DURBAN, South Africa – Is Africa ready for another big pandemic? The answer is a resounding “No”, said Dr Jean Kaseya, Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC).

Kaseya blames this worrying state of affairs on the absence of national public health institutes in some countries, data management difficulties, a lack of laboratories, shortcomings in surveillance and coordination, and the recent sharp decline in donor funding.

Briefing media at the start of the Conference on Public Health in Africa (CPHIA) 2025, which Africa CDC is co-hosting, Kaseya said there had been more outbreaks of disease in Africa in the first semester of this year than in the whole of last year.  

“We are still fragile,” he warned, but added that there were reasons to be upbeat.

The response to outbreaks, while not up to scratch in Africa, has improved since the COVID-19 pandemic.

In Kaseya’s home country, the Democratic Republic of Congo (DRC) “that gets outbreaks every week”, ad hoc committees established to deal with individual outbreaks have been replaced with institutes. This has meant better, quicker responses, benefiting from “institutional memory”, he said.

Further improvements in public health in Africa must be supported by efforts to increase domestic financing, drawing on properly costed, multi-year plans; innovative taxes and the rollout of universal health insurance; local drug manufacture and better connectivity, Kaseya added.

African sovereignty

In his opening address to the conference on Wednesday evening, Kaseya said African countries need to assume greater sovereignty over their healthcare to secure the well-being of their people. 

The theme of the conference is “Moving Towards Self-Reliance to Achieve Universal Health Coverage and Health Security in Africa”, and sustainable financing and local manufacturing were recurring subjects on the opening day.

Kaseya quoted Rwandan President Paul Kagame as saying that the work to build the continent, including health, cannot be outsourced. 

Africa CDC will deploy 10 public finance experts to 10 countries in November to bridge the gap between the ministries of health and finance.

This initiative must be allied to efforts to strengthen governance, to see that money goes where it is intended, while donors and other partners must align their visions of the countries they support, said Kaseya.

Aligning with national visions

Dr Sania Nishtar, the chief executive of Gavi, the vaccine alliance, spoke to the conference  via video link about her organisation’s determination to redirect more of its funding to Africa and of its desire to ensure it aligns its programmes with the national visions of the individual African countries it is assisting

Kaseya welcomed this, praising Gavi for listening to African voices, and said pressurise other global health initiatives to follow this model.

“We don’t want to hear of a partner coming to a country and implementing a programme without the knowledge of the ministry,” he said, calling for respect.
Kaseya said driving the “manufacturing agenda” to develop and make vaccines and other drugs in Africa was vital to sovereignty.

He pointed out that, in India, there were about 10,000 manufacturing companies making health products, in China, about 5,000, but in Africa, with its growing population, there were only around 570 manufacturers.

Africa CDC is involved in a mapping exercise to better coordinate manufacturing on the continent, supported by efforts to harmonise regulations to make local manufacture more viable, driving down prices and allowing countries to redirect money to primary health.

Kaseya told guests there would be a strong emphasis on science at the conference, which included 113 speakers and 94 abstract presenters, representing 35 countries.

 “We want to see how science can lead the decision-making process,” he said, adding that the aim would be to take conference recommendations to the G20 Health Ministers’ meeting in early November under South Africa’s G20 Presidency. 

The South African government and AfricaBio are co-organisers of the conference, which closes on Saturday.

Global Fund replenishment

Dr Joe Phaahla, South Africa’s Deputy Minister of Health, tackled the thorny question of declining funding from donor agencies and countries.

These were threatening multilateral organisations, including the WHO, UNAIDS, and the Global Fund to fight AIDS, Tuberculosis and Malaria, he said.

On 21 November, the Global Fund will host its final replenishment summit in Johannesburg and seeks “a very ambitious” $18 billion for 2027-2029.

The United States was the Global Fund’s largest contributor, but with US priorities having shifted elsewhere, Phaahla called on African governments and the continent’s private sector to step up and contribute to the fund.

Geopolitical developments were very concerning, said Phaahla, noting that several other countries that had been contributing to the African health initiatives were now focusing on climate change and national security, and this was affecting Africa’s ability to fight epidemics.

Phaahla called on the continent to look for innovative, sustainable funding solutions.

“If we fail to make sure our people can access good quality health services without catastrophic expenditure, we will not have made good progress,” said Phaahla.

Drug discovery

Dr Nhlanhla Msomi, president of AfricaBio, told Health Policy Watch that biotechnology offered an opportunity for African countries to leapfrog other technology-driven industries.

The conference is part of efforts to “decouple sexy science” in “favour of innovations with impact” and that “we as scientists should not be playing with our toys”, said Msomi.

Unless the continent moved away from “borrowed” technology and science, it was not likely to win the public health battle, he said.

Msomi said that his non-profit hoped to work with Africa CDC to roll out a drug discovery platform geared towards developing drugs and products on a priority list.

He said that by working together and sharing infrastructure, the healthcare industry could be transformed to better address African challenges while spurring economic development and entrepreneurship.