Health sovereignty takes center stage at Nairobi summit amid US aid cuts

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African health leaders gathered in Nairobi this week for the World Health Summit Regional Meeting, where the dominant theme was "health sovereignty"—the continent's push to take charge of its own health services in the wake of significant US aid cuts. The summit, attended by 15 African health ministers and thousands of NGO and academic delegates, was framed by organizers as an opportunity to reimagine health systems, despite the challenges posed by the withdrawal of donor funding.

Coverage comparison

The summit was covered by multiple outlets with differing emphases. Africa News highlighted the summit's focus on health sovereignty and described the US funding cuts as a potential catalyst for Africa to assert greater control over its health services. AllAfrica ran two pieces: one critical of a new US-Uganda health agreement and its effects on post-abortion care, and another more optimistic, focusing on the summit's calls for innovation and industrial development in African health systems.

Key claims

The World Health Summit Regional Meeting, held at the UN Office in Nairobi, brought together more than 2,000 delegates from over 50 countries, according to AllAfrica's keynote address. The summit's co-host, Lukoye Atwoli, told reporters that the aid system in Africa was based on "poor medicine for poor people," adding that "that era is gone." World Health Summit president Axel Pries called the cuts a "wake-up call" after the COVID-19 pandemic exposed Africa's vulnerability, saying, "We don't have the virus, but we have a political virus."

Africa News reported that the summit's overarching theme was health sovereignty, and that many African leaders see the loss of donor funding as an opportunity. The same report noted that massive aid cuts by Western donors, especially President Donald Trump's decision to scrap the $40-billion-a-year USAID agency, have been "welcomed by many Africans who say aid has fuelled corruption and lethargy in their governments."

A separate AllAfrica report detailed a $2.3 billion health agreement between Uganda and the United States that integrates donor-funded programs into Uganda's public health system while reducing reliance on NGOs. According to the report, Uganda has pledged to increase domestic health funding by about $50 million annually. A US State Department spokesperson said the deal is "a joint commitment to sustain lifesaving programmes while building national capacity."

However, the same report quoted health workers and activists who say post-abortion care and HIV/AIDS services are being negatively impacted. It cited the case of Suzan Akello, a 23-year-old Ugandan woman who died in February after taking herbal medicine to terminate a pregnancy. Post-abortion care is legal in Uganda, but health workers report increasing pressure to turn away women who show signs of a terminated pregnancy.

Africa's dependence on imported pharmaceuticals was also a key talking point. AllAfrica's summit coverage noted that during the COVID-19 pandemic, Africa manufactured less than two per cent of the vaccines it consumed. The report pointed to countries like India, Brazil, and South Korea as examples of nations that have built robust pharmaceutical manufacturing capacity.

Perspectives

Optimistic view: Some delegates at the summit view the US aid cuts as a long-overdue catalyst for Africa to develop self-sufficient health systems. The theme of health sovereignty was embraced as a chance to move away from a "donor-recipient paradigm" that many consider outdated and even harmful, as evidenced by Atwoli's remarks about "poor medicine for poor people."

Critical view: The US-Uganda agreement, while framed as a step toward national ownership, is seen by some health workers and activists as a threat to vital services, particularly post-abortion care and HIV/AIDS programs. They argue that the transition of responsibility is happening too quickly and without adequate safeguards, leading to a deterioration in care for the most vulnerable.

Pragmatic view: The summit also focused on practical steps beyond funding, such as developing local pharmaceutical manufacturing capacity. This was highlighted as an economic and strategic necessity, not just a public health issue, with lessons drawn from countries like India and South Korea.