By: Financing Alliance for Health (FAH)
The 4th International Conference on Public Health in Africa (CPHIA 2025), held in Durban under the theme “Moving Towards Self-Reliance to Achieve Universal Health Coverage (UHC) and Health Security in Africa,” was more than a gathering, it was a continental reckoning. Across four powerful days, delegates called for a new era of health sovereignty anchored in primary health care (PHC), sustainable financing, and shared accountability. A unified message resounded across Africa: Health is not charity — it is sovereignty. This message crystallized into a bold declaration — the Durban Promise.
The Durban Promise marked the birth of Africa’s Health Sovereignty Movement, a commitment to manufacture its own vaccines, finance resilient systems, transform primary health care, prepare for pandemics, empower its people, and own its data. This was not just a conference outcome — it was a continental call to action, turning crisis into opportunity and aspiration into action.
Day 1 – Self-Reliance and Health Sovereignty
Opening the conference, Dr Jean Kaseya, Director-General of the Africa CDC, captured the moment perfectly:
“For the first time, Africa is inspiring the world. The world is coming to learn from Africa. … we are 1.4 billion proud Africans making our own agenda.”
The call was clear Africa cannot outsource its health future.
“Our healthcare industry still relies on borrowed technologies and ideas. We must decouple from that dependence if we are to win the battle for health sovereignty.” – Nhlanhla Msomi, President of AfricaBio
This framing strongly echoes FAH’s first strategic pillar – Mobilise More Money for Health. Financing is not only about new resources, but about building domestic fiscal space, integrating health into national development priorities, and managing funds more efficiently through performance-based and accountable systems.
Day 2 – Local Manufacturing and System Investment
Day 2 focused on building Africa’s health-product ecosystem -from research and regulation to manufacturing and market access.
“We need to complete the ecosystem for vaccine manufacturing,” delegates urged, emphasizing that health sovereignty requires investment not just in products but in systems that sustain delivery.
This day underscored that financing must go beyond episodic donor projects to long-term, integrated investment in PHC and community systems – the foundation on which supply chains, human capital, and service continuity depend.
Day 3 – Financing Resilience and Accountability
Day 3 turned to the heart of the financing conversation. Africa faces an estimated USD 12 billion annual funding gap, threatening to reverse recent health gains. Delegates called for domestic resource mobilisation, pooled funds, and improved expenditure tracking to make every dollar count.
But the most striking discourse came around Primary Health Care. Former Zambian First Lady Christine Kaseba reminded participants:
“We are stuck because we are yet to understand that primary is fundamental to achieving universal healthcare.”
Her words resonated deeply. PHC was positioned not just as a service-delivery tier, but as the core strategy for achieving UHC and health security, the space where financing reforms become tangible.
For FAH, this reinforces Pillar 3 – Ensure Money Is Spent Efficiently. Investing in PHC delivers high value for money: it prevents disease, protects households from financial hardship, and strengthens resilience against shocks such as pandemics and climate crises.
Day 4 – Innovation, Youth, Climate and One Health
The closing day celebrated innovation, digital transformation, and youth leadership as accelerators of PHC and system resilience.
“Africa has reached its M-PESA moment in healthtech. Let’s make it count,” urged Francis Ohanyido, highlighting the continent’s capacity to innovate for equity and access.
He added: “CPHIA is more than a gathering … It’s where knowledge meets action, innovation meets impact, and where we begin to take full ownership of our health systems.”
Discussions also integrated climate and One Health perspectives, calling for financing models that protect both people and the planet. FAH’s work on innovative PHC investments and digital public-financial-management tools mirrors this approach ensuring that financing builds systems that are not only efficient but also adaptive and sustainable.
FAH at CPHIA 2025: Side Events, Abstracts & Knowledge Sharing
This year’s Conference on Public Health in Africa (CPHIA) offered a defining moment for health financing — what many have called its “pandemic moment.” Across plenaries and side events, the message was clear: without financing, primary healthcare remains a promise without power.
From October 23–25, 2025, the Financing Alliance for Health (FAH) was represented in six high-level sessions and two abstract presentations — putting health financing squarely at the heart of the global health conversation.
Side Events We Led or Participated In
- Thu, 23 Oct, 11:00–12:30 (DEC Hall 1) — From Policy to Practice: How Kenya’s Primary Care Networks Are Transforming PHC Reforms & Financing (PATH)
Dr. Rebecca Musyoki of MoH Kenya, presented here, drawing from Kenya’s PCN experience and FAH’s support to translate policy into lived financing reforms. - Thu, 23 Oct, 16:00–17:30 (Hall 2D) — Health as an Investment: Sustainable Resourcing for Comprehensive PHC & UHC (Africa Health Business & Novartis)
FAH CO-CEO Soleine Scotney spoke on the imperative of positioning primary health care at the center of sustainable financing strategies. - Thu, 23 Oct, 18:00–21:00 (Onomo Hotel Durban) — Driving Networked Advocacy to Advance Africa’s Resilience (Amref, PACJA & RANA)
Dr.Mpuma Kamanga Health Financing Manager-Anglophone Region, represented FAH, reinforcing our commitment to civil society coalitions and country resilience agendas. - Fri, 24 Oct, 07:00–08:30 (Meeting Room 12) — CSOs at the Centre: Networked Advocacy in Driving Pandemic- & Climate-Resilient One Health Systems
Soleine Scotney emphasized links between health, climate, and systems financing, and how CSOs can help close accountability gaps. - Fri, 24 Oct, 16:00–17:30 (Hall 2D) – FAH Side Event: Securing the Future of Primary Health Care: Innovative and Sustainable Financing Pathways for AfricaThis CPHIA 2025 side event explored how Africa can secure sustainable PHC financing through innovative pathways—raising domestic resources, protecting PHC budgets, and improving spending efficiency. It featured insights from Kenya, Zambia, Senegal, and Sierra Leone, with highlights of practical solutions to strengthen resilience and advance universal health coverage.
- Sat, 25 Oct, 07:00–08:30 (Hall 3 A2) —Health R&D Financing in Africa: Towards Resilience, Innovation, and Sovereignty (PATH & IGH)
Soleine joined partners such in advancing discussion on financing African-led research and health innovation.
FAH ABSTRACTS
Financing Alliance for Health (FAH) was glad to have presented two abstracts at CPHIA 2025, contributing to Track 2 discussions on advancing self-reliance and health security through innovative and sustainable health financing for universal health coverage in Africa.
1. Vertical or Horizontal? Trends in Government and Donor Funding for Community Health Worker (CHW) Programmes in Sub-saharan Africa (SSA)
Presented by Ms. Shivani Shukla, EPA Agenda Associate, FAH, this abstract explored 20 years of financing data for Community Health Worker (CHW) programs across Sub-Saharan Africa. Between 2002 and 2022, the region received approximately US $11 billion in external assistance—76% of global CHW funding—with 76.4% directed toward vertical, single-disease programs, largely funded by a few donors such as the Global Fund. From 2016 to 2022, external assistance continued to dominate, accounting for 82.3% of CHW program financing in SSA.
2.Global Budgeting for Primary Health Care: Early Implementation Experiences from Kenya’s Social Health Authority and Facility Improvement Financing Reforms – The Case of Nairobi City County.
In collaboration with Dr. Rebecca Musyoki, the poster highlights Nairobi’s early implementation experiences from Kenya’s Social Health Authority and Facility Improvement Financing reforms, showcasing how these recent health financing innovations are transforming the funding landscape for public primary health care facilities. Early findings reveal that the global budgeting provider payment mechanism model has improved financial access, predictability, and service delivery, offering valuable lessons for building equitable and sustainable PHC financing systems across Africa. Notable gains include over 91% of facilities now having access to funds—up from a system where smaller facilities often missed out—alongside improved cash flow predictability (62%) and revenue forecasting (64%), enabling more effective planning and management.
From the Durban Promise to Action
From Durban, the message is unmistakable: financing is the breath that powers the promise of Universal Health Coverage. African leaders and stakeholders made bold, actionable commitments to advance the continent’s health sovereignty. These included mobilizing domestic resources through innovative financing mechanisms like health levies, sovereign funds, and diaspora bonds to support local manufacturing of vaccines, medicines, and diagnostics. Governance and accountability were prioritized through the Pan-African Health Financing Compact, while primary health care systems were set to be revitalized by institutionalizing and remunerating Community Health Workers and leveraging digital and solar innovations. Regional solidarity was strengthened via platforms like the African Vaccine Manufacturing Accelerator (AVMA) and the African Pooled Procurement Mechanism (APPM), aimed at integrating markets and reducing costs. The continent also committed to building climate-resilient, pandemic-ready One Health systems and reframing health as a strategic investment tied to economic growth and national security. These efforts are anchored in the Durban Promise — a declaration that Africa will lead, innovate, and thrive through five catalytic pillars: African manufacturing, innovative health financing, PHC transformation, pandemic preparedness, and data ownership.
FAH’s five-pillar strategy directly supports this agenda:
- Mobilize More Money for Health – Expand domestic and innovative financing.
- Direct More Funding to PHC and CH – Invest where impact begins.
- Ensure Money Is Spent Efficiently – Build accountability and PFM capacity.
- Build Government Capacity & Ownership – Institutionalize reforms.
- Shape the Regional Environment – Foster collective investment platforms like AFF.
Africa’s sovereignty in health begins with financial self-determination. Every dollar must do double duty improving lives and strengthening systems.
As the Financing Alliance for Health, we carry forward CPHIA’s momentum, supporting governments to mobilize, manage, and optimize resources so that the vision of Universal Health Coverage is powered by strong, financed, and people-centered Primary Health Care, and is not just a shared vision, but a lived reality for every African.
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