With donor funding for health programs in Africa continuing to shrink, experts are calling for the need for urgent, innovative reforms in healthcare financing and delivery across the continent.
Speaking at the plenary session titled ‘optimising domestic financing for development in Africa’ attended by policymakers, health economists, and civil society leaders, Dr Daniel Mwai, Presidential Advisor on Health Financing in Kenya, pointed to the fragmentation of services and vertical health programmes as key barriers to efficient health financing.
“We can cut the cost of healthcare in Africa by 40percent if we reorganise and plan well in its delivery,” Dr Mwai said.
The experts were speaking at the second day of the Evidence for Development (Evi4Dev) Conference in Nairobi.
He called for integration of vertical health programs and multi-skilled healthcare workers urging countries to focus on preventive healthcare as compared to curative healthcare.
Dr Jackson Otieno, Senior Policy Analyst at the African Institute for Development Policy (AFIDEP), painted a sobering picture of Africa’s fiscal landscape. He highlighted multiple challenges such as climate change, shrinking external aid, growing debt burdens, and global economic uncertainty. Otieno noted that in 2020, Development Assistance for Health (DAH) accounted for more than 20percent of health spending in 24 African countries and even surpassed government expenditure in 10 countries.
“African countries should transition from donor dependency to domestic resource mobilisation,” Dr Otieno said.
Otieno proposed innovative domestic health financing options such as health taxes, and robust anti-corruption measures that could unlock 5–10 Percent in savings.
He also highlighted the need for expanding health insurance coverage, integrating technologies like AI to minimise waste, and strengthening financial oversight.
Professor Victor Murinde, Executive Director African Economic Research Consortium said that African government’s need to unlock the potential of new technology by adopting artificial intelligence, big data and machine learning to reduce inefficiencies.
“We can use artificial intelligence and machine learning in asset management, monetary policy and economic forecasting big data,” he said adding “that central banks use big data and artificial intelligence to analyse vast amounts of data for decision making and forecasting.”
Kwame Owino, CEO of the Institute of Economic Affairs (IEA-Kenya), emphasised the need for fiscal discipline and efficient resource utilisation in Africa’s healthcare systems.
“Citizens across East Africa are reaching their limits, the protests last year in Kenya were a clear sign. We must get the most from the taxes by prioritising high-impact public goods and reducing wastage through corruption. Governments must spend conservatively in areas with the greatest public demand.”
Dr. Patrick Zimpita, Principal Secretary for Economic Planning and Development in Malawi, called for budget reform transformation saying that rising debt and dwindling donor funding requires financial accountability.
“There is a need for budget reforms to optimise available resources for service delivery as most African governments spend 70percent of their budgets in recurrent expenditures while 30percent on development of which from the 30percent of the development expenditure is coming from donor funding,” Dr. Zimpita said.
The experts called for homegrown solutions, stronger stakeholder engagement, and strategic investments in health-focused technology and financing models. As countries face pressure to deliver quality healthcare amid shrinking budgets, experts agreed that bold reforms, partnerships, and innovation should take centre stage.
The conference is co-convened through a strategic partnership between AUDA-NEPAD, AFIDEP, and SFA Foundation, along with leading institutions in the science, data, research, and innovations space in Africa and beyond.
