The UN Economic Commission for Africa and former Vice-President Yemi Osinbajo are leading efforts to promote sustainable domestic health financing in Africa.

According to a statement by the ECA on Friday, the initiative seeks to help African governments mobilise sustainable, predominantly domestic resources to strengthen health systems across the continent.

It builds on the Tangier Declaration adopted by African finance, planning and economic development ministers in March 2026.

The declaration recognises health spending as an investment in human capital and economic resilience, rather than a cost to be managed.

The ECA executive secretary, Claver Gatete, said, “Nothing can be done without people. We need them to be healthy to contribute. The initiative is particularly important amid declining official development assistance for health and rising debt burdens limiting fiscal space.”

Mr Gatete restated the need for stronger coordination between health and finance ministries, alongside domestic resource mobilisation, innovative financing and private investment.

Meanwhile, Mr Osinbajo, the champion of the Initiative, said the constitution of the High-Level Advisory Group marked a shift from aid dependency towards greater domestic ownership of health financing. He said ministries of finance and health needed to work jointly, rather than operate in parallel, to address the continent’s financing challenges.

Senait Fisseha, the vice-president for Global Programmes at the Susan Thompson Buffett Foundation, said philanthropy should serve as a catalyst rather than replace government financing.

Ms Fisseha said philanthropic support should ultimately be assessed by the institutions and systems it helped establish rather than grants that were repeatedly renewed.

Representing the African Union Commission Chairperson, Julio Rakotonirina, director for Health and Humanitarian Affairs, outlined five guiding areas for the initiative.

He said, “These include domestic resource mobilisation, efficiency, equity, financial protection and fiscal space, aligned with Agenda 2063 and other continental health frameworks.”

Mr Rakotonirina added that the ongoing Ebola outbreak response in the Democratic Republic of the Congo demonstrated that health financing and health security could not be treated separately.

“The initiative comes amid declining external health financing, narrow domestic revenue bases and increasing debt-service pressures across African countries,” he noted.

Meanwhile, Africa’s average tax-to-GDP ratio is about 16 per cent, while out-of-pocket spending remains the primary health financing source in roughly half of African countries.

Botswana, Ethiopia, Guinea, Sierra Leone and Togo are participating as early adopters, with technical assessments and country-led financing solutions under development.

The inaugural meeting brought together ministers and senior officials from across Africa to discuss pathways to sustainable, domestically financed health systems.

The High-Level Advisory Group subsequently moved into closed deliberations to advance its work on strengthening health financing across the continent.

(NAN)