Africa is at a crossroads. The continent is fighting multiple disease outbreaks amid a tightening fiscal space that is affecting many of our trusted funding partners. It will take collaboration beyond the health sector, adaptation to the rapidly changing world, advancing digital health solutions and investment in local manufacturing - all while bringing together African countries toward regional unity, leveraging our collective effort to respond to public health emergencies and pandemics, and strengthening primary health care as a vehicle for achieving Universal Health Coverage by 2030.
Addressing over 300 delegates, including health ministers and representatives of international organizations from across the globe at the presidential opening of the 52nd Board Meeting of the Global Fund on November 19 in Lilongwe, the Malawian capital, Dr Jean Kaseya, Director General of the Africa CDC emphasized several key approaches that could help Africa address systemic barriers and advance sustainable solutions for global health resilience.
"Africa CDC recognizes the Global Fund's invaluable role in supporting health systems and improving pandemic preparedness and response across the continent," he said. "This partnership has great potential in fortifying the systems to ensure equitable access to healthcare."
Dr Kaseya noted that the 2024 Global Preparedness Monitoring Board report highlights four critical pandemic risk drivers that urgently require action: agricultural practices, climate action, conflict and instability, and economic inequality impacting both the emergence and response capacity of public health emergencies.
He said that the dramatic increase in livestock farming, coupled with inconsistent biosecurity measures, heightens the risk of zoonotic spillovers like Mpox and Marburg virus.
"Our continent's suboptimal health system capacity further aggravates these," he said, adding, the recent outbreaks of COVID-19, cholera, and, currently, mpox have exposed vulnerabilities of Africa's public health systems. "These crises have shown us that health is not an isolated sector but is intricately linked to agriculture, education sectors as well as governance, and economic and political stability."
"The Africa CDC stands at the forefront of safeguarding the health security of over 1.4 billion Africans, but it needs a unified, coordinated effort to tackle the challenges ahead," Dr Kaseya said.
Mpox was once confined to rural areas of Central and West Africa, but it is now presenting complex challenges as it spreads across the continent. Since January 2024, over 50,000 mpox cases have been reported across 20 African countries, including 11,147 confirmed cases and 1,109 deaths, reflecting a case fatality rate of 9.9%, disproportionately impacting vulnerable populations--children, pregnant women, and those with compromised immune systems.
"As we confront these challenges, we must recognize that the solutions lie in collaboration across sectors, borders, and continents. Africa CDC remains committed to leading the way, but we cannot do this alone," Dr Kaseya said. "The need for strengthening our regional and global response mechanisms, investing in health systems, and addressing the root causes cannot be overstated."
As pandemics do not respect borders, sectors, or disciplines, an effective response requires collaboration beyond the health sector is required. For instance, strengthening agriculture and food systems to prevent zoonotic spillovers, he suggested. Partnering with education systems to promote health literacy and awareness creation would go a long way, as would leveraging digital innovation from the private sector for early-warning systems. "Through such partnerships, we are not just fighting diseases; we are safeguarding livelihoods, food security, and our collective future," Dr Kaseya said.
The rapidly changing world has seen pathogens evolving even faster, calling for agile strategies. The Director General of Africa CDC said that embracing digital health solutions for real-time surveillance and data sharing is essential. He said investing in local manufacturing of vaccines, diagnostics and therapeutics, expanding Africa CDC's emergency response teams with cross-disciplinary experts who can pivot swiftly during outbreaks, is key to providing appropriate response. "Adaptability ensures that we are prepared not only for today's threats but also for tomorrow's unknown health challenges," he said.
Africa's strength lies in its solidarity with its strategic partners, driven by regional collaboration. The power of unity in the Continental Mpox Incident Management Team has been evident in driving Mpox and Marbug outbreaks response efforts on the continent. The Africa Vaccine Acquisition Task Team (AVATT) worked hard to secure vaccines during COVID-19 and lessons learned informed how Africa positioned itself to secure and allocate Mpox vaccines to Member States. "Public health emergencies require us to unify disease surveillance systems across borders, as envisaged in our "One Health" approach," said Dr Kaseya. While Africa CDC is continuously building its capacity at its headquarters in Addis Ababa, there is an equal effort to operationalize the Regional Collaborating Centres (RCCs) in the five regions of Africa and to establish country offices, decentralizing expertise and resources, and empowering every region to respond autonomously and effectively.
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"We cannot discuss health resilience without addressing the issue of equity. A resilient Africa is one where no one is left behind. Communities must be at the heart of our efforts. Their knowledge and trust are the bedrock of a successful response," he said.
Dr Kaseya called on the Global Fund, a private-public partnership, to continue partnering with African countries and support them in better resource management and accountability.
Dr Jerome Salomon, Assistant Director-General for Sustainable Development Goals at the World Health Organization, agreed with Dr Kaseya that a strong partnership between African countries and the Global Fund was necessary to achieve success.
Dr Salomon, who is also WHO's representative on the Global Fund Board, noted that with only five years to go until 2030, countries worldwide are off track regarding health targets under the Sustainable Development Goals (SDGs), especially the Goals to end AIDS, tuberculosis, and malaria, among other diseases, by 2030. "Difficult times call for more international solidarity. We can only achieve more if we work together. So, partnerships are more important now than ever," he said.