Tangier: Claver Gatete, UN Under-Secretary-General for the Economic Commission for Africa (ECA), has called for an urgent overhaul of health financing across the African continent due to declining aid and increasing debt pressures that are tightening fiscal space.
According to News Agency of Nigeria, Gatete emphasized that the era of aid as the primary source of health financing is over, during his speech at the 58th Session of the Conference of African Ministers of Finance, Planning and Economic Development. He urged African governments to adopt sustainable, domestically driven funding strategies to build resilient health systems.
The event, themed ‘High-Level Forum on Sustainable Health Financing,’ highlighted that Africa spent approximately 145 billion dollars on health in 2022, with less than half funded through public financing. Gatete warned that reliance on donors and household funding is pushing many into poverty and exacerbating inequality in access to healthcare.
Gatete also pointed out that public debt in Africa averages 63 per cent of GDP, with several countries allocating more funds to debt servicing than healthcare systems. He described the situation as a critical turning point for transforming health systems through scale, integration, and innovative financing mechanisms.
Highlighting the African Continental Free Trade Area (AfCFTA) as a key element in developing continental health solutions, Gatete noted that Africa imports over 70 per cent of its pharmaceuticals, leaving countries vulnerable to global supply disruptions and rising costs. He advocated for coordinated action to integrate emerging pharmaceutical hubs in Morocco and Algeria, and growing manufacturing capacity in Rwanda and South Africa, to achieve scale and sustainability.
Gatete outlined four priorities for reform, starting with stronger domestic resource mobilization to reduce reliance on external funding. He called for innovative financing tools such as blended finance, debt-for-health swaps, and risk-sharing mechanisms to attract private capital.
On the issue of insurance, Gatete urged wider risk pooling to reduce the burden on households and governments, citing Ghana’s National Health Insurance Scheme and Rwanda’s community-based model as successful examples. He emphasized the need for urgent expansion of coverage, especially for vulnerable and underserved populations.
Gatete also called for increased private sector participation across healthcare delivery, logistics, pharmaceuticals, and digital health innovation, stressing that public financing alone cannot meet the scale of Africa’s health needs. He urged stronger regulatory and investment frameworks to incentivize capital response.
He stressed that financing alone cannot achieve desired results without skilled personnel, strong institutions, and adequate infrastructure. Gatete emphasized investing in people, systems, and institutions to ensure financing translates into better health outcomes.
Gatete highlighted the importance of digital health tools, including data systems and telemedicine, in expanding access and improving efficiency. He reiterated that preparedness is essential, drawing lessons from past Ebola and COVID-19 outbreaks.
He concluded by affirming that health is an investment in people, productivity, and prosperity, and emphasized that Africa’s greatest asset is its people. He reaffirmed the Economic Commission for Africa’s readiness to support countries with policy guidance, partnerships, and financing solutions.