HARARE, Zimbabwe — A new and severe Ebola outbreak in the Democratic Republic of Congo and Uganda is sparking a health crisis that is pushing African nations to lessen their reliance on international donors. Support from global partners, particularly the United States, has significantly decreased, halving over the last five years.
The drop in assistance, particularly due to funding cuts from the Trump administration, clashes with Africa’s rapidly growing population, currently over 1.5 billion. This latest Ebola strain introduces a troubling scenario as there are no approved treatments or vaccines available. Moreover, just recently, an unusual hantavirus outbreak on a cruise ship raised further alarms across the continent.
Dr. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention, emphasized the critical nature of consistent healthcare funding while announcing a new initiative aimed at achieving greater self-reliance in health financing.
He pointed out that when outbreaks occur, many countries scramble for external partners since they lack adequate budget allocations for health emergencies. Clearly, it’s an unsustainable situation that needs rethinking.
African nations have made commitments for health funding
The Africa CDC warns that the continent is facing an unprecedented financing crisis. Official development aid has plummeted from around $26 billion in 2021 to an anticipated $13 billion by 2025 as wealthier nations turn their focus to other geopolitical matters.
For years, leaders across Africa have promised to prioritize funding for their health systems, yet these pledges often seem to remain unfulfilled. Back in 2001, nations committed to allocating at least 15% of their national budgets to health, but only a few, like Rwanda, Botswana, and Cape Verde, have made significant progress out of the 54 countries on the continent.
“The conversation was somewhat academic because the donor system was still operational,” pointed out Dr. Alex Ajangba, who specializes in health financing and helped edit the new African Journal of Health Economics, Systems and Policy. “Now, however, that safety net is gone.”
He added, “What we’re encountering isn’t just a temporary setback in aid; it’s more long-lasting.”
Focus on ‘health sovereignty’ is growing
Governments are ramping up their initiatives toward “health sovereignty,” aspiring to finance and manage their health systems with far less foreign assistance. Efforts like Ghana’s “Accra Reset,” launched in September, and the Africa Health Security and Sovereignty Agenda, embraced by leaders in February, aim to build enduring resilience.
Health ministers are pushing for local solutions, such as imposing higher taxes on harmful products, collective procurement of medicines for reduced costs, and boosting local manufacturing of vaccines and pharmaceuticals while addressing existing inefficiencies.
The need is evident. Africa relies on imports for over 90% of its health commodities, including essential vaccines and medicines. Health crises — from mpox to cholera and now Ebola — have surged, with the Africa CDC reporting that outbreaks jumped from 153 to 242 between 2022 and 2024. The goal is for the continent to produce 60% of its vaccines by 2040.
“‘Health sovereignty’ is a term that comes up frequently in policy discussions these days,” Ajangba noted, but he is wary it could become merely a catchy slogan.
Africa has resources but lacks funding
Experts argue that while Africa is rich in natural resources, it struggles financially. The continent possesses about 30% of the world’s mineral reserves, vital for technology and renewable energy. Unfortunately, much of this wealth is lost through weak contracts, illicit financial flows, and insufficient local processing.
The United Nations Economic Commission for Africa estimates the continent loses around $40 billion yearly due to illicit financial activities in sectors like mining and oil.
To transition away from dependence on aid, African nations must explore co-financing, where countries contribute more alongside international donors.
Gavi, a global vaccine alliance, highlighted that low-income nations offered a record $302 million for vaccines in 2025, totaling about $1 billion over five years. This approach fosters financial predictability, unlike sole reliance on aid.
New aid conditions complicate the situation
However, the transition isn’t without friction. The Trump administration’s push for co-financing as a prerequisite for health deals with several African nations is transforming how aid is dispensed, requiring countries to ramp up domestic health spending within set timelines or risk losing support.
Some nations are rejecting these conditions, frustrated with demands for sharing health data without guarantees of reciprocal benefits. Others decry the idea of trading health resources for natural resource concessions.
While most governments voice a need for self-sufficiency, some critics argue that U.S. stipulations apply undue pressure on already burdened economies.
“They are being set up to fail,” said Asia Russell, the executive director of Health GAP, an advocacy organization. “When an administration states, ‘If you don’t meet these targets, we’ll cut you off,’ it’s a serious threat.”
Health spending suffers under debt burdens
With rising debt loads, many African nations now find themselves spending more on servicing debts than on health initiatives. Approximately 40% of these countries allocate more funds to debt obligations than to healthcare.
Jen Kates, a senior vice president at the nonprofit KFF, highlighted that “Many of these countries face substantial debt, creating significant challenges. Ultimately, the population in these countries will bear the brunt of these issues.”
Africa’s total debt is reported to have surged to about $1.2 trillion, necessitating tough financial decisions. According to the United Nations, debt servicing currently consumes about 19% of government revenue in sub-Saharan African countries.
