ADDIS ABABA, Feb. 15 (Xinhua) -- Africa has seen a sharp decline in development assistance to the health sector, down to roughly 39 billion U.S. dollars in 2025 from about 80 billion U.S. dollars in 2021, Claver Gatete, Executive Secretary of the United Nations Economic Commission for Africa (UNECA), has said.
In his remarks at a side event of the 39th AU Summit on Africa's health sovereignty in Addis Ababa, the capital of Ethiopia, on Sunday, Gatete said Africa spends approximately 145 billion U.S. dollars annually on health while governments finance less than half, which "unfortunately" leaves households to bear heavy out-of-pocket payments.
Across many countries on the continent, he noted, families sell vital assets to pay medical bills, which in turn results in not only social but also macroeconomic consequences.
"Health financing cannot be an auxiliary budget line. It must be integrated into national fiscal frameworks and financed predictably, just as nations finance infrastructure, energy, and security," Gatete said.
According to Gatete, it is unacceptable that a continent of over 1.4 billion people, carrying nearly a quarter of the global disease burden, is served by fewer than 1,000 pharmaceutical manufacturers, and it produces only a small share of the medicines it consumes.
"Import dependence exposes our health systems to external prices, external decisions, and external disruptions," said Gatete, noting that the African Continental Free Trade Area (AfCFTA) would help address these problems by harmonizing regional value chains.
He noted that UNECA contributes by linking health financing to macro-fiscal planning, domestic resource mobilization, debt sustainability, and regional integration, adding that health sovereignty cannot be achieved by ministries of health alone. Finance, trade, industry, and planning authorities must act together.
The executive secretary called on African governments to integrate health financing into their national development plans and medium-term fiscal frameworks, so prevention and primary healthcare are funded predictably.
Furthermore, he highlighted the urgency of developing pharmaceutical and vaccine production centers through regulatory harmonization, technology transfer, and private investment, in order to strengthen health systems across Africa. ■
