Cut reliance on health aid, WHO urges Africa

At the event, WHO Africa Regional Director Mohamed Janabi delivered a sobering message: African countries must now “recalibrate and build stronger health budgets” to withstand current and future crises.

“Funding support to WHO has dropped by about 70 percent following the withdrawal of major donors, including the United States,” Prof Janabi said.

“What remains is for countries to reorganise themselves and allocate larger portions of national budgets to health so that they can respond effectively when these challenges arise.”

Prof Janabi, who assumed office on July 1, 2025, described his first five months as among the most difficult in WHO Africa’s history.

On his first day, the organisation was facing a deficit of $1.5 billion. That financial shock forced sweeping reforms, including a painful reduction of the workforce.

“I was responsible for more than 2,500 staff across 47 African member states,” he said. “We had to separate at least 25 percent of the workforce.

About 420 employees, highly skilled professionals with Master’s and PhDs, are set to lose their jobs. It has and still is, a very difficult time.”

Yet even as WHO struggled internally, Africa faced relentless external pressures. Within weeks of his appointment, Ebola resurfaced in the Democratic Republic of Congo, but contained within 90 days. Marburg virus disease in Ethiopia also is under control.

Cholera outbreaks are currently affecting at least 15 African countries, while polio persists in parts of West Africa.

Climate-related disasters, including floods, droughts and even earthquakes, such as the recent one in Burundi, have further strained fragile health systems and displaced thousands.

“Before I could even recover, we were fighting Marburg in Ethiopia, cholera across the continent, Rift Valley fever in Senegal spilling into Mauritania and managing refugees in Burundi and Ethiopia,” Prof Janabi said.

The call for increased health spending is deeply rooted in lessons learnt from Covid-19, which exposed Africa’s vulnerabilities and the current unpredictable donor-scenarios.

Many countries were caught off-guard, lacking intensive care capacity, surveillance systems and supply chains for essential medicines and vaccines.

“We learnt the hard way during Covid-19,” Prof Janabi said. “Africa imports about 99 percent of its vaccines and 85 percent of its medicines. That dependence left us exposed when global supply chains collapsed.”

Climate change is now compounding these risks. Rising temperatures and extreme weather events are fuelling outbreaks of diarrhoeal diseases, vector-borne illnesses and malnutrition, placing additional pressure on already stretched budgets.

At the same time, antimicrobial resistance, described by Prof Janabi as “a silent pandemic”, kills about one million people globally each year, further underscoring the need for resilient, well-financed health systems.

Local manufacturing as a strategic response

To reduce import dependency, WHO is strongly advocating for local pharmaceutical and vaccine manufacturing. Under the new MoU, ECSA-HC has pledged to, among other things, support member states that are already laying the groundwork for domestic industries.

Tanzania is among the countries positioning itself for this shift. The government has outlined plans to expand pharmaceutical manufacturing through public-private partnerships, investment incentives and regulatory reforms, including strengthening the Tanzania Medicines and Medical Devices Authority (TMDA).

Ongoing initiatives aim to attract investors into industrial parks dedicated to health products, building on lessons from Covid-19 when access to essential supplies became a matter of national security.

“We want to harmonise regulations so that a medicine registered in Kenya does not have to be registered again in Tanzania,” Prof Janabi said. “We are encouraging countries to work closely with investors and financial institutions to establish local industries.”

A timely partnership

The WHO–ECSA-HC MoU comes at a critical moment. The agreement aligns with WHO’s Fourteenth General Programme of Work (2025–2028) and focuses on primary healthcare, disease prevention, health workforce development, digital health transformation and emergency preparedness.

“This MoU is not only about cooperation between institutions,” Prof Janabi said, “but about delivering better health outcomes for Africans, especially the most vulnerable.”

ECSA-HC Director-General Dr Ntuli Kapologwe echoed the sentiment, noting that the partnership would help countries “build resilient, equitable and people-centred health systems” through coordinated regional solutions.

"This MoU strengthens our long-standing collaboration with WHO AFRO and enhances our collective ability to support countries in building resilient, equitable and people-centred health systems,” he said.