From malaria to maternal mortality, Africa bears some of the world’s heaviest health burdens.
Nearly 70% of global maternal deaths occur in sub-Saharan Africa. More than 50% of people who need rehabilitation services can’t access them, and the continent faces a critical workforce shortage, running short of the ratio of doctors and midwives required by global standards.
The cracks run even deeper. Many African nations spend far below the 15% health budget benchmark. Nigeria’s health allocation for 2025, for instance, is a paltry 5.18% (2.48 trillion naira) of its annual budget.
This meagre investment leaves hospitals chronically understaffed and without essential supplies. Clinics in rural communities typically rely on donor support for medicines, while health workers grapple with poor pay and limited training.
The result is a cycle of dependency, where progress rises and ebbs according to external aid. The looming withdrawal of USAID support has only worsened a health system that’s fast on the decline.
A renewed pledge
This week, in Lusaka, Zambia, health ministers from 47 African nations gathered for the 75th session of the WHO Regional Committee for Africa. The focus? How to build robust national health systems that are self-reliant, accountable, and adapted to African realities.
The WHO has pledged stronger support, framing health not only as a social good but also as a driver of trade, industrialisation, and continental resilience.
Over the three-day meeting, ministers will debate critical reforms such as expanding oral health care, enhancing blood-supply systems to tackle chronic shortages, transforming services for women, children, and adolescents and amplifying the fight against malaria.
The timing of these conversations comes against a troubling backdrop. The United States Agency for International Development (USAID) is winding down several health programmes in Africa, citing funding cuts and shifting priorities.
For decades, USAID has been one of the biggest funders of HIV/AIDS treatment, malaria prevention, and maternal health projects across the continent. Its withdrawal threatens to widen the cracks in fragile systems.
For many rural clinics that depend on external funding, this could mean medicine stockouts, fewer trained health workers, and patients turned away at the door.
The implications of WHO’s renewed support are significant. For countries battling chronic underfunding and donor fatigue, stronger technical and financial backing could mean more resilient health systems able to withstand shocks like COVID-19 or cholera outbreaks.
It also signals a shift toward regional ownership, where African nations are encouraged to harmonise policies, pool resources, and reduce dependence on volatile donor aid. This in the long run could close critical gaps in maternal health, workforce training, and access to essential medicines.
WHO’s promise of support is timely, but sustainability poses a challenge. Can African nations build health systems that outlast donor cycles, political shifts, and global emergencies?
The truth is, without serious domestic investment, innovation, and stronger cross-border collaboration, the continent risks being locked in a cycle of dependency.
Africa must decide whether its future will be shaped by fragile health systems propped up by temporary aid or by resilient, homegrown structures that match the continent’s ambitions. WHO can lend technical support, but the responsibility rests squarely on African leaders to prioritise health as infrastructure, security, and human dignity rolled into one.
The Lusaka assembly is pushing for a continent where a mother’s survival does not depend on foreign aid and where quality healthcare is guaranteed for every African. Anything less will leave the promise of “health for all” as just a forlorn hope.
Africa faces significant health challenges, with the continent bearing the brunt of global maternal mortality rates and inadequate access to rehabilitation services due to a critical workforce shortage. Many African nations are not meeting the recommended health budget expenditure, exemplified by Nigeria's low health allocation for 2025. This underfunding results in understaffed and poorly resourced hospitals, particularly in rural areas, which heavily depend on donor funding for essential services and medicines. The impending withdrawal of USAID support exacerbates the fragility of these health systems.
In response, health ministers from 47 African nations gathered in Lusaka, Zambia, for the 75th session of the WHO Regional Committee for Africa, aiming to establish robust health systems that are self-reliant and suited to local contexts. The WHO pledged stronger support for healthcare, viewing it not just as a public good but also as a driver of economic resilience. The discussions centered on vital reforms, including improving oral healthcare, blood supply systems, and services for vulnerable groups, amidst the backdrop of USAID's funding cuts.
The WHO's renewed support aims to enhance technical and financial backing, promoting regional collaboration and reduced reliance on volatile donor aid. However, without substantial domestic investment, African countries may remain dependent on external assistance. The Lusaka assembly is advocating for resilient, sustainable health systems to ensure healthcare access and quality for all Africans, devoid of dependency on foreign aid, thus fulfilling the promise of universal health for the continent.
