The COVID-19 pandemic exposed critical vulnerabilities in Africa’s public health infrastructure, but also spurred a surge in external funding and a renewed focus on self-sufficiency. Now, as the world cautiously emerges from the acute phase of the crisis, the question is whether African nations will capitalize on this momentum and build lasting health security, or revert to reliance on external aid when the next inevitable pandemic arrives. A key figure advocating for the former is John Nkengasong, former director of the Africa Centres for Disease Control and Prevention (Africa CDC).
Nkengasong, writing this week, emphasizes that the influx of funding following the initial outbreak of COVID-19 was instrumental in strengthening the Africa CDC’s capacity. This support facilitated not only improvements in disease surveillance and response but also crucial investments in local vaccine manufacturing and the development of robust genomic networks across the continent. These networks are vital for rapidly identifying and tracking emerging pathogens, a capability sorely lacking at the start of the pandemic.
The urgency of the situation became starkly clear to Nkengasong in late 2019, while he was attempting to recover from months spent battling a deadly Ebola outbreak in the Democratic Republic of Congo (DRC). The first reports of a novel respiratory infection emerging in Wuhan, China, prompted him to immediately recall his team from Addis Ababa, recognizing the potential for a global crisis. This swift action, enabled by the existing (though limited) infrastructure of the Africa CDC, highlights the importance of having a dedicated, continent-wide public health agency.
However, funding alone is not enough. Nkengasong’s central argument is that African governments must now demonstrate a sustained commitment to supporting these initiatives. The initial surge in external funding, while welcome, cannot be relied upon indefinitely. Building true health sovereignty requires consistent domestic investment in public health systems, research and development, and manufacturing capacity. This is not merely a matter of preparedness for future pandemics; it’s also about addressing the ongoing burden of endemic diseases like malaria, HIV/AIDS, and tuberculosis.
The challenges are significant. As highlighted in a 2020 analysis of Africa’s preparedness for COVID-19, the continent faced – and continues to face – substantial hurdles in terms of healthcare access, infrastructure, and economic resources. The potential for catastrophic outcomes was, and remains, very real. The earlier Ebola epidemic in the DRC, which began in August 2018 and continued well into 2020, demonstrated the continent’s vulnerability to infectious disease outbreaks even before the arrival of COVID-19. That outbreak saw over 3,444 cases, underscoring the need for constant vigilance and robust response mechanisms.
The pandemic also exposed the dangers of “vaccine nationalism,” where wealthier nations prioritized their own populations in accessing limited vaccine supplies, leaving African countries at a significant disadvantage. Establishing local vaccine manufacturing capacity is therefore a critical component of achieving health sovereignty. It reduces reliance on external suppliers and ensures that African nations can respond more effectively to future outbreaks. The current efforts to build this capacity, supported by the initial influx of funding, must be sustained and expanded.
The Africa CDC’s emergence as a decisive political actor during the pandemic, as noted in recent research, is a positive development. It’s no longer simply a technical agency; it’s a voice advocating for the continent’s health interests on the global stage. This political influence is crucial for securing continued support from international partners and for shaping global health governance in a way that prioritizes equity and access.
The path forward, according to Nkengasong, requires a fundamental shift in mindset. African nations must view investment in public health not as a cost, but as an investment in economic stability and long-term prosperity. A healthy population is a productive population, and a resilient health system is essential for mitigating the economic shocks of future pandemics. The lessons of COVID-19 are clear: health security is national security, and it requires sustained commitment and strategic investment.
The role of organizations like Gavi, the Vaccine Alliance, remains important, but the responsibility for building health sovereignty rests with African governments. The opportunity to learn from the past and prepare for the future is now. Failure to do so risks repeating the same mistakes and leaving the continent vulnerable to the next global health crisis.
