ECA launches plan to boost sustainable funding for Africa’s health systems

Africa’s health systems are facing renewed pressure as governments struggle to balance rising costs with limited public funds.

For many families, the strain is personal — healthcare bills are still largely paid out of pocket, often pushing households deeper into poverty. 

At the same time, policymakers are under growing pressure to deliver better services with tighter budgets.

Health spending remains below expectations in many countries, even as populations expand and demand for care rises. 

Against this backdrop, the UN Economic Commission for Africa (ECA) has launched a new push to reshape how the continent pays for healthcare.

The Sustainable Health Financing Initiative, unveiled at a meeting of finance ministers in Morocco, is designed to help countries rely less on donors and build stronger, more predictable funding systems. 

Despite years of reform, governments still cover less than 41% of health spending across Africa.

That gap leaves millions without reliable access to care and exposes economies to long-term risks tied to poor health outcomes. 

Aboubakri Diaw, chief of staff to the ECA’s executive secretary, said the current model is “economically damaging.”

Even if countries meet the Abuja target of allocating 15% of national budgets to health, he said, Africa would still face a shortfall of about $60 billion a year.

Focus on domestic funding 

The initiative centers on raising more funds at home while improving how money is managed.

It calls for closer coordination between finance, health and planning ministries so that healthcare is treated as part of broader economic policy, not a standalone expense. 

It also links health funding to the African Continental Free Trade Area, with an emphasis on building local pharmaceutical capacity.

ECA officials say the issue is not a lack of global capital, but the absence of clear systems that can attract long-term investment.

Why it matters for governments 

Speakers at the event said health spending is not just a social need but a political one.

Former Nigerian Vice President Yemi Osinbajo pointed to survey data showing healthcare ranks among voters’ top concerns, warning that weak systems can erode trust in government. 

Experts also flagged gaps in how funds are used, calling for more focus on results rather than spending levels alone. Poor data remains a challenge, making it harder to track outcomes and plan effectively. 

The ECA is working on new data platforms to help governments link spending to results and draw in private investors.

Digital tools — including mobile payments and insurance platforms — are already helping expand access, but wider adoption will depend on better infrastructure and skills. 

Pilot programs are underway in parts of West Africa, but officials say progress will depend on one key factor: whether governments follow through.