For decades, African countries have relied heavily on foreign aid to fund their healthcare systems. International donors contribute significantly to programs supporting HIV treatment, maternal health, and vaccination campaigns. However, since 2018, there has been a global decline in aid directed toward Africa. Countries like Germany, France, and Norway have scaled back their contributions, and in 2020, the UK reduced its Overseas Development Aid (ODA) from 0.7% to 0.5% of gross national income.
The freeze of U.S. aid to Africa in January 2025 is the latest example of shrinking financial support. This has already disrupted critical health programs, including polio eradication efforts and HIV treatment under the President’s Emergency Plan for AIDS Relief (PEPFAR). South Africa alone faces an annual loss of $400 million in HIV program funding, which threatens treatment continuity and could lead to increased infection rates and mortality.
While aid has played an essential role in improving health outcomes, overdependence on foreign funding leaves Africa vulnerable to shifting donor priorities. It also limits national decision-making on health policies, as external funders often set the agenda. To address this challenge, African nations must develop sustainable, locally driven healthcare financing mechanisms. The following four strategies can help reduce reliance on foreign aid.
One effective approach is to expand domestic revenue sources, particularly through targeted taxation. For example, tobacco and alcohol taxes can be directed toward healthcare funding. Zimbabwe’s AIDS levy, a 3% tax on corporate and individual income, provides a model for how African nations can generate funds for critical health programs.
Similarly, Nigeria has demonstrated a commitment to domestic financing by absorbing 28,000 health workers previously supported by USAID. This shift highlights the potential of national governments to take ownership of their healthcare workforce and funding.
Collaboration between governments and private entities can bridge healthcare financing gaps. These partnerships enable governments to invest in infrastructure and service delivery without bearing the full financial burden.
A notable example is the 2015 partnership between Kenya’s government and GE Healthcare. Under this agreement, GE provided radiography equipment and services, while the government paid in installments over several years. Such models allow for strategic healthcare investment without immediate large-scale spending.
Africa relies heavily on imported medicines, much of which is funded through foreign aid. By strengthening regional pharmaceutical production, the continent can reduce dependency on external funding. The African Union’s Africa Medicines Agency (AMA) is a step in this direction, creating a unified regulatory framework that supports local manufacturers and ensures cost-effective medicine distribution.
This shift toward local production will not only make healthcare more sustainable but also reduce costs and improve accessibility, particularly in rural and underserved communities.
Development finance institutions such as the African Development Bank (AfDB) and the African Export-Import Bank can play a crucial role in mobilizing funds for healthcare projects. These institutions provide capital and expertise to health initiatives that traditional investors may perceive as too risky.
AfricInvest, an investment platform supported by DFIs from the U.S. and Europe, has raised over $100 million for African healthcare investment. One of its notable achievements includes establishing 45 dialysis centers, delivering over 130,000 affordable dialysis sessions annually. Such initiatives highlight how innovative financing models can improve healthcare access without relying on foreign aid.
The decline in global aid to Africa underscores the urgent need for self-sufficiency in healthcare financing. While international assistance has historically filled funding gaps, overreliance on it limits long-term stability and national autonomy in health policy decisions.
By implementing diversified taxation, fostering public-private partnerships, strengthening local pharmaceutical production, and engaging development finance institutions, African nations can build resilient health systems that do not depend on unpredictable foreign aid. A strategic, multi-pronged approach will ensure that essential healthcare services remain available to all, regardless of shifting global priorities.
