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This article was originally published by Devex
By Jean Kaseya, Diene Keita, Dr. Mohamed Yakub Janabi, Rajat Khosla
As African leaders gather for the African Union Assembly of Heads of State and Government this week, the continent faces a defining policy moment. Amid climate shocks, humanitarian crises, demographic change, tightening fiscal space and shifting geopolitics, Africa must decide what it will prioritize to secure its prosperity, stability, and sustainable growth.
The question before leaders is not whether Africa recognizes the importance of health — it does — but whether governments, regional bodies, and partners will take the concrete decisions needed now to protect the continent’s most valuable asset: its people, especially women, children, and adolescents.
The African Union Summit must therefore move beyond reaffirming commitments to financing and implementing them at scale.
A persistent crisis, but a solvable one
Africa continues to carry the heaviest global burden of preventable maternal, newborn, and child deaths, as well as stillbirths. These outcomes are not inevitable. They reflect gaps in the design and implementation of primary health care, underfunded health systems, workforce shortages, inequitable access to essential commodities, weak data systems, and suboptimal quality of care, all compounded by conflict and climate shocks.
The consequences extend far beyond the health sector. Preventable deaths erode trust in public institutions, weaken human capital, and constrain economic growth.
The good news is that evidence-based solutions already exist, and many are being tested successfully across the continent. What is needed now is political prioritization, scaled implementation, sustained domestic investment, greater efficiency, and stronger accountability.
Health as an economic and sovereignty imperative
Investments in women’s, children’s, and adolescents’ health, or WCAH, including in sexual and reproductive health and rights, or SRHR, are among the highest-return investments available to governments. Healthy women participate more fully in the workforce. Healthy children learn more effectively. Healthy adolescents become the skilled workers and innovators who will drive Africa’s demographic dividend.
Yet, financing remains inadequate. Many countries remain below the commitment to allocate 15% of national budgets to health, while external funding is declining and fiscal pressures are intensifying.
African leaders have called for a shift from fragmented, donor-driven financing toward coordinated, innovative, continent-led approaches anchored in the Lusaka Agenda and the recently endorsed Africa’s Health Security and Sovereignty Agenda, within the broader health sovereignty movement. This shift aims to strengthen domestic financing and build resilient health systems that protect and prioritize WCAH as a foundation for security, equity, and sustainable development.
What must we do now?
Africa needs a focused set of practical actions that governments, regional institutions, and partners can implement.
1) Finance the transformation of primary health care at scale
Governments should accelerate progress by institutionalizing essential frontline health services, particularly maternal, newborn, child, and adolescent health, or MNCAH, including stillbirth reduction, by:
• Aligning national budgets and insurance schemes to fully cover essential MNCAH services.
• Ensuring efficient use of available funds and strengthening accountability mechanisms.
• Leveraging the AU champion for human resources for health and community health delivery partnership to accelerate the training, equipping, deployment, and fair remuneration of 2 million polyvalent community health workers by 2030.
• Prioritizing digitalization of primary health care as a transformational investment to improve system efficiency and health outcomes.
• Ensuring the consistent availability of essential services and commodities at primary care facilities and within community health systems.
2) Take immediate financing decisions
Within existing fiscal constraints, governments should:
• Protect or increase health budget allocations, prioritizing high-impact interventions.
• Expand national health insurance coverage and strengthen financial protection for maternal and child health services.
• Implement innovative financing mechanisms such as pooled procurement, blended financing, and debt-for-health swaps.
3) Invest in the health workforce as a driver of growth
Africa’s health and care workforce is both the backbone of service delivery and a major economic opportunity. Immediate steps include:
• Accelerating the training and deployment of doctors, midwives, nurses, and community health workers where they are most needed.
• Creating clear employment pathways for young people in the health care sector.
• Improving retention through better working conditions, fair remuneration, and structured career progression, particularly for community health workers.
4) Scale regional manufacturing and supply chains
Recent investments in African pharmaceutical and vaccine production show what is possible. Over the coming year, leaders should:
• Prioritize local production of essential maternal, newborn, child, and reproductive health commodities, leveraging continental initiatives including the Platform for Harmonized African Health Products Manufacturing, and advancing the commitment to procure 60% of vaccines used in Africa locally by 2040.
• Use continental and regional procurement platforms to create predictable demand (e.g., the African pooled procurement mechanism established by the Africa Centres for Disease Control and Prevention).
• Harmonize regulatory processes across regional economic communities, in coordination with the African Medicines Agency.
5) Address structural barriers facing women and adolescents
Policy reforms that tackle adolescent pregnancy, child marriage, gender-based violence, and inequitable access to services can yield rapid health and economic gains. Governments should:
• Integrate sexual and reproductive health services into universal health coverage benefit packages.
• Strengthen school- and community-based programs for children and adolescents.
• Implement and enforce laws and policies that protect girls’ rights and bodily autonomy.
6) Invest in data and climate resilience and preparedness
Stronger civil registration, health-data systems, and early-warning mechanisms enable governments to target resources more effectively and respond rapidly to shocks. Climate-resilient health infrastructure and humanitarian preparedness must be integrated into national plans, alongside shared reporting frameworks that support cross-sectoral tracking and accountability for WCAH outcomes.
Across the continent, reforms are already demonstrating what is possible when political leadership, financing, and implementation align. Countries that invest in primary health care, strengthen and protect their health workforce, reform financing systems, and expand regional manufacturing are seeing measurable gains. The challenge is not innovation but scale and sustainability.
A practical call to action
The 39th AU Summit presents an opportunity not only to reaffirm commitments, but to take strategic decisions that determine whether progress follows.
We support the call by African ministers of health to institutionalize reporting on women’s, children’s, and adolescents’ health, including SRHR, made at the World Health Organization Regional Committee for Africa meeting as a priority within the continental health security and sovereignty agenda, with accountability mechanisms at continental, regional, and national levels. Institutionalized reporting would move this agenda from periodic advocacy to sustained political accountability, ensuring that commitments translate into implementation.
A defining moment for Africa’s future
Investing in WCAH will involve real trade-offs. Prioritizing health requires difficult fiscal and policy choices: reallocating constrained budgets, strengthening domestic revenue for social sectors, improving budget efficiency, reforming procurement and financing systems, and demanding stronger accountability for results.
But the alternative carries far greater costs: lost productivity, rising treatment expenditures, weakened resilience to crises, and preventable deaths that erode trust and undermine development.
The continent now has an opportunity to move from declarations to delivery, ensuring that the next generation measures this moment not by what was promised, but by what was implemented.