Abdelmonem Fawzi
Africa’s health security is inseparable from global security.
As external aid shrinks and threats multiply, the continent is forging sovereign, Africa-led systems, proving that true resilience lies in ownership, not perpetual dependence.
In recent years, Africa has faced escalating public health challenges.
The Africa Centres for Disease Control and Prevention (Africa CDC) tracked a surge in emergencies, rising sharply in the early 2020s and continuing into 2025, with outbreaks straining systems across most member states.
These represent core threats to national security, economic stability, and state legitimacy.
Sustainable development and sovereignty demand robust health preparedness as a foundation pillar.
This urgency coincides with a structural global shift: declining development assistance for health, dropping dramatically from peaks around 2021 to far lower levels by 2025.
In many African countries, households now shoulder 40-60 per cent of health costs through out-of-pocket payments, shifting global risks onto the most vulnerable.
No responsible state can tolerate this transfer of burden. The only sustainable path forward is to treat health security as a strategic investment in sovereignty.
Africa must build systems for prevention, early detection, and rapid response that operate independently of external whims.
This approach strengthens not only the continent but also global equity and preparedness.
Africa is translating vision into action through the Africa’s Health Security and Sovereignty Agenda, launched in 2025.
This framework creates an operational ecosystem backed by continental coordination and accountability.
Progress is tangible: event-based surveillance now covers dozens of states, routine reporting timeliness has climbed significantly, genomic sequencing is widespread with dramatically reduced turnaround times (from over 30 days to under seven), and National Public Health Emergency Operations Centres have expanded from a handful to over 30.
All 55 AU member states contribute to the African Health Volunteer Corps, enabling deployment within 48-72 hours.
Africa CDC has also advanced a Central Data Repository and governance framework, ensuring African data informs African decisions swiftly and securely.
These steps embody genuine scientific and operational sovereignty.
At the 2026 African Union Summit, Economic Commission for Africa Executive Secretary Claver Gatete emphasised this shift in a high-level address.
He described health as a strategic economic sector essential to sovereignty, amid a global move from hyper-globalisation to strategic resilience.
With aid cuts leaving Africa exposed to supply shocks and high domestic costs, he urged integrating health into fiscal planning, mobilising domestic revenues, building regional pharmaceutical value chains via the AfCFTA, and strengthening infrastructure.
“Health sovereignty is, ultimately, economic sovereignty,” he declared.
The US withdrawal from the WHO in early 2026, formalised after a 2025 executive order, has accelerated this dynamic.
Washington redirected resources towards a bilateral, “America First” approach, reportedly proposing up to $2 billion annually for its own global surveillance and response network under HHS oversight.
This leverages private-sector innovations like AI and drones for rapid containment, prioritising US biosecurity through direct agreements with over 100 countries.
While potentially faster in targeted areas, this risks fragmenting global health efforts into “island data” silos.
Experts warn of delayed information on emerging threats in non-aligned countries, disrupted programmes like HIV/AIDS (potentially millions more infections), and perceptions of aid as geopolitical leverage.
Africa faces a pivotal choice, either deepen self-reliance or navigate competing powers’ offers.
By accelerating domestic financing, manufacturing, and governance, the continent can emerge as a producer rather than consumer in global health.
In this new era, health and vaccines have become powerful currency in geopolitical alliances.
Africa’s sovereign path offers the surest defence for its people and the world.
Abdelmonem Fawzi is a writer and expert on international relations.
