Your Excellency Ambassador Amma Twum-Amoah,
Director General Dr Kelechi Ohiri,
Executive Director Peter Sands,
Excellencies, dear colleagues and friends,
I thank the African Union and the Government of Nigeria for convening this important discussion.
The world is facing a global health financing emergency that demands urgent, coordinated action.
In 2025, external health aid is projected to fall by over 30% compared to 2023, with the deepest impacts on low-income countries.
These sudden cuts are already causing widespread disruption to health systems and services.
One-third of countries now report critical shortages of essential medicines and health products.
Cuts in official development assistance have triggered job losses among health workers in many countries, and health worker training programmes are being disrupted.
Even before these cuts, health financing was off track.
The COVID-19 pandemic left countries with soaring debt and shrinking fiscal space, exacerbating decades of chronic underinvestment in health from national budgets.
This has driven reliance on inequitable out-of-pocket spending and external aid.
So, while this year’s aid cuts did not create this crisis, they have exposed and amplified long-standing vulnerabilities, threatening progress towards universal health coverage and risking hard-won gains.
But in this crisis also lies an opportunity – an opportunity to leave behind the era of aid dependency, and embrace a new era of sovereignty, self-reliance, and solidarity.
Many African leaders have told me they are ready to make that transition.
The Africa Leadership Meeting, launched in Addis Ababa 6 years ago, by the African Union and Rwanda, under the leadership of President Kagame, is today more important than ever.
This political and technical leadership are key in assisting and empowering countries to steadily increase domestic investment in health.
Importantly, it also sets out the data mechanisms for countries to hold each other accountable for their commitments.
The initiative of the AU, with Rwanda’s leadership, has now been complemented and reinforced by other initiatives undertaken this year.
In May, the World Health Assembly adopted a landmark resolution led by Nigeria and co-sponsored by over 25 countries – including Ghana, South Africa, Senegal and Zambia – calling for more domestic investment and deeper governance reform.
I commend Nigeria and the co-sponsoring Member States for their leadership in advancing this resolution, which reflects the Lusaka Agenda and the principles of “one plan, one budget, one report.”
In August, I was honoured to join His Excellency President Mahama in Accra for the Africa Health Sovereignty Summit, which gave birth to the Accra RESET.
WHO is now working with governments and partners in Africa to mobilize domestic resources and improve value for money in several ways:
In the short-term, we’re supporting countries to develop affordable essential health benefit packages;
To introduce or increase health taxes on tobacco, alcohol and sugary drinks;
Through pooled procurement and investment in domestic manufacturing;
By integrating donor-funded vertical programmes into government-led systems based on primary health care;
And through better budget execution using digital financial management systems.
In the longer term, countries can strengthen risk-sharing mechanisms to improve financial protection, including through publicly-financed health insurance.
To guide these reforms, WHO is today issuing important new guidance on how countries can implement immediate measures and longer-term shifts.
This new guidance is based on the best evidence of what works, and the experience of Member States.
It provides practical actions and analytics for countries to protect access to essential services in the short term;
With recommendations for making the shift toward more sustainable, domestically-financed and self-reliant health systems for the future.
The guidance emphasizes the need for coordinated, system-wide responses through close collaboration between ministries of health, finance, and development.
This is also an area of work WHO is taking forward through our partnership with the World Bank in the context of the new UHC Hub, which we look forward to launching at the UHC Forum in Tokyo later this year.
The UHC Hub will support capacity building, political commitment, and better data for decision-making.
Excellencies, let me close with three asks for countries:
First, to act rapidly to protect access to essential services, especially for the most vulnerable.
Second, to make health a political and fiscal priority in national budgets.
And third, to remember that health spending is not a cost to be contained, but an investment to be nurtured in social stability, economic resilience, and productivity.
Thank you all once again for your commitment to meeting the crisis we face, and to seizing the opportunity it presents – the opportunity to build a healthier, safer, fairer future for the people of Africa, and the whole world.
I thank you.