Gawanas calls for Africa’s health self-reliance

Africa must take charge of its health future and reduce reliance on external aid.

This is according to Global Fund to Fight AIDS, Tuberculosis and Malaria vice chairperson Bience Gawanas, who was speaking at the fourth International Conference on Public Health in Africa held in Durban, South Africa.

Gawanas says Africa should be “a partner, architect and leader of its own response” in achieving universal health coverage and health security.

She notes that over the past two decades, the Global Fund partnership has saved 70 million lives, the vast majority in Africa.

“The Global Fund has invested more than US$69 billion (about N$1.19 trillion) and helped reduce the combined death rate of HIV, tuberculosis (TB) and malaria by 63% in the countries where it invests – with 70% of that investment in Africa,” she says.

“This is not simply a grant; it is a collective investment in livelihoods,” Gawanas adds.

She emphasises that the Global Fund supports countries to move from dependence on external grants to sustainable, country-led systems.

“This means aligning grants with national strategic plans, nurturing domestic investments, strengthening supply chains, laboratories and human resources, and integrating disease programmes into broader primary health care,” she says.

However, she cautions that Africa’s journey to self-reliance must recognise the continent’s realities – fragile economies, competing demands, climate shocks, conflict and displacement.

Gawanas highlights three themes guiding the fund’s current work: ‘The Eighth Replenishment of the Global Fund, ‘Africa’s Pathway to Self-Reliance’, and ‘The Critical Role of Communities, Especially Women and Girls, in Driving Progress’.

“The Global Fund is not simply a fund. It is a collective investment in livelihoods, communities and hope for future generations,” she says.

“Africa is a partner and co-architect of the future of global health, and this replenishment is an opportunity to translate that into concrete investments in African health systems and long-term self-reliance.”

She says the upcoming eighth replenishment – aimed at saving an additional 23 million lives and cutting mortality from HIV-AIDS, TB and malaria by 64% – requires renewed commitment from global donors.

“The journey towards self-reliance cannot be achieved by governments alone. At the heart of self-reliance lie communities,” Gawanas says, calling for greater investment in community-led organisations, frontline health workers, women’s networks and youth groups.

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