Amid escalating global challenges, the 75th session of the World Health Organization’s (WHO) regional committee for Africa (RC75) in Lusaka presents a critical opportunity for health ministers. Given the current financial crisis and mounting public health issues, there is an urgent need for the African region to look beyond narrow technical resolutions and address systemic barriers to health.
Contextual Background
As Professor Mohamed Janabi assumes the role of the new Regional Director for Africa, the backdrop is complex and pressing. WHO Director-General Dr. Tedros Ghebreyesus is about to complete his term amid discussions about adapting WHO to the realities of fractured geopolitics and diminishing multilateral support. The organization faces heightened scrutiny to prove its efficacy, accountability, and impact, particularly in Africa, where health systems are at their breaking point.
External health assistance has sharply decreased over the last three years, forcing many African nations into distress. With debt servicing projected to exceed $80 billion by 2025, significantly more than national health expenditures, countries are struggling to maintain robust health systems. Most governments are falling short of the Abuja Commitment to allocate 15% of national budgets to health, exposing their health infrastructure even as public health emergencies, including cholera and Ebola outbreaks, surge.
Additionally, climate change exacerbates these challenges, contributing to extreme weather events that impact health and worsen food security. The rise of non-communicable diseases (NCDs) and the migration of health professionals add further strain, along with the weak local supply chains that rely heavily on imports.
Initiatives and Frameworks
In response to these multifaceted crises, several strategic frameworks have emerged. The New Public Health Order, advocated by the Africa CDC, calls for stronger national health institutions and resilient financing. Similarly, the Lusaka Agenda emphasizes collaboration between global health initiatives and domestic financing to maximize health impacts.
However, these frameworks must translate into actionable policies and integrated efforts that truly reflect the urgency of the current health landscape. The overarching question for RC75 is whether the resolutions adopted will resonate with the broader challenges, rather than merely focusing on technical specifics.
The Meeting Agenda
RC75’s agenda is comprehensive, covering critical areas such as rehabilitation, oral health, malaria, and health emergencies. The progress review of the Regional Health Data Hub aims to standardize health information systems across countries, which is significant given the previously overlooked role of data in service delivery. Nevertheless, these discussions appear narrow when juxtaposed against the defining issues shaping Africa’s health future.
The committee, while not equipped to resolve sovereign debt crises, must acknowledge these fiscal pressures. The reality that funding for health is collapsing necessitates an open dialogue among member states about sustaining essential services amidst dwindling aid.
Missed Opportunities for Discussion
The agenda notably sidesteps urgent topics like the dramatic reduction in official development assistance, particularly the recent reduction of support by the U.S. Agency for International Development (USAID). The diminishing reliance on donor funding and shifts in foreign aid require honest conversations on how to ensure health services remain robust.
Additionally, issues such as the climate crisis, NCDs, and workforce migration are barely mentioned, even though they represent significant pressures facing health systems. Local manufacturing and resilient supply chains are only indirectly addressed through procurement discussions, failing to align with the critical initiatives outlined in the New Public Health Order and the Accra Initiative.
Need for a Systemic Approach
While the technical matters of oral health, blood safety, and rehabilitation are important, the imbalance in discussion topics raises concerns. The RC75 must recalibrate its approach to address the existential threats posed by financial, climatic, and workforce challenges to public health.
The WHO AFRO secretariat may lack the financial leverage necessary to fix the debt crisis or increase donor funding, but it can guide countries in navigating these realities. This includes framing health financing as essential to debt sustainability, elevating NCDs, and ensuring that workforce retention is treated as a priority.
Action Steps for Member States
The onus also lies on member states to mobilize domestic resources, integrate climate resilience and NCD prevention strategies into primary healthcare, and foster local manufacturing capabilities. They must view interoperable digital systems as vital components of health infrastructure rather than mere add-ons.
The Lusaka meeting must be an opportunity for WHO AFRO and health ministers to demonstrate the importance of addressing systemic issues rather than focusing solely on technical resolutions. The true measure of success will not be the adoption of documents, but the acknowledgment of constraints and the alignment of discussions with urgent realities.
When considering the spiraling crises, health must be a priority in debt frameworks. Climate and NCD resilience should be prioritized in any primary care strategy, and investments in digital systems and local procurement must form a central part of the agenda.
Conclusion
RC75 has the potential to be a transformative moment for Africa’s health trajectory. By facing the realities of fiscal constraints and converging health challenges head-on, member states can create a pathway toward sustainable health systems that integrate innovative solutions while reinforcing existing infrastructures.
Ultimately, Africa’s health future is contingent upon ensuring that the resolutions and strategies agreed upon during the Lusaka meeting are cognizant of the larger socio-economic and environmental landscapes that define health in the region. Recognizing these connections can lead to cohesive policies that promote resilience, improve outcomes, and safeguard the health of African populations amidst a backdrop of uncertainty.
