronger governance.
This push for self-reliance comes as external aid to the health sector faces significant reductions. Official development assistance declined by 23% in 2025, with external health aid dropping by 40%, marking the largest annual decline ever recorded. This trend necessitates a re-evaluation of Africa's health financing strategies, moving away from historical dependence on foreign assistance. The continent's health future must be financed sustainably and predictably, governed accountably, and transformed through purposeful innovation.
Ambassador Amma Twum-Amoah, African Union Commissioner for Health, Humanitarian Affairs and Social Development, stated that Africa has reached a defining moment in its quest for universal health coverage. She emphasized that despite progress, growing financing gaps, demographic pressures, and emerging public health threats require African governments to take greater ownership. She stressed that health expenditure should be viewed as an investment in human capital, economic growth, and national resilience, not merely a social cost.
Former President of Tanzania, Dr. Jakaya Mrisho Kikwete, highlighted the urgency for African countries to finance their own health priorities due to changing global financing patterns. He noted that nearly 70% of the world's maternal deaths occur in Africa, despite available preventative technologies. Dr. Kikwete urged governments to make national budgets the primary source of health financing and encourage greater private sector investment. Tanzania's experience, with sustained investments reducing maternal mortality from over 550 deaths per 100,000 live births to 104, serves as a powerful example.
Ghana's Deputy Minister of Health, Professor Grace Ayensu-Danquah, speaking on behalf of Vice President Professor Naana Jane Opoku-Agyemang, affirmed Ghana's commitment. She stated that Ghana is pursuing universal health coverage through expanded access, improved health outcomes, and reduced out-of-pocket expenditure. Flagship interventions include the Ghana Medical Trust Fund, which supports chronic non-communicable disease diagnosis and treatment, and the Free Primary Healthcare Initiative, focusing on preventive care, maternal and child health, and immunization.
A key outcome of the dialogue was the unveiling of the African Renaissance Health Financing Insights Dashboard. This continental accountability platform will help governments monitor health financing commitments, track implementation, identify funding gaps, and improve coordination between Ministries of Health and Ministries of Finance. This tool aims to enhance transparency in budgeting, procurement, and implementation, ensuring that financing is coupled with accountability to prevent inefficiency.
The call for increased domestic financing and accountability will likely shape future health policy discussions across Africa. Decision-makers will need to focus on innovative financing mechanisms and robust governance structures. The success of these initiatives will depend on sustained political will and effective collaboration between various stakeholders, including governments, the private sector, and civil society organizations. The emphasis on internal solutions marks a significant shift towards greater self-determination in Africa's health agenda.