Since 2018, aid to Africa has been steadily declining. Many donors are changing their focus due to various political and social factors. Countries like Germany, France, and Norway have all cut back their support over the past five years. The UK also reduced its overseas aid, cutting it from 0.7% to 0.5% of its national income in 2020.
This reduction in aid is particularly troubling for health services across Africa. Many vital programs rely on this funding to deliver essential care, ranging from vaccines to maternal health support.
The impact of these aid cuts can be severe. For example, due to cuts from the UK, around 72 million people couldn’t receive treatment for neglected tropical diseases between 2021 and 2022.
In January 2025, the US also froze its aid to Africa, which has already started to disrupt vaccination campaigns for diseases like polio and programs that treat HIV/AIDS. In South Africa alone, a cut of $400 million to HIV programs could lead to more infections and deaths.
These trends highlight Africa’s reliance on foreign aid for health funding. As a global health expert involved with agencies like the World Health Organization (WHO) and other funding bodies, I see the need for local and sustainable funding solutions.
To reduce dependency on aid long-term, Africa must take proactive steps towards sustainable health funding.
Challenges and Local Solutions
African nations are currently battling two pressing health challenges: high rates of communicable diseases like malaria and rising non-communicable diseases such as diabetes and heart disease. Unfortunately, many health systems are underfunded, leaving them unable to tackle these issues effectively.
On average, African governments spend less than 10% of their GDP on health. This falls far short of the estimated $26 billion needed each year to meet the evolving health needs of their populations. A significant amount of health funding comes from international aid, with many sub-Saharan African countries relying on external support for over a third of their health expenditures.
While foreign aid has been helpful, it creates vulnerabilities. Countries risk losing autonomy over their health priorities, as funding depends largely on the interests of donors. This often results in a narrow focus on single diseases, which hampers the development of integrated health services.
Innovative Financing Strategies
With aid continuing to decrease, Africa must explore other financing options. Here are some underutilized strategies:
- Diversifying Domestic Resource Mobilization: Countries can boost health funding through local taxes, like tobacco taxes, which remain underused. Zimbabwe’s successful 3% AIDS levy shows how local financing can reduce dependence on foreign aid.
- Public-Private Partnerships: Collaborations between local governments and private companies can effectively fill funding gaps. For instance, GE Healthcare partnered with the Kenyan government to provide health services while spreading costs over time.
- Promoting Regional Integration: By working together, African countries can strengthen local production of medical supplies and reduce the need for imports. The African Union’s initiative for a single continental market for medicines supports this aim.
- Engaging Development Finance Institutions: Specialized financial organizations can provide capital and expertise for health projects that might be risky for traditional investors. The AfricInvest platform has raised significant funds to support health initiatives like dialysis facilities across Africa.
By implementing a mix of these strategies at various levels, African countries can take meaningful steps towards breaking free from aid dependency and building a stronger, more self-sufficient healthcare system.
