Africa’s path to health sovereignty: ECA chief calls for fiscal transformation to finance health

Speaking at a high-level side event during the 2026 African Union Summit of Heads of State and Government, Executive Secretary of the Economic Commission for Africa (ECA), Mr. Claver Gatete urged African leaders to treat health as a cornerstone of economic security and sovereignty.

Addressing key representatives from government and the health sector under the theme “From Commitment to Action: Accelerating Health Financing, Partnerships and Delivery at Scale,” Mr. Gatete said the global order is shifting from “hyper‑globalisation” toward “strategic resilience,” where nations secure critical sectors such as food, energy and now, health.

“Health is no longer a social service; it is a strategic economic sector,” he said. “Health security is national security.”

Citing recent declines in development assistance for health — from roughly US$80 billion in 2021 to US$39 billion in 2025 — the he warned that Africa’s reliance on external financing and imported medical supplies leaves the continent vulnerable to price shocks and supply disruptions. Despite spending about US$145 billion annually on health, less than half comes from public budgets, forcing families to bear high out‑of‑pocket costs.

“The consequences of inadequate and unpredictable financing are not only social but macroeconomic,” he stated. “If the effects are economic, the response must also be economic.”

Mr. Gatete outlined four priorities to unlock Africa’s health sovereignty: integrating health into medium‑term fiscal plans; mobilising domestic revenues through innovative financing tools; developing pharmaceutical and vaccine manufacturing via AfCFTA‑enabled regional value chains; and strengthening health delivery infrastructure.

He highlighted the ECA’s efforts to support governments in linking health investments to macro‑fiscal planning, resource mobilization, and industrial development — including a new partnership with the Susan Thompson Buffett Foundation on financing options to be launched at the upcoming ECA Conference of Ministers in March.

“The choices we make now will determine whether Africa remains a consumer in the global health system or becomes a producer within it,” he concluded. “Health sovereignty is, ultimately, economic sovereignty.”