STRENGTHENING HEALTH SYSTEMS FOR UNIVERSAL HEALTH COVERAGE WITHIN THE AFRICAN UNION’S AGENDA 2063 (current concerns 2-001)

 current concerns 2-001

STRENGTHENING HEALTH SYSTEMS FOR UNIVERSAL HEALTH COVERAGE WITHIN THE AFRICAN UNION’S AGENDA 2063
-by Dr. Uzodinma Adirieje / +2347015530362 (WhatsApp) / druzoadirieje2015@gmail.com

 

As the African Union advances Agenda 2063—its roadmap to achieve “The Africa We Want” by 2063—the imperative to strengthen health systems across the continent has never been more urgent. Central to this vision is the goal of Universal Health Coverage (UHC): ensuring that all Africans have access to quality health services, when needed, without suffering financial hardship. Despite growing momentum, half of Africa’s population still lacks access to essential care, and nearly 97 million people experience catastrophic health spending annually.

 

Agenda 2063 and Health Systems: A Strategic Nexus

Adopted in January 2015, Agenda 2063 outlines Africa’s long‑term development trajectory—including poverty eradication, integration, and resilient institutions. Health systems strengthening (HSS) is embedded in multiple flagship initiatives and strategic priorities—particularly in workforce development, primary health care, digital health, local pharmaceutical manufacturing, and regulatory harmonisation. These align with the AU’s Africa Health Strategy 2016‑2030, which explicitly targets UHC by 2030.

 

The Workforce Imperative

A major barrier to UHC is the severe shortage of skilled health professionals: Africa could face a gap of over 6 million health workers by 2030. The AUDA‑NEPAD Continental Primary Healthcare Programme (2025‑2030), launched on 24 May 2024, is specifically designed to train and empower Community Health Workers (CHWs), underscoring their central role in reaching underserved communities. Simultaneously, governments must address brain drain by improving salaries, working environments, and professional development opportunities—especially in rural and underserved areas.

 

Primary Health Care as the Foundation of UHC

The UHC2030 coalition and AU policy advocates, consistently highlight that primary health care can deliver up to 90% of essential health services and extend average life expectancy by nearly four years if prioritized effectively. Embedding PHC at the centre of national systems ensures resilience and readiness to confront emerging health threats—from pandemics to climate‑induced disease outbreaks.

 

Digital Health and Innovation

The digital transformation of health systems—through telemedicine, biomonitoring, interoperable electronic health records (EHRs), and AI‑assisted surveillance—offers opportunities to bridge gaps in infrastructure, data, and quality of care. The AU’s recent World Health Day webinar affirmed its commitment to scaling homegrown digital tools, including AI‑powered diagnostics and patient monitoring systems like Rwanda’s IMPALA system – now gaining recognition for its potential to improve newborn care in Rwanda and beyond, which demonstrated up to 32% reductions in neonatal mortality during early adoption.

 

Pharmaceutical Sovereignty and Regulation

Under Agenda 2063, enabling local pharmaceutical production and strengthening regulation are vital. The African Medicines Agency (AMA) - a specialized Agency of the African Union (AU) dedicated to improving access to quality, safe and efficacious medical products in Africa; operational since 2021, is expected to harmonise regulatory standards across AU member states—bolstering medication quality, safety, and availability across borders. This supports AU efforts to reduce dependency on imports and curb the proliferation of counterfeit medicines.

 

Financing Health Systems

The AU has repeatedly called on member states to meet or exceed the Abuja Declaration target—allocating at least 15% of national budgets to health—but few have done so consistently. In 2024, however, 23 countries actively increased health spending as a share of GDP, moving toward the aspirational 5% benchmark. Strategic financing models—including blended finance mechanisms and innovative taxation (e.g., an “African air tax”)—are being explored to sustain domestic health investments and reduce reliance on external aid.

 

Governance, Coordination and Accountability

To ensure coherence and political permanence, the AU must adopt an enduring continental Health Architecture—a standing, institutionalized framework akin to the AU’s Peace and Security Council—to monitor progress, hold governments accountable, and coordinate joint action. Proposals include an annual “State of Africa’s Health” report to the AU Assembly and a scorecard that tracks member states’ fulfilment of health pledges—creating peer pressure and fostering transparency.

 

The Role of Partnerships and Multisectoral Engagement

Achieving UHC demands alliances across governments, civil society, academia, development partners, and the private sector. Civil society organisations, such as Afrihealth Optonet Association (AHOA), are vital in raising awareness, demanding accountability, and supporting community engagement. Similarly, strategic partnerships—such as Gavi’s collaboration with Japan and the AU—advance immunisation and financing goals aligned with Agenda 2063 and the SDGs.

 

Africa CDC’s “New Deal” and Public Health Security

Africa CDC’s strategic “New Deal” for health security aims to integrate digital health, supply chain resilience (e.g., regional drug depots), workforce development, and innovative financing—complementing efforts toward UHC and Agenda 2063’s health objectives africacdc.org. This continental cohesion bridges preparedness for emergencies and routine health service delivery.

 

Call to Action/Recommendations

 

Based on the many discussions, dialogues, and field interventions I’ve led—including the 2024 UHC Day event—I urge urgent, coordinated action in five key domains:

 

1. Political Commitment and Domestic Investment: AU Member States must recommit to the Abuja target, embedding health financing into national fiscal planning. Innovative taxes and public–private investment should be pursued to ensure sustainability.

2. Empower Primary Health Care and Health Workforce: Scale the AUDA‑NEPAD CHW programme continent‑wide, with consistent support for recruitment, training, and retaining talent. Health worker remuneration and work environments must improve systematically.

3. Accelerate Digital Health Innovation: Incentivise interoperable EHR systems, telemedicine, AI disease surveillance and remote monitoring in PHC settings—prioritising systems that improve access in rural and low‑resource regions.

4. Institutionalise Health Governance and Accountability: Establish a permanent AU health coordination platform, regularly reporting national progress, harmonising regulatory systems via the AMA, and aligning with Agenda 2063’s integration goals.

5. Foster Inclusive Partnerships and Community Leadership: Civil society must remain central in health advocacy. CSOs should drive awareness about health rights and monitor resource usage. Public–private partnerships should support technology scale‑up and local pharmaceutical industrialisation.

 

Conclusion: Toward “The Africa We Want”

 

As an African health advocate and development professional, I firmly believe that Universal Health Coverage is not a distant dream—but an attainable goal, if health systems are robust, equitable, digitally empowered, and fully funded. Agenda 2063 provides the blueprint; AU strategies, institutions like Africa CDC and AMA, and local innovations supply the tools. Member States must act now, in unity and with resolve, to realize a continent where every person—regardless of geography or income—can access high‑quality, affordable healthcare.

As we march toward 2063, strengthening health systems is not just a health-sector agenda—it is a pillar of economic growth, social justice, and continental self‑reliance. We can—and must—deliver UHC for all Africans. The time to act is now.

 

about the author:                                                                                                                                        Dr. Uzodinma Adirieje is a seasoned consultant with extensive expertise in global health, development planning, project management, sustainable development goals (SDGs), governance, health/community systems strengthening, policy advocacy, and monitoring and evaluation (M&E). He provides high-level consultancy services to governments, UN agencies, international organizations, NGOs, and development partners across Africa, leveraging over 25 years of multidisciplinary experience across Africa and the Global South.