Civil society organizations (CSOs) from across Africa have called on national governments to urgently increase domestic investment in health, amid shifting patterns in foreign aid and development assistance. In a forum on 30th April, 2025, themed “Charting a Pathway for Sustainable Financing of Africa’s Resilience”, the call was loud and clear: Africa must move from donor dependence to self-reliance in safeguarding public health.

The convention brought together key players, including Resilience Action Network Africa (RANA), AIDS Healthcare Foundation (AHF) Kenya, Pandemic Action Network (PAN), and representatives from trade unions, feminist movements, climate advocates, and development partners.

They were involved in discussions that reflected a growing concern over declining international funding and its impact on vulnerable populations across the continent.

Article 43 of Kenya’s Constitution affirms that health is a fundamental right for all. Yet, the lived reality for millions tells a different story. Access to basic health services remains out of reach for many, and the situation has worsened following the suspension of thousands of USAID-funded programs targeting diseases such as malaria, TB, and HIV. European governments have also gradually reduced aid to low- and middle-income countries (LMIC), including Kenya.

These geopolitical and economic difficulties amidst the changes have direct consequences that trickle down to the community level.

Margaret Wavinya, a TB survivor and community health volunteer, gave a powerful testimony during the session, revealing the tribulations that thousands might be facing silently.

“When PEPFAR funding was halted, it became a matter of life or death. I didn’t vote in the U.S.; I voted in Kenya. Our government must protect our right to health,” said Wavinya.

Speakers at the forum displayed insightful presentations with a call that emphasized the need for a paradigm shift in how African countries approach healthcare. The Civil Society Organizations’ representatives pointed out a need for an approach that meets citizens on the side of health instead of focusing on healthcare in a curative manner.

Dr. Gitahi Githinji, CEO of AMREF, noted that most systems remain reactive, focusing on treating illness rather than preventing it. “We should not wait for people to fall sick. We must promote and protect good health from the start,” he said.

Currently, domestic resources finance roughly 40% of health services, donors contribute around 20%, and households cover the remainder. Despite this, sectors like HIV, TB, and malaria remain heavily donor-dependent, limiting African nations’ ability to determine their health priorities and policies independently.

Dr. Aggrey Aluso, Executive Director of RANA, underlined that while donor funding has played a role in supporting health systems, African countries must begin to meet their obligations. “Donors cannot carry the full burden. Our governments must allocate at least 15% of their national budgets to health, as pledged in the Abuja Declaration,” he stated.

Civil society organizations issued several key recommendations. First, they called for stronger transparency and accountability in how public funds are managed. Citizens must be involved in budgeting and oversight processes.

Secondly, they urged governments to renegotiate national debts, especially given that some countries, including Kenya, now spend more on debt servicing than on health.

The discussion also touched on the urgent need to link health financing with broader development goals. With Africa’s large and youthful population, strategic investment in health could unlock a demographic dividend and boost economic resilience. However, such outcomes require governments to treat health spending not as a cost, but as a long-term investment.

Climate change was also highlighted as a compounding factor for the increase in climate-sensitive diseases, with Africa recording over 300 disease outbreaks. Africa is facing a 63% rise in zoonotic outbreaks, diseases that jump from animals to humans, driven by environmental degradation.

However, despite these revelations, less than 0.5% of global climate adaptation financing currently supports health. As such, the participants stressed that this share has to rise to at least 15%, aligning health and climate resilience efforts.

Dr. Aggrey revealed that with the continent facing extreme weather shifts that are unpredictable, there is an apparent rise in outbreaks of diseases related to the environment. “The outbreaks of cholera, recurring dengue fever, and Influenza A are some of the climate-sensitive diseases that will continue occurring unless proactive, preventive action is taken,” he said.

Development partners were urged to rethink how aid is structured. Instead of narrowly focused, short-term projects, investments should strengthen entire systems and build local capacity. Aid should reinforce, not replace, domestic accountability and ownership.

An emphasis on the same came from Mr Harry Olal from the Social Justice Movement, was a reflection of the priorities in government during allocation of the budget. He points out that some dockets should not be prioritized above a basic need and right, which is health care for the citizens.

Evelyne Kibichu, Coordinator of the TB Caucus in Kenya and Africa, advocated for dialogue between finance committees and CSOs during loan arrangements to engage meaningfully about the key priorities and highlight key gaps faced at the community level that need to be addressed.

“We need to sensitize communities more as we bring media past engaging with CSOs only and venturing further to taking the local communities members voices on some of the kjey issues affecting them in their surrounding,” said Evelyne.

As foreign aid becomes less predictable, civil society emphasized that Africa must take charge of its development narrative. “There’s always talk about Africa, but rarely a unified voice from Africa,” one participant noted. “Now is the time for our governments to step up, for partners to act in true solidarity, and for citizens to hold leaders accountable.”

The message from the Civil Society Organizations in the Nairobi forum is both a challenge and a rallying cry: Africa’s resilience must be built from within by investing in its greatest asset, its people.