Commentary: A Vision Anchored in Equity, Institutional Coherence and Clarity Would Better Serve Africa CDC
Author: Daniel Reidpath
As Africa faces a steep drop in ODA, Africa CDC’s financing strategy is a bold pivot toward self-reliance. But boldness alone won’t do it. Equity must be baked in—by design, not as an afterthought. The health financing strategy offers a robust response to an urgent crisis. Many African countries face immense pressure with massive projected drops in foreign aid. In this context, Africa CDC’s plan—centred on domestic resource mobilisation, solidarity levies, and innovative financing—marks a shift toward sustainability and sovereignty.
However, boldness must be matched by attention to equity and clarity of roles. The strategy’s use of airline taxes, import levies, and diaspora bonds is forward-thinking but not equally accessible. States like South Sudan and The Gambia, with limited remittance inflows or tourism sectors, may struggle to generate sufficient revenue. And even if every state met the 15% Abuja Declaration target, the per capita impact would vary dramatically across the continent.
The proposal emphasises governance, scorecards, and transparency. It aligns resources with needs. However, the pathway for redistribution remains underdeveloped. Pooled procurement and revenue are mentioned, but there’s little clarity on how funds would be shared. Criteria such as disease burden, fiscal capacity, and vulnerability to shocks could help ensure that pooled resources are distributed to narrow, not widen, existing health inequities.
In that spirit, one opportunity would be to expand the idea of the Africa Epidemics Fund (AfEF) as a rapid response tool for outbreaks and as a stabilising mechanism for health systems strained by humanitarian or climate-driven crises. Collapse doesn’t always wait for a virus. Resilience must be broader. In a context where disparities persist—and may deepen—the devil is in the details. Africa CDC’s financing vision is important. It’s a proposal to develop, but without strong redistributive mechanisms, it risks favouring the least vulnerable.
The other issue is institutional coherence. Africa CDC’s strength lies in its public health mandate: surveillance, response, and lab systems. The proposal suggests a role in financing reform—advocacy, guidance, and monitoring. This blurs the lines and risks mission drift. Africa CDC must remain a technical convener, not a financial intermediary. Its legitimacy and effectiveness depend on it.
To its further credit, the strategy includes risk-mitigation tools like phased rollouts, tiered taxes, and public awareness—necessary safeguards as countries test new revenue pathways. It also recognises the shift health financing must make from episodic aid to predictable investment, if universal health coverage and pandemic resilience are to be realised. What’s needed now is detail and balance. Vision anchored in equity. Institutional clarity.
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Science & Health Communications | Experienced Researcher | Dedicated Advocate for Education & Women Empowerment | Supporting Social & Behavioral Change in Africa
4moThis is an exciting and well-articulated piece that captures both the urgency and the promise of Africa CDC’s shift toward self-financing. The analysis is sharp, and the questions it raises around equity, redistributive mechanisms, and institutional clarity are timely and necessary. As someone deeply engaged in health communications and research across Africa, I’m especially encouraged by the recognition that bold reforms require more than technical design they need public trust. For me, the missing link in many financing strategies is communication that truly informs and engages communities. No new levy, tax, or innovation fund will be effective if people don’t understand its purpose, don’t see its impact, or don’t feel part of the process. We must embed science and health communication not as an afterthought, but as a core lever of change used to build confidence, transparency, and shared ownership of health outcomes. This strategy is a step forward. To fully realise its potential, it must speak to people, not just policymakers.