By Maya Hayakawa
The African Union Summit left us with a deep sense of hope and urgency.
On the sidelines of the 39th African Union Summit in Addis Ababa, leaders, ministers, partners, and practitioners came together with one shared conviction. Sustaining Africa’s health systems starts with people. And it starts in communities.
Across powerful discussions on health workforce, community health, maternal and child health, and the future of global health financing, the message was clear. Africa is moving toward stronger ownership, stronger systems, and stronger financing.
There was renewed commitment from African leaders to scale up the health workforce, including the goal of deploying two million community health workers by 2030. Today, about one million community health workers are already deployed across the continent, serving as the backbone of primary health care. Yet the gaps remain significant. The average ratio is still one community health worker for every 1,335 people, and only 51 percent of this workforce are women, highlighting both access and gender equity challenges.
Encouraging progress is underway. Out of 55 African Union member states:
- 31 countries now allocate national budgets for community health programmes
- 26 countries pay community health workers through government wage bills
- Yet only six countries finance more than 80 percent of their programmes domestically
- And18 countries still rely on development partners for more than 90 percent of funding
These realities underscore a critical truth. Sustainability remains the biggest challenge. At the same time, the stakes are rising. Africa faces an estimated six million health worker shortfall by 2030, driven by migration, skills gaps, and limited investment. If unaddressed, workforce migration alone could cost the continent an estimated 1.4 trillion dollars by 2063. But if properly financed and supported, this workforce could unlock one of the largest demographic dividends in the world.
Evidence continues to show the value of investing in community health. The return is clear. Every dollar invested in community health workers generates strong health and economic benefits, improving maternal and child health, disease prevention, and productivity.
What felt different this year was not the ambition. It was the shift in mindset.
DAY 2
Day two discussions highlighted a major continental transition. Ministers and partners aligned around stronger government leadership, direct financing to governments, and integrated national plans and budgets. The era of fragmented, vertical programmes is steadily giving way to stronger primary health care systems. There was strong endorsement of domestic resource mobilisation, catalytic financing, and better use of grants to unlock long term sustainability.
Conversations on maternal and child health reinforced that progress depends on execution. Countries shared real examples of reducing maternal mortality through integrated approaches that bring together financing, skilled health workers, commodities, and data. Persistent bottlenecks in procurement, supply chains, and budget execution were recognised as key barriers that must be addressed to save lives.
There was also renewed political momentum around local pharmaceutical manufacturing and regulatory sovereignty, including strengthening the African Medicines Agency as a cornerstone of Africa’s health security.
For Financing Alliance for Health, these discussions reaffirm why our work matters. The future of health financing in Africa will be defined by strong public financial management, domestic resource mobilisation, strategic purchasing, and real time data for decision making.
Countries are no longer asking only for strategies. They are asking for costed plans, financing pathways, and execution support. They want to move from commitments to results.
We are encouraged by the growing alignment between ministries of health and ministries of finance. We are inspired by the political leadership and momentum. And we remain committed to supporting governments to mobilise more resources, use those resources more efficiently, and strengthen the systems that deliver impact for communities.
The future of primary health care in Africa is not just being discussed. It is being built, one brick at a time.
And we are proud to be part of that journey.
