Lagos: Dr Ebere Okereke, an Independent Global Health Expert and Associate Fellow of Chatham House, has called on African Governments to reframe health spending as a strategic economic investment rather than a social cost.
According to News Agency of Nigeria, Okereke highlighted the need for governments to rethink how health financing is presented during national budgets and policy discussions, noting that it is often framed in humanitarian or social terms, making it vulnerable to cuts amid fiscal pressures.
She emphasized that governments should present health in terms of economic return, labor productivity, resilience, and the cost of inaction, rather than merely as a need. Okereke explained that underinvestment in primary care, prevention, and health system preparedness leads to greater long-term costs through disease outbreaks, loss of workforce productivity, household impoverishment, and expensive emergency responses.
Furthermore, Okereke stressed the importance of extending health financing discussions beyond ministries of health to include ministries of finance, planning, labor, and heads of government, recognizing the strong link between health systems and national economic performance. She pointed out that linking health to workforce participation, human capital, fiscal risk, and social stability makes it easier to prioritize even during tight budgets.
Despite decades of commitments to strengthen health systems across Africa, Okereke stated that the core challenge often lies not in resource availability but in governance and implementation. She advocated for moving from allocation to execution, improving budget execution, strengthening procurement transparency, and reinforcing public financial management systems to translate allocations into actual health service improvements.
Okereke highlighted the need for accountability mechanisms involving institutions beyond the executive arm of government, emphasizing the role of parliaments, audit institutions, civil society, and the private sector in strengthening health financing governance. She urged African governments to prioritize domestic financing mechanisms, such as health levies, excise taxes, insurance pooling arrangements, and debt-for-health swaps, as potential sustainable funding sources.
She also underscored the importance of strong governance structures for these financing instruments to succeed, emphasizing the need for a clear legal basis, transparent reporting, independent oversight, and protection against diversion and inflation erosion. Improving the use of funds already approved in national budgets could provide one of the fastest ways to strengthen health financing, especially in the current context of tight fiscal space and declining external assistance.
On the role of data in policy decisions, Okereke urged governments to ensure that evidence is not only generated but also effectively used in budgeting and planning processes. She recommended realistically costing a defined package of essential health services to guide budget decisions and called for stronger integration between routine health data, National Health Accounts, private-sector service data, and fiscal planning to enhance the credibility of reforms based on country-owned evidence.