A new deal for African health security

A new deal for African health security

Africa Centres for Disease Control and Prevention has a vision: to become world class and self-sustaining and position itself in line with universal health coverage, Sustainable Development Goals and the African Union’s Agenda 2063. To do so, it is proposing a New Deal 

Infectious diseases continue to be the major causes of mortality and morbidity in Africa. The impact of known existing, emerging and re-emerging diseases such as malaria, tuberculosis, HIV/AIDS and others are causing suffering and mortality to a wide proportion of populations in low- and middle-income countries in general, and Africa in particular. Over 227 million years of health life have been lost with an annual productivity loss exceeding $800 billion in Africa. With malnutrition a common contributor to illness, the five highest causes of mortality in Africa are acute respiratory infections, HIV/AIDS, diarrhoea, malaria and tuberculosis – being responsible for about 80% of the total infectious disease burden and claiming more than 6 million people every year.

The Covid-19 pandemic significantly affected lives, livelihoods and economies in Africa. It has claimed over 250,000 lives and over 12 million reported cases. The Africa Centres for Disease Control and Prevention led a continental pandemic response by designing appropriate strategies that targeted the unique challenges and diverse epidemiology of the disease. Despite the challenges, the continent’s response was quick and unified, with strong public support for safety measures. It has significantly learned from the experiences of past outbreaks, such as Ebola and polio.

One emergency to another

As the continent emerges from the Covid-19 pandemic, it faces multiple public health emergencies, including emerging and re-emerging infectious diseases such as Ebola virus disease, Marburg virus disease, cholera, meningitis, measles, Mpox, yellow fever, dengue fever and Rift Valley fever. Multiple factors contribute to the rise of emerging infectious diseases in Africa, with more than 100 disease outbreaks reported every year. These outbreaks are exacerbated by the disruption of health services by the Covid-19 pandemic, economic challenges that affect investment in health, changes in climate and weather, changing ecosystems, rapid population growth, rapidly increasing urbanisation, limited access to clean water and sanitation, and social inequality and instability, among other factors. Much remains to be done to achieve zero transmission and eliminate malaria, tuberculosis and HIV/AIDS in Africa. The ever-increasing challenges and complexity of infectious diseases call for building strong and resilient healthcare systems that improve the quality of primary health services across the continent. Adequate financial support to strengthen public health institutions and laboratories is also critical to prepare, detect and respond effectively to emerging and re-emerging infectious diseases.

Non-communicable diseases such as cancer, cardiovascular diseases and diabetes are significantly increasing in Africa. The proportion of NCD-related deaths increased from 24% in 2019 to 37% in 2020. Africa CDC has developed strategic priorities for NCDs including enhancing capacity to develop and implement policies to prevent, protect and manage them; political advocacy for better financing; workforce development; and increased access to essential technologies, medicines and diagnostics in Africa.

Climate change is among the most significant health threats facing the African continent. With increasing temperatures, environmental and ecological changes, the continental disease profile is changing. The 2023 monsoon flooding in Malawi and Mozambique exacerbated the cholera outbreak, leading to the largest and most deadly outbreak in Malawi. It is critical for Africa to build a climate-resilient health system with the utmost urgency. The unmet needs of sexual and reproductive health, malnutrition, injuries and mental health also remain major health challenges in Africa.

In February 2022, the African Union Assembly of Heads of State and Government elevated Africa CDC to an autonomous public health institution. Despite its early successes, it must improve its operations to fulfil the substantial demands placed upon it. Our vision is for Africa CDC to become world class and self-sustaining. This entails assembling a team of renowned experts and reliable on-the-ground rapid-response units. Adequate funding and efficient resource allocation are crucial. Africa CDC will contribute to strengthening national institutions to detect, prevent and control diseases, aligning with universal health coverage, the Sustainable Development Goals and the AU’s Agenda 2063. To achieve this, we propose Africa CDC’s New Deal, focused on governance, performance and accountability. It involves integrating digital technologies and public health intelligence and establishing effective partnerships. It will use performance indicators to ensure transparent and accountable alignment and coordination of interventions and resources.

An instrumental deal

Africa CDC’s New Deal will be instrumental to implement the New Public Health Order. Working alongside a variety of stakeholders, it will integrate the continent’s public health assets. To do this, the following actions are necessary.

First, we must enhance the capability to combat infectious diseases by strengthening preparedness and response capacities, risk assessment and disease prevention. This includes establishing common drug-procurement mechanisms, subregional medicines depots and medical supplies.

Second, we must accelerate the digitalisation of biomonitoring, telemedicine and real-time health data management to advance health systems. This will enable equitable access to telemedicine and biomonitoring, and streamline programme management and responsiveness to epidemics.

Third, we must enhance collaboration with public-private partners and African communities across all levels of intervention, for example expanding partnerships to accelerate the digital health transformation in Africa and involving high-level political representatives to advocate for
health funding.

Fourth, we must raise awareness among different audiences, including the private sector, governments and community organisations. Diverse communication channels and activities, such as sports, cultural and business, will promote Africa CDC’s vision and build trust.

Fifth, we must implement innovative financing mechanisms. Africa CDC has successfully mobilised resources from institutions and private investment for specific projects, employing a blended financing model. Introducing sustainable financing mechanisms, such as an African air tax, can strengthen our autonomy and capacity for action.

Sixth, we must expand the industralisation of health products and technology innovation and manufacturing. Ensuring the supply security of health product commodities of Africa requires the localisation of manufacturing of priority vaccines, therapeutics and diagnostics.

Africa CDC leads the continent in addressing health security challenges. It aims to improve and become more effective, efficient and reliable in supporting AU member states. Africa CDC will integrate the five key actions of the New Public Health Order into the New Deal and thus fulfil its mandate.