Lomé, Togo, 11 September 2026 (ECA) – The United Nations Economic Commission for Africa (ECA) and the Government of Togo have taken forward discussions on sustainable health financing, as ECA begins translating its continental Sustainable Health Financing Initiative into country-level action.
The engagement follows the launch of the initiative in Tangier, Morocco, in April 2026 and is anchored in a central proposition: health should be considered not only as a social expenditure, but as an investment in people, human capital, productivity and economic resilience.
Togo provides an important starting point for this work. The country has already made progress towards universal health coverage and is progressively extending health protection across different segments of its population. The next challenge is ensuring that this progress can be sustained while responding to the different economic realities of Togolese households.
During the mission, ECA engaged with institutions responsible for health, finance and economic policy to examine the opportunities and challenges associated with financing universal health coverage sustainably.
Discussions with the Ministry of Health highlighted Togo's progressive approach to extending coverage. While salaried workers have regular and traceable incomes from which contributions can more readily be collected, expanding protection to informal, agricultural and self-employed workers requires mechanisms adapted to incomes that may be irregular or seasonal.
Ensuring protection for vulnerable populations who may be unable to contribute themselves adds another dimension to the financing challenge.
These realities underscore why universal health coverage is not solely a health-sector issue. Financing choices have implications for household income and financial protection, public expenditure and the wider economy.
Discussions with the Office of the President and the Ministry of Finance and Budget therefore focused on strengthening the connection between health and economic policymaking, including domestic resource mobilisation, fiscal space, expenditure efficiency, innovative financing and the role of reliable data in informing investment decisions.
For ECA, the objective is to help countries move beyond the question of how much health costs towards a broader understanding of what investment in health makes possible.
A healthier population is better able to learn, work, produce and contribute to economic activity. At the same time, stronger financial protection can reduce the economic vulnerability experienced by households when illness occurs.
From narrative change to evidence
The Togo engagement also highlighted the importance of changing the health-financing narrative at different levels.
For policymakers, this means strengthening recognition of health as an investment in human capital and economic development and bringing health considerations more firmly into fiscal and development planning.
For citizens, sustainable health protection also depends on greater awareness and trust in insurance and risk-pooling mechanisms, particularly among workers whose contributions are not automatically deducted from regular salaries. This means strengthening understanding of health protection as an investment made before illness occurs, rather than only a cost incurred when care is needed.
ECA and national counterparts will now build on the mission by deepening the analytical work needed to support these conversations. This includes examining how health-financing choices interact with household welfare, public finances and wider economic activity, while strengthening the evidence available to policymakers.
The approach is intended to complement reforms already underway in Togo and support nationally determined priorities rather than introduce a predetermined financing model.
From Tangier to country action
As the first country-level engagement following Tangier, the lomé mission provides an opportunity to test how the Sustainable Health Financing Initiative can translate a continental proposition into practical country-level analysis and action.
The next phase will focus on continued technical engagement with national institutions, strengthening the evidence base and examining sustainable financing options that can support Togo's universal health coverage ambitions.
Lessons from Togo will also help inform ECA's engagement with other African countries as the initiative expands.
Ultimately, the proposition behind the initiative is straightforward: an economy is built by its people. Protecting their health strengthens their ability to learn, work and produce. Investing in health is therefore also an investment in economic resilience and Africa's future.
Issued by:
Communications Section
Economic Commission for Africa
PO Box 3001
Addis Ababa
Ethiopia
Tel: +251 11 551 5826
E-mail: eca-info@un.org