Africa’s health financing model remains structurally fragile. Governments finance less than 41 per cent of total health expenditure on average, while out-of-pocket payments push over 150 million people into poverty annually. Rising debt distress and declining concessional flows are further compressing already limited fiscal space.

This configuration is unsustainable against the backdrop of demographic expansion, epidemio­logical transition, and climate vulnerability. Health financing must be repositioned from a residual social expenditure into a macroeconomic stabili­zation and growth instrument, embedded in fiscal frameworks, public financial management systems, and regional integration strategies.

ECA’s initiative — “Transforming Health Financing in Africa” — proposes a systemic architecture built on seven interlinked outcomes combining fiscal embedding, innovative instruments, digital gover­nance, primary health care modernization, regional public goods, institutional capacity, and narrative transformation across 25 countries over 5 years (2026–2030).

Read the Special Health Financing Bulletin

The High-Level Forum is conceived not as a tech­nical symposium but as a catalytic political plat­form and the formal launch of the ECA initiative. It is designed to:

• Formally launch the initiative and secure anchor commitments from early-adopter partners.
• Align Ministries of Finance and Health around a shared macroeconomic framing of health investment.
• Engage development banks, bilateral donors, institutional investors, and health partners on structured financing pathways.
• Advance regional integration through the AfCFTA as a health financing multiplier.
• Initiate a concrete resource mobilization process toward the project’s US$100 million financing requirement.

High-Level Forum Resources:

• Concept Note
• Programme

In Pictures: High-Level Forum and Launch of the Health Financing

• https://www.uneca.org/eca-events/albums/com2026-high-level-side-event-health-sovereign-investment
• https://www.uneca.org/eca-events/albums/com2026-high-level-side-event-health-sovereign-investment-continued