It has been almost two months since the AU hosted its 36th Annual Summit. This post will share some public health highlights from the Summit.
The 36th African Union (AU) Summit was held from January 16th, 2023, to February 19th, 2023. The Summit is an annual event bringing together the Permanent Representative Committees, The Executive Council, and the Heads of State of African Union (AU) Member States. This year’s summit focussed on institutional reforms, drafting legal instruments, and the appointment of the Director General of Africa CDC. The Heads of States convening was held on February 19th, 2023 at the African Union Headquarters in Addis Ababa, Ethiopia. This year’s theme was “The Year of AfCFTA: Acceleration of the African Continental Free Trade Area Implementation.” The idea of one African market to enable the continent to compete economically with other trade areas has been discussed over 60 years ago in Dr. Kwame Nkrumah's Book Africa Must Unite.
The aim of this theme was to generate more political support and commitment to trade as a developmental agenda for the continent. Several articles have been written on how AfCFTA can help improve health on the continent, which are listed below. It definitely is time for action to be taken to implement this agreement so our continent can witness the benefits, but this is going to take political will, transportation networks, and investments amongst other factors. Utilizing the regional networks can help to establish a free trade area as achieving continental-wide unity can be challenging. It is also going to take time to implement this agreement and as Idris Elba told us African governments are slow so we have to be patient.
At the Summit, there were several discussions that focused more specifically on health topics. These included the operationalisation of Africa CDC, progress on the establishment of the African Medicines Agency (AMA), and the implementation of the roadmap of the AU on the 2022 theme of Nutrition. The Africa CDC is an autonomous organization of the AU and the platform to convene all AU members on health security issues. AMA is a specialized AU entity that has the objective to enhance Member States' ability to regulate medical products by providing a continental-wide quality assurance to improve their quality and access. If implemented properly this can ensure the safety of medical products on the continent, and also standardize products facilitating continental-wide supply chains. The implementation of the AU roadmap on the 2022 theme of Nutrition is important as according to the British Red Cross 146 million people on the continent are growing hungry and this is largely due to droughts in East Africa and as well as the conflict in Ukraine which is a major grain exporter, and the surge in food prices. External factors impact food access on the continent as in 2015, the net food import bill for the continent was $35 billion and this is expected to grow to $110 billion in 2025.
"There is absolutely no reason why Africa is a net food-importing region, spending over $35 billion importing food. Africa must feed itself – and Africa must become a global powerhouse in food and agriculture." AfDB President, Akinwumi Adesina
During the COVID-19 pandemic, we have all witnessed the countless ways the African continent has been excluded from needed equipment, vaccines, and other medical products. With these occurrences, the Africa CDC launched Africa's New Public Health Order officially on September 21, 2022, as a side event at the 77th Session of the United Nations General Assembly. Dr. John Nkengasong paved the way for the establishment of the 'New Public Health Order.' Following this, there have been growing calls to establish this New Public Health Order focusing on these 5 areas:
Strengthening African Institutions for Public Health
Strengthening Public Health Workforce
Expanding Local Manufacturing of Health Products
Increasing Domestic Investment in Health
Promoting Action-Oriented and Respectful Partnership
The Summit also saw the appointment of the new Director General of the Africa CDC, Dr. Jean Kaseya. Prior to this selection, there were discussions on the importance of selecting a woman leader as this could lead to gender-transformative leadership that could bring a diversity of perspectives to Africa CDC. As well, there is another article discussing some of the main priorities for the new director general. While there currently is not a woman leader, gender-transformative leadership and bringing a diversity of perspectives to the decision-making table are still needed to ensure substantive improvements to health systems on the continent.
The Africa CDC and African Union also launched the ministerial forum for Ministers of Health
on the continent. This included the Ministers of Health from Sierra Leone, Tunisia, and Uganda. See below for the full session.
Some of the side events that were health-related are below.
New commitments to end AIDS: African Leaders adopted a declaration to boost progress toward ending the AIDS epidemic. This is a timely action taken as this is the first time in over two decades that progress towards ending the AIDS epidemic has halted which is partly due to the redistribution of funds to the COVID-19 pandemic.
Closing Gender Gap: The Commissioner for Health, Humanitarian Affairs, and Social Development, Her Excellency Ambassador Minata Samate Cessouma reaffirmed the AU's commitment to promoting women's and girls' empowerment. The First Lady of Namibia who is also the President of the Organisation of African First Ladies for Development (OAFLAD), Her Excellency Madam Monica Geingos recommitted to closing the gender gap. OAFLAD works closely with women and children to advocate for policy and social change.
Building Momentum For Routine Immunisation Recovery in Africa: This event was chaired by His Excellency President Dr. Julius Maada Bio, the President of Sierra Leone. This event encouraged continued progress for vaccinations while highlighting the return on investments for countries for immunization initiatives. There was also a call to integrate national immunization campaigns into service delivery programs.
At the Summit, Africa CDC also launched a press release urging all member states to seek Expressions of Interest for the Pandemic Fund and noted that it will not participate in the first call as it waits for its request to be an implementing entity. As Africa's institution to coordinate and manage public health emergencies, it should be given an acting voice in the Pandemic Fund and not just be a passive observer.
The Summit also called for reforms to the global financial system. As I write this post, it is the International Monetary Fund and World Bank spring meetings so we will see in the coming months which action is taken to reform these institutions. According to the Mo Ibrahim Foundation, many African countries spend a lot of government revenues on debt servicing and, over half of the African Union Member states spend more repaying public debt than healthcare. This continues the debt cycle as countries need to continue borrowing money to fund health and development projects. There is continued dependence on international organizations/donors, limiting African agency in our health systems.
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The AU Summit concluded with a Press Release urging Member States to "double the spirit of Pan-Africanism, Solidarity and Brotherhood by accelerating the operationalization of the AfCFTA." The spirit of inclusivity and an intersectional approach also needs to be considered. An inclusive approach, especially at the high-level needs to occur so we can bring various voices to the table see some transformative policies implemented. While it is great that all these discussions and commitments have been made which are applauded, there also needs to be accountability if commitments are not met. I am concluding with the title of a UNDP Africa article reflecting on the Summit as this summarizes my thoughts.
Selection of Articles on AfCFTA and Health Systems
COVID-19 in Africa: Supply chain disruptions and the role of the Africa Continental Free Trade Agreement, by Jonta Kamara and Ukeme Essien (2022)
The AfCFTA agreement should be radical in prioritizing Africa’s health by Ebele Mogo (2021)
This is how an African free trade area could impact people's health by Walter Ochieng (2019)
Potential Health Impact of the African Continental Free Trade Area Agreement by Abiodun Awosusi (2019)