Smarter Health Financing for Self-Reliance and Resilience Across the African Continent​

Leveraging Data for High-Impact Health Security Investment ¹

The COVID-19 pandemic caused a significant slowdown in economic growth across Africa and triggered widespread debt distress, leaving many countries struggling to recover. Growth is expected to remain sluggish for several years, contributing to significant reductions in health spending. Official development assistance (ODA) has dropped 70 percent since 2021, even as disease outbreaks have surged by more than 40 percent between 2022 and 2024. These trends place overwhelming strain on health systems across the continent.

The combination of economic slowdown and reductions in ODA is unfolding in a time of increasing​​ biological threats. Climate change disproportionately impacts African countries, driving a surge in infectious disease outbreaks across the continent. At the same time, rapid technological advances are lowering barriers to the misuse of biology. Yet many countries in the region lack the necessary data and core capacities to keep their populations and economies safe from emerging health crises.

A Call to Action

In April 2025, Africa CDC launched a continent-wide health financing strategy to strengthen resilience and drive sustainable investment in health security. Complementing this effort, the Pandemic Fund and the High-Level Independent Panel on Financing the Global Commons for Pandemic Preparedness have called for more coordinated, data-driven approaches to identify existing gaps and prioritize resources.

The imperative is clear: African countries must continue leading​ ​and shaping their health financing agenda, ensuring that investments are guided by robust data and meaningful metrics. This message resonated strongly at the 2025 International Conference on Public Health in Africa (CPHIA 2025) where Africa’s health sovereignty was framed as a critical foundation for economic transformation and regional security. The Durban Promise (launched at CPHIA 2025) sets forth a roadmap for African self-reliance, sustainability, and leadership in global health. Innovative health financing, pandemic preparedness and response, and data ownership and governance are among the catalytic priorities that emerged as key pillars for advancing Africa’s health sovereignty.

The G20 High Level Independent Panel on Pandemic Financing also recommends in its November 2025 report that governments present clear pandemic preparedness and response plans. Such plans should be funded through domestic and international financing, in alignment with gaps highlighted through transparent assessments (including the Global Health Security Index).

Guiding Smarter Health Security Investments

On the occasion of the World Bank–IMF Annual Meetings in October 2025, NTI, the Brown University Pandemic Center, Economist Impact, and the Science for Africa Foundation convened senior leaders and experts in health, finance, and development to explore how governments, multilateral development banks, and other investors can deploy data tools like the forthcoming Africa Health Security (AHS) Index to guide health security investments. The AHS Index—like the Global Health Security (GHS) Index from which the data framework was derived—will help to identify critical health security gaps and guide investments across sectors to build resilience against emerging threats.

The Importance of Data

Experts in this roundtable noted that using the right data is essential for guiding strategic decisions and ensuring effective health security financing. Having a clearer understanding of where the greatest risks and demands are can show where investments can have the most impact and how to measure success. Without this information and strategic investments to match—hard-won gains over the past three decades on morbidity and mortality, maternal and child health, disease prevention, and health security are at serious risk. The data also need to be specific and tailored for action, including measuring the value of impact so that it can be used for domestic resource mobilization and smarter, more aligned policy goals and donor engagement.

African countries, like many countries around the world, face a range of systemic and structural challenges that hinder their ability to scale up investments in essential health security capacities like surveillance, workforce development, and laboratory infrastructure. These include, but are not limited to:

• Fragmented and vertical data systems that do not communicate across sectors. This hinders both interoperability and higher-level decision-making.
• Poor​, under-utilized​ ​to no ​digital infrastructure, particularly in rural areas, limits access to real-time data and tools.
• For all countries, not just those on the African continent, insufficient political will² and regulatory frameworks can delay mobilization during outbreaks.
• Difficulty in demonstrating return-on-investment (ROI) for public health spending weakens the case to policymakers for sustained funding.

Even so, policy makers, donors, and investors have several existing tools they can use to align funding with needs:

• The GHS Index for assessing preparedness and identifying gaps.
• The World Health Organization’s Joint External Evaluation (JEE) for standardized benchmarking of national capacities.
• Pandemic spending trackers for monitoring investments and improving accountability.
• Localized and community-specific data for supporting targeted investments and ensuring relevance.
• The ONE Data Agent for accessing millions of health financing data points, powered by AI.

Roundtable participants also highlighted additional forthcoming tools and resources that their organizations are developing. They further noted that underutilization of existing tools leaves missed opportunities to identify existing capacity gaps before biological threats emerge.

Participants acknowledged that the prevalence of vertical, non-interoperable data systems places a heavy burden on the health workforce and limits the effectiveness of decision-making. Artificial intelligence (AI) offers promise—particularly in harmonizing fragmented data and enabling culturally sensitive tracking—and it has quickly moved from serving as merely a tool to becoming part of the infrastructure of data creation, analysis, and application​​. It must be integrated strategically, and foundational connectivity is essential for its success.

Driving more Equitable Health Finance Access

The AHS Index and other tools support decision-makers across multiple levels:

• Policymakers can use the GHS and AHS Indexes to identify gaps in policy or resource provision; justify budget allocations for health security prevention, preparedness, and response activities; and track progress over time.
• Investors benefit from a standardized framework to compare country-level needs and guide high-impact investments.
• International organizations can use the indexes and other tools for regional benchmarking, coordination, and policy advocacy.

The data needs of these stakeholder groups differ significantly:

• Policy makers require localized, actionable data that tie​ ​health outcomes to political and economic priorities.
• Investors need aggregated, comparative data to assess where their funds will be most effective.
• International organizations seek harmonized, cross-country data to guide regional and global strategies.

Participants suggested that new or improved metrics in health financing, system resilience, and governance and impact would be helpful to track progress and return on investments. These metrics provide a comprehensive framework for evaluating progress and guiding future investments in health systems in African countries.

Conclusions

Roundtable participants emphasized several key themes and offered actionable recommendations to guide future efforts. 

Advance Health Sovereignty through Harmonized Finance Frameworks
African countries must lead their health financing agendas. Data play a key role in advocacy for domestic resource mobilization. Donors and investors should be engaged in coordinated planning under one national plan and budget.

Use Data to Mobilize Smarter, More Aligned Financing
A strategic approach to funding health security across the African continent must prioritize the efficient, equitable use of resources in alignment with national priorities. To achieve this, decision-makers should emphasize the role of data in guiding investments—ensuring coordination, such as by using pooled procurement mechanisms, could maximize value-for-money and return on investment. Leveraging data effectively enables smarter, more targeted interventions that reflect country-specific needs and strengthen long-term health system resilience.

Design Solutions that Fit Countries and Circumstances
Data alone are insufficient without political will​​ and capacity to act. Governments and advocates must translate data into clear, policy-relevant language that resonates with decision-makers to build political will and governance capacity.³ Governments should also include biosecurity and epidemic preparedness in their mid- and long-term budgets to ensure sustained investment and readiness.

Strengthen Data Systems and Integration to Advance Interoperability 
Vertical, siloed, and non-interoperable data systems can hinder the identification and implementation of effective health security capacities. To address this, investments in interoperable data platforms and connectivity that enable communication across sectors and borders could improve coordination. AI can play a valuable role in harmonizing fragmented data sets, but success depends on strong foundational infrastructure. Furthermore, establishing national pandemic spending trackers can strengthen transparency and accountability by monitoring and evaluating health security investments.

Looking Ahead: the 2026 Africa Health Security Index 

This is a transformative moment for global health and health security, where country leadership and sovereignty are critical, and data are key. Country-driven leadership does not preclude regional cooperation—it is critical to that collaboration.

The 2026 AHS Index compiles open-source data for 54 African countries for 190 indicators across six key categories—capabilities to prevent, detect, and respond to epidemics and pandemics, and the status of the health system, compliance with international norms, and the risk environment. The AHS Index builds on the GHS Index framework but will also include a focused analysis of African priorities:

• Preventing accidental and deliberate biological events (biosafety and biosecurity)
• Detecting and reporting emerging outbreaks (biosurveillance)
• Bolstering medical countermeasure development and deployment
• Assessing how climate change affects health security on the African continent and in subregions
• Evaluating how the African continent’s five regions have built regional capacities to augment national health security infrastructure

The AHS Index will help address the challenge of siloed data by consolidating data from different countries and subject domains into a single resource. This consolidation permits more integrated and country-driven decision-making and supports sustainable political accountability to incentivize governments to invest in pandemic preparedness capacity within their borders.

This paper was developed by NTI | bio, in partnership with the Brown University Pandemic Center, Economist Impact, and the Science for Africa Foundation.

This analysis was informed by a consultative meeting that included the following thought leaders and experts. It does not necessarily reflect the views of their institutions or consensus view on all points by all participants.