The tariffs imposed by the United States on goods from several African countries on Wednesday will make it even more difficult for African countries to increase their health spending, said Dr Jean Kaseya, Director General of the Africa Centres for Disease Control and Prevention (Africa CDC).

These tariffs – ranging from 10% for Kenyan goods to 50% for impoverished Lesotho – come on top of the loss of billions of dollars of US aid for health programmes including vaccinations, maternal and child health, HIV, tuberculosis and malaria.

Madagascar, Lesotho, Mauritius, Botswana & South Africa were hit with some of the highest rates (30%- 50%) in Trump’s sweeping global retaliatory tariffs. Nigerian exports were hit too, but at just 14%.

I created this table to better visualize the tariffs on African exports. pic.twitter.com/b2lWmS5G5e

— Abubakar (@IAtalkspace) April 2, 2025

The cuts to aid for healthcare is likely to result in two to four million additional Africans dying annually according to Africa CDC modelling, Kaseya said recently.

“[These tariffs] will not make African products competitive. Africa will sell less products and get less money. And when there is not enough funds, you have competition because you have so many priorities,” Kaseya told a media briefing on Thursday.

The Africa CDC reported that White House officials they met with in Washington DC last week want the continent to provide opportunities for US companies – a “health as business” approach rather than support via grants.

Since last week’s meeting, there has been “almost daily contact” between Africa CDC and US officials to explore financing options, said Kaseya.

A joint Africa-US team was working on “all ideas and concepts that we developed” and how to translate these into a concrete action plan, he added.

“They told us life-saving humanitarian interventions will continue, and they shared with us some places where it has restarted,” said Kaseya who claimed a “strong relationship” with the Trump administration. “We are following everything that is done. We are also providing our feedback to them.”

The challenge of domestic financing

The Africa CDC launched a concept paper on health financing on Thursday outlining how countries could mobilise more resources for health in the face of a 70% decline in official development assistance (ODA) between 2021 and 2025, from $81 billion to $25 billion.

“This collapse is placing immense pressure on Africa’s already fragile health systems as ODA is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services and disease control programs are all at risk,” the Africa CDC notes.

“Compounding this is Africa’s spiralling debt, with countries expected to service $81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments,” the paper notes.

It proposes a three-pillar approach involving increased domestic funding, “innovative financing” including targeted ‘sin taxes’ and airline ticket levies; and “blended financing” involving public-private partnerships, the World Bank and donors.

Kaseya castigated African countries for under-investing in health despite a 2001 undertaking to spend 15% of the budgets on the sector – something only Rwanda, Botswana, and Cabo Verde have done. Over 30 African countries spend well below 10% of their national budgets on health.

“Countries were expecting that US will be there forever. EU will be there forever. Gavi will be there forever. Global Fund will be there forever. World Bank will be there forever. We need to stop that,” said Kaseya.

“If today we start to provide more resources, others will match what they are doing and they will respect us.”

While acknowledging that domestic financing was tight – most African economies have not recovered from the COVID-19 pandemic – he hailed the “innovative financing mechanisms” as a means to bolstering national budgets.

“We are talking about a tax on airline tickets, a tax on tobacco, sugar. That there will be a solidarity fund that can help to resolve a number of issues while we are supporting countries for pandemic preparedness and response,” said Kaseya.

“The solution for the future is not to see what Western countries can do. The solution for the future is to see what Africans can do for themselves, by themselves, complementing what is coming from external partners.”

However, Kaseya acknowledged that the slashing of ODA means that fewer health workers will be trained, countries will be less equipped, with fewer vaccines, medicines and diagnostics to respond to outbreaks.

“Our message to our colleagues from Western countries is: you are not protected, because if there is a pandemic coming from Africa, you will be affected,” said Kaseya.

The Africa CDC also launched its annual report for 2024 which notes a 41% increase in disease outbreaks between 2022 and 2024.

Mpox continues to spread

Meanwhile, mpox continues to spread with a 17,7% increase over the past week – although the conflict in the eastern Democratic Republic of Congo (DRC), the epicentre of the outbreak, makes it hard to establish a full picture of the extent of new cases. Ghana reported a new mpox case after 11 weeks without any new cases in a man with no history of travel – proving that there is “community transmission”, said Kaseya.

“We are doing our best to support countries, providing test kits, providing PCR machines, providing training, but we are not donors. We don’t have funding to support sample collection and sample transportation,” Kaseya added.