Speaking at a ministerial dialogue held on the margins of the 76th WHO Regional Committee for Africa RC76, Aboubakri Diaw, Chief of Staff of the United Nations Economic Commission for Africa (ECA) and project lead for ECA’s Sustainable Financing Imitative launched in March 2026, called for a fundamental reset in how African governments and their finance ministries fund health systems, warning that the continent’s challenge is not a shortage of reforms but a shortage of financed reforms.
“We have a fundamental fiscal problem that is tied to the health-sector problem,” Diaw told ministers and senior officials gathered for the dialogue. “Many countries on this continent now spend more on servicing debt than on public health.”
As indicated by Diaw, health is a central pillar of Africa’s socioeconomic transformation. Strategic investment in health systems contributes directly to human capital development, productivity, and inclusive growth. Yet Africa’s health financing model remains structurally fragile: governments finance less than 41 per cent of total health expenditure on average, and unpredictable donor funding pushes households toward out-of-pocket payments that drive more than 150 million people into poverty every year.
