Anchor on Responsibility and Accountability: Reclaiming Africa’s Health Sovereignty through Equity, Foresight, and Internal Investment
Luchuo Engelbert Bain, MD, PhD.
Africa’s global health reform discourse is at a crossroads. We are taking global health reform more seriously than many of our northern partners—an irony that exposes the very inequities we seek to dismantle. The time for rhetorical lamentation is over. We know the problems, and we know the solutions. We cannot pretend we were unaware of the decline in Official Development Assistance (ODA), yet we remained reactive rather than proactive, trapped in wishful thinking.
Responsibility, accountability, and equity must now anchor Africa’s approach to health diplomacy and development. Our collective future depends on building learning health systems grounded in South–South collaboration, where African institutions exchange expertise, strengthen capacity, and learn from one another—without waiting for permission to innovate.
True sovereignty begins with funding from the inside out: financing national health systems, transforming them into learning systems from within, investing in research, and strengthening Africa CDC as the continental hub of accountability and coordination. We cannot afford to replicate donor-dependent structures. Instead, we must fund excellence, demand transparency, and hold ourselves and our institutions to the highest standards.
“Global health reforms alone are secondary, change will come through budgets, laws, and who signs the cheques.”
Africa’s diplomacy must project confidence: our scientists, public health experts, and innovators have earned global recognition through results, not validation. From COVID-19—where the predicted continental apocalypse never came—to effective responses to outbreaks such as Marburg in Rwanda, evidence shows Africa is mature enough to lead in global public health innovation. There is no justification for holding ourselves back. Take responsibility, fund the work, and build robust accountability mechanisms to track progress.
“Africa does not lack expertise; it lacks the courage to trust and fund its own experts.”
The continent’s challenge now is not capability—it is courage. The homework is ours to do, the responsibility ours to bear. The era of dependency must end. The time for action is now: walk the talk, fund the future, and lead unapologetically.
