Africa: ‘Africa Not a Guest, But Co-Architect’ of Global Health Systems #CPHIA2025

Durban, South Africa — Public health in Africa is at a pivotal moment, shaped by both longstanding challenges and emerging opportunities.

However, a revolution is brewing. Africans are taking control of their health destiny with innovation and resilience through cutting-edge digital health solutions and bold strides in local manufacturing. The 2025 Conference on Public Health in Africa (CPHIA) serves as a critical platform to address these dynamics and chart a sustainable future for global health.

Three key priorities shaping Africa’s health future will be highlighted at the conference, including innovations led by Africans in primary healthcare. The innovations will include telemedicine and AI-powered digital tools that will help rural and underserved communities gain access to quality healthcare. African countries will be able to control their own health priorities by exploring innovative ways to fund resilient, sustainable health systems. The governments will also enhance health sovereignty by enhancing local manufacturing to increase the production of vaccines, medicines, and diagnostics.

This year’s conference unfolds under the ambitious theme Moving Towards Self-Reliance to Achieve Universal Health Coverage and Health Security in Africa.

In his welcoming address, eThekwini Mayor Cyril Xaba said that this year’s theme addresses the collective aspiration to transform Africa’s public health system and reduce dependency by strengthening our capabilities in science, innovation, financing, and community-led solutions. He said that eThekwini was proud to host the landmark gathering, especially at a time when South Africa also chairs the G20. The G20 will further amplify Africa’s call for health sovereignty and equitable partnerships, marking a new chapter in African health leadership.

Xaba said that the timing of CPHIA 2025 provides a unique opportunity to align regional public health priorities with global efforts for equity and sustainability in healthcare.

The mayor said that CPHIA is “more than just a conference”, describing it as “a movement towards reimagining African health architecture, where local solutions, traditional knowledge, scientific excellence, and community-led innovations shape a new public health order”. Xaba urged participants to seize the moment to forge lasting partnerships, invest in youth and innovators, and build a system that can withstand tomorrow’s challenges.

“We need to work together. Africa has shown extraordinary resilience in the face of unprecedented health challenges, from pandemics and epidemics to the system of inequality that impacts health care access and delivery.”

Yet within our crisis lies an opportunity, Xaba said, adding that the conference offers a vital platform to reflect on progress, evolve strategies, and amplify Africa-led innovations making a tangible difference in communities. “It is here that we bridge research and practice, policy, and people in innovation to the future,” said Xaba.

The eThekwini mayor said that this year’s gathering would also focus on institutionalizing women’s, children’s, and adolescent health, calling it central to building an inclusive health system that “leaves no one behind.”

Xaba said that CPHIA 2025 embodies a unique vision, a future where Africa not only survives health threats but also leads in preventing and solving them. “As we begin this important journey, let us engage, collaborate, and innovate, knowing that the future of Africa’s health is in our hands.”

Africa Urged to Own Its Health Future

South Africa’s Deputy Minister of Health, Dr. Joe Phaahla, said the CPHIA gathering was a premier African event and not just an ordinary conference. He added that the theme captures Africa’s determination to shift from dependency to autonomy, from vulnerability to resilience, and from being recipients of aid to architects of our own health future.

Phaahla, speaking on behalf of President Cyril Ramaphosa, said that while Africa has made significant progress in health outcomes over the past decades, the real measure of success lies not in the number of decisions we make but in translating them into improved lives. He urged delegates to ensure the conference produces measurable outcomes, practical commitments, and innovations that “reach the last mile.”

He called for greater investment in local manufacturing, pandemic preparedness, digital health, and AI-driven efficiencies, saying that Africa must ensure that artificial intelligence works for us to deliver efficiently, reduce costs, and expand access. He urged African governments and the private sector to support the Global Fund’s ongoing replenishment effort to raise $18 billion.

“The business-as-usual paradigm must stop here,” said Phaahla. “Every decision we take must move us closer to health equity, economic inclusion, and social justice. Through African leadership and global solidarity, we can build a future where our health systems are financed, powered, and sustained by Africans themselves, ensuring that no community anywhere in this continent is left behind.

“Our time is now. Let us rise together.”

Hon. Dr. Elijah Muchima, Zambia’s Minister of Health, said the conference’s theme captures a defining moment for the continent. “To me, CPHIA 2025 is not only a conference, but a movement for global health sovereignty and self-reliance,” he said. The third edition of the International Conference on Public Health in Africa (CPHIA) was held at the Mulungushi International Conference Center in Lusaka, Zambia, in 2023.

Muchima said that the time for action has now come, and Zambia is very ready.

Despite Zambia’s challenges, he said that the country is ready to move forward with the rest of Africa, stressing that “political will is key” to making progress. Africans must “speak with one voice” and reject division regardless of linguistic and regional divides, he said. CPHIA, he added, remains a vital platform where governments, experts, and communities can “reimagine and tackle our most pressing challenges” – from health financing to leadership, innovation, and sustainable partnerships.

Muchima also said that Africa can no longer afford to be a guest in rooms where global health reforms are discussed. “We must not be bystanders; we must be the architects of the future global health systems.” He called for four urgent actions: to strengthen African unity in global health forums; ensure inclusive decision-making; promote equitable financing rooted in domestic systems; and align global health initiatives with Africa’s Agenda 2063.

Representing the Chairperson of the African Union Commission, H.E. Amb. Amma Twum-Amoah, Commissioner for Health, Humanitarian Affairs, and Social Development, has called for Africa to take the lead in building resilient, self-reliant health systems and shaping a fairer global health order. She said that the gathering was “more than a technical forum.” She called it “a strategic platform to accelerate Africa’s journey toward health sovereignty and to reframe global health governance with Africa as a co-architect, not a bystander.”

Twum-Amoah said that Africa’s health security must rest on African financing, African innovation, and African institutions, especially amid climate shocks, economic instability, and shrinking global health funding. Twum-Amoah said the AU’s frameworks, such as Agenda 2063, the Africa Health Strategy, and the Pharmaceutical Manufacturing Plan for Africa, describing them as “instruments for coordinated action.” She announced that the African Medicines Agency (AMA) is now operational, with its Director-General assuming office on October 1, 2025. AMA, she explained, offers “an opportunity for Africa to harmonize regulatory systems and ensure safe, locally manufactured medical products reach all populations.”

Twum-Amoah urged African leaders to adopt digital health and artificial intelligence ethically and inclusively, under strong governance frameworks. “Africa’s leadership will shape the norms and standards that define the future of health innovation globally,” she said.

As Africa prepares to host the G20 Health Ministers Meeting for the first time, she called the presidency “not symbolic, but tactical and right,” saying it must be used to push for equitable reforms in global health governance.

“Africa’s path to self-reliance is not optional – it is a necessity,” said Twum-Amoah. “Our time is now. Let us rise together.”

HIV is not outside the universal health agenda

HIV Prevention, Health Sovereignty, and the Road to Universal Coverage

Dr. Thembisile Xulu, the Chief Executive Officer of the South African National AIDS Council (SANAC) and Chairperson of the Global Fund Country Coordinating Mechanism, said that coordinating South Africa’s multisectoral national strategic plan for HIV, TB, and STIs “means going beyond the three syndromes.”

“Why?” she asked, “because our people living with HIV are aging, they are developing NCDs, and many live in communities with trauma, and they are facing violence and inequalities,” she said. “Therefore, coordination across community and health systems is not optional, but it is essential.” She said that the intersection between HIV and universal health coverage (UHC) is not a side road or an off-ramp. It is the main highway.

Dr. Xulu said that HIV is not outside the universal health agenda, and every investment in HIV strengthens the healthcare system. She said that we will not achieve universal health coverage unless we confront HIV head-on because HIV epidemic control is universal health coverage in action.

Turning to prevention, Dr. Xulu praised South Africa’s “historic progress” with pre-exposure prophylaxis (PrEP), saying that over two million people have been initiated on oral PrEP and that 98% of the country’s primary healthcare facilities now provide it, coverage she described as “unprecedented worldwide.”

“This kind of success has been based on the very core principles of universal health coverage, equity, access, community-led delivery, and systems integration,” she said. “When scaled up properly, PrEP is not only life-saving, but it is cost-saving. For every new HIV infection that we prevent today, that means a lifetime of treatment costs saved tomorrow.”

Dr. Xulu also discussed Lenacapavir, the new long-acting injectable for HIV prevention, clarifying that it is “not a magic bullet” but an addition to existing prevention tools. She said SANAC recently convened a national roundtable to explore Lenacapavir access, sustainability, and impact, which produced key recommendations, including ensuring security of supply through pooled procurement, promoting local manufacturing, and developing an investment case for domestic financing.

“We need domestic investments to complete the bridge,” she said as she expressed gratitude to the Global Fund for its donations. However, Africa must now complete that bridge with domestic investments, she added.

Dr. Xulu was sharply critical of Gilead Sciences for not issuing “a single voluntary license to a sub-Saharan manufacturer despite our participation in their clinical trials.” She said it was unacceptable that the region, which bears the world’s highest HIV burden and consumes the most antiretrovirals, remains excluded from producing the very medicines it relies on. “That is neither sustainable nor equitable,” she said.

She said that while Lenacapavir could transform HIV prevention, it must be introduced “with transparency, sustainability, and accountability,” without undermining existing tools and with strong community involvement.

As she closed her remarks, Dr. Xulu reminded participants that HIV prevention is central to universal health coverage, while local manufacturing and domestic financing are non-negotiable for accelerated and sustainable impact.

Domestic financing is an urgent requirement, she said.

The power to transform our health systems no longer lies in what donors decide but in what Africa chooses to build,” she said. ” It lies in our decision to produce our own medicines, to finance our own priorities, and to strengthen the systems that serve our very own people.

“If Lenacapavir is to be a game changer,” said Dr. Xulu, “it won’t be because of the science of the molecule alone, but because Africa chose to be – because we ensured it was equitably accessed, sustainably financed, locally produced, and delivered through people-centered systems. That is health sovereignty. That is what universal coverage demands. And that is the Africa we are building together.”

Investing in Africa

Bience Gawanas, Vice Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, talked about Africa’s lasting strength, unity, and shared purpose.

Her key points were the replenishment of the Global Fund, Africa’s path to self-reliance, and the communities’ essential role. She said that her reflections were informed by both her role at the Global Fund and her “decades of working with women, girls, and vulnerable communities.”

She said that the eighth replenishment of the Global Fund this year, co-hosted by the Republic of South Africa and the United Kingdom, carries profound significance for Africa and for global health. The Eighth Replenishment was launched in 2025 for the funding period 2026-2028. The partnership hopes to raise 18 billion dollars to reduce the number of deaths caused by AIDS, tuberculosis, and malaria. The Global Fund, powered by donor governments, implementing countries, the private sector, and affected communities, has contributed to the saving of 70 million lives since its founding. In 15 sub-Saharan African countries, life expectancy has increased from 49 to 61 years, with more than half of the increase attributable to progress against these three diseases.

She described the progress as remarkable, yet fragile. It could be undone without renewed commitment and investment.

” For Africa, this replenishment process, anchored for the first time on the continent, elevates African leadership and solidarity in shaping the response to HIV, TB, and malaria,” she said. She said that the co-hosting arrangement sends a powerful message, that “Africa is not just a beneficiary but a partner and core architect of the future of global health.” The replenishment, she added, is an opportunity to translate that vision into concrete investments in African health systems, communities, and long-term self-reliance.

Putting money where it matters

Turning to Africa’s pathway to self-reliance, Gawanas said true ownership means “not just taking charge of the problems, but also of the solutions, and that means putting money where it matters.” She said that the Global Fund supports this shift by aligning grants with national priorities, strengthening institutions, and promoting domestic investments and regional cooperation. Gawanas acknowledged Africa’s complex realities – fragile economies, climate shocks, and conflicts – but said that Global Fund investments remain “smart, flexible, and responsive, tailored to the African context.”

On her third theme, the role of communities, women, and girls in driving health outcomes, she reminded delegates that behind every number, there are the faces of people.

“I cannot emphasize enough the role of communities, those living with HIV, TB, and malaria, key populations, women and girls, youth, and marginalized groups,” she said. “The Global Fund Board is built on the principles that communities have received at the table that their voice matters.”

Drawing from her long career, Gawanas said she has seen firsthand how empowering women and girls strengthens entire communities. “When girls stay in school, when women access sexual and reproductive health services, when gender-based violence is addressed – health outcomes improve,” she added. She called for continued investment in community organizations, frontline health workers, women’s networks, and youth groups. “Without their leadership, we cannot achieve the ambition we set,” she said, adding that in Africa, investing in young women “is investing in our continent’s future.”

“The Global Fund is more than finance, it is hope, solidarity, and a pathway to dignity,” she said. ” … be bold, commit to mobilizing resources to build stronger systems to enable African leadership to center communities.”

Let us pledge that the global fund remains not only a driver of health results, but a catalyst for transformation, for equity, and for self-reliance. Together, we can ensure Africa leads the way and that no one is left behind. In South Africa, we say Ubuntu: you are because I am,” said Gawanas.

Africa’s Proven Resilience

Prof. Mohamed Yakub Janabi said that when he assumed office as WHO Regional Director for Africa on July 1, 2025, his vision was to build a healthier Africa and a resilient healthcare system.

“Today,” he said, “that vision is beginning to take shape.” He pointed to renewed investments in primary healthcare, closer regional collaboration, and a growing sense of possibility across the continent, even as challenges remain.

Janabi said that his leadership is guided by four core principles: universal health coverage, health security, sustainable financing, and innovation. “Across Africa, I see governments taking national priorities seriously,” he said. “WHO AFRO is listening to member states and aligning country priorities with regional and global goals.” He said that Africa’s strength lies in innovation and local solutions, adding that young entrepreneurs are designing solutions that fit our people and our countries.

As for public health emergencies, Janabi recounted the recent outbreak of Ebola in Kasai province, in the Democratic Republic of the Congo ( DR Congo).

“DR Congo is vast, a four-day drive from Kinshasa to the epicenter,” he said. “But within the first week, working with the government and partners, seven tons of Ebola supplies were delivered. Within weeks, vaccines were on the ground. The last patient has now been discharged, and we hope to declare the end of the outbreak soon.”

The outbreak was declared on 4 September in Bulape health zone, Kasai Province, resulting in 64 cases, 53 confirmed and 11 probable. A total of 19 patients have recovered from the disease. The outbreak will be declared over in early December 2025 if no new casesare detected.

He attributed the swift recovery to strong partnerships and national expertise. He credited the strong public health systems in DR Congo, saying, “We didn’t go there to supplement, but we went to complement. That’s what resilient primary healthcare looks like.”

Africa’s greatest wealth lies in its people…

Janabi said that self-reliance does not mean isolation. It means leading from the front. It means ensuring every partner aligns with Africa’s priorities. He added that domestic health financing and local vaccine production are growing, strengthening both confidence and security. “Digital innovation is connecting rural clinics with specialists,” he said. “Real-time data is guiding real decisions, and this is how we ensure no one is left behind.”

He said that Africa’s greatest wealth lies in its people. He added that we are 1.5 billion today and will reach 2.5 billion by 2050. If we don’t invest in health, 60% could become a liability instead of a dividend. But if we invest in our people, especially young people, that’s our strength.

“Our challenge is to do it faster, smarter, and together…,” said Janabi. Africa has proven its resilience. Now we must make that resilience self-sustaining, powered by our own resources, institutions, and innovations.”

Africa will no longer be the patient of global health policy

Dr. Jean Kaseya, Director-General of the Africa Centre for Disease Control and Prevention (Africa CDC), said that the CPHIA was deliberately designed to bring together scientists and decision-makers, ensuring that policy is guided by evidence. “The CPHIA is mostly scientific people,” he said. “We wanted to see how science can lead the decision-making process because we want to use this opportunity to bring your recommendations to the G20 ministerial meeting in Limpopo.”

Dr. Kaseya reminded delegates that, despite many countries achieving the Millennium Development Goals (MDGs) on health and education, sustaining that progress has been challenging in the past.

“Can we say today that these countries are still sustaining this progress? The answer is clear – it’s no,” he said. “Only a few have maintained it because they took leadership and ownership.”

He attributed this challenge to the continent’s lack of health sovereignty, which he defined as sustainable financing, local manufacturing, data ownership, stronger public–private partnerships, robust pandemic preparedness and response, and amplifying Africa’s voice globally.

“We didn’t have an agenda of health sovereignty in Africa,” he said. “That’s what we are building now.”

He recalled how the agenda took shape during Rwanda’s Marburg outbreak in 2024 when international partners were slow to respond. “President Paul Kagame, our champion for domestic resources, said, ‘African countries cannot continue to outsource solutions for their problems externally. We must find ways to address them financially, especially those affecting ordinary people.”

This led several African leaders to begin taking decisive steps towards self-sufficiency.

In August 2025, President John Mahama addressed the African Health Sovereignty Summit, saying, “Africa’s health sovereignty is more than a slogan; it’s our moral duty to ensure no African child waits for permission from elsewhere to live.” At the UN General Assembly in September, President Cyril Ramaphosa said, “Africa will no longer be a patient of global health policy. It will build its own health sovereignty.”

According to Kaseya, these statements have set a clear direction for the continent.

Beyond financing, he stressed the need for stronger governance and alignment between governments and global health partners. “We don’t want to see a partner coming to a country and implementing a program without the knowledge of the minister,” he said. “That will not happen again. Partners must align with the national vision.”

He praised Gavi as as a model for respecting African leadership in global health.

“We don’t want to see again a partner coming to a country, implementing a programme without the knowledge of the minister. This one will not take place again. We want to see our partners coming, working with our government. Respecting our government.”

Turning to local manufacturing, Kaseya said Africa must be realistic but ambitious. Dr. Kaseya said that the African Food Procurement Mechanism (APPM) supports local manufacturing and reduces costs, citing a 75% cost reduction in drug procurement for Botswana and Namibia. “That money will now go into their health systems,” he added.

Data sovereignty, he said, should never again be threatened by global partners pulling out of Africa’s data. Africa CDC’s Digital Transformation Agenda, set to be approved by the AU Assembly in February, aims to ensure that “Africa owns its data and its decision-making process.”

Dr. Kaseya also celebrated Africa’s collective response to outbreaks like Mpox, cholera, and Ebola, saying the expansion of laboratory capacity from 2 labs in 2023 to 27 by July 2025, and the increase in genomic sequencing capabilities from 7 to 41 countries. He credited the creation of National Public Health Institutes as another legacy of Africa CDC’s coordination. “We’ve moved from 14 to 25 institutes in four years,” he said. “That’s real progress.”

“We are shaping the agenda, not waiting for it.”

He called this a reform of the global health architecture, in which Africa is no longer a recipient but a co-architect. “At the World Health Assembly, Africa CDC was invited as an entity,” he said proudly. “We are shaping the agenda, not waiting for it.” He advocated for a single, integrated strategic plan for health programs, co-financed by governments, and called for greater private sector involvement to support Africa’s health vision.

“I dream that when I leave Africa CDC, I can say I helped build a stronger Africa for the next generation. For the first time, Africa is leading, and the world is watching,” Africa CDC Director General Kaseya said.

By Melody Chironda