The New Public Health Order for Africa (https://bit.ly/3CkZuG5) is a roadmap to sustainable health outcomes and health security. It is defined by five pillars:

1. Strong African Public Health Institutions that represent African priorities in global health governance and that drive progress on key health indicators;
    
2. Expanded Manufacturing of Vaccines, Diagnostics, and Therapeutics to democratize access to life-saving medicines and equipment;
    
3. Investment in Public Health Workforce and Leadership Programs to ensure Africa has the workforce it needs to address health threats;
    
4. Increased Domestic Investment in Health, including the domestic mobilization of financial resources, human capital, technical resources, and networks; and
    
5. Respectful, Action-Oriented Partnerships to advance vaccine manufacturing, health workforce development, and strong public health institutions.

Call to Strengthen African Public Health Institutions

African leaders called for support to strengthen Africa’s public health institutions, including the Africa CDC which led the coordination of Africa’s pandemic response, helping to significantly reduce loss of life during COVID-19.

“To achieve [its public health goals], the African Union Assembly in February 2022 granted Africa CDC autonomy to be able to fulfill its mandate, supporting member states to achieve health sovereignty,” said African Union Chairperson Moussa Faki. “But Africa CDC alone cannot meet this challenge,” he added.

“If you don’t have strong public health institutions before an emergency, when the emergency comes it doesn’t matter how many resources you have. You’ll still struggle,” said Dr. Ahmed Ouma, Acting Director of the Africa Centres for Disease Control and Prevention.

Call to Support Vaccine Manufacturing in Africa

Leaders also called upon all vaccine-purchasing mechanisms, such as the Global Alliance for Vaccination and Immunization (GAVI), to purchase at least 30 percent of their vaccines from manufacturers in Africa. While Africa currently produces one percent of its routinely used vaccines, it has set a bold target of meeting up to 60 percent of its vaccine demand through regional manufacturing by 2040. By making explicit commitments to offtake vaccines from Africa, vaccine-purchasing mechanisms can stimulate private sector investment in vaccine manufacturing.

Call to Support Health Workforce Development

Health workforce development was another prominent focus. According to the WHO, Africa currently has a ratio of 1.55 health workers (physicians, nurses, and midwives) per 1,000 people. This is below the WHO threshold density of 4.45 health workers per 1,000 people needed to deliver essential health services and achieve universal health coverage.

“Health workers are a crucial pillar in a well-functioning health system. Yet, they have been historically deprioritized in discussions about improving health systems,” said President Cyril Ramaphosa in a statement read on his behalf by South Africa Health Minister Dr. Joe Phaahla. “It is good economics to invest in the health workforce as the return is measurable and dependable,” he added.

Leaders urged greater investment in health workforce development, and specifically called for stronger support of Community Health Worker programs in Africa.

“Experience shows that professional community health workers who are properly paid, trained, equipped, and supervised are best prepared to provide essential health services in their communities,” said President Ellen Johnson Sirleaf. She also highlighted that most community health workers in Africa are women who perform exceptional work but are unpaid for their efforts. “It is time to correct this injustice,” she urged.

Respectful, Action-oriented Partnerships

To advance progress towards stronger public health institutions, a robust workforce, and medical manufacturing in Africa, the Africa CDC and African Union Commission need partners. Leaders emphasized that the nature of these partnerships is important and called for partnerships oriented around principles of mutuality and respect, that recognize African knowledge and expertise and deliver contextually-relevant support and programs.

Partners of the African Union Commission and Africa CDC underscored that delivering a New Public Health Order for Africa is key to strengthening the global health infrastructure and ensuring better global preparedness to effectively respond to infectious disease outbreaks in the future.

"Achieving this future will take partnership, and not just any partnership but partnership that's rooted in respect – and that means starting by listening, understanding and then responding to real needs and to priorities," said Reeta Roy (https://bit.ly/3dPK2bT), President and CEO of the Mastercard Foundation, which last year partnered with the Africa CDC to launch the $1.5 billion Saving Lives and Livelihoods initiative. The Saving Lives and Livelihoods initiative has purchased vaccines for over 65 million people in Africa and is enabling the vaccination of millions more. The initiative is also designed to drive health workforce development and strengthen the Africa CDC to ensure long-term health security.