In Africa, every dollar spent on health can mean the difference between life and death. That’s why it is critical to invest wisely and strategically, rather than reactively. In 2024, as countries recover from the COVID-19 pandemic and face new public health threats, African leaders and global partners must revisit the question: Are we investing in the right priorities?

Lesson from the Pandemic: Prevention as the First Line of Defense 🧼📉🧬

One of the clearest lessons from the COVID-19 pandemic is that when there is no immediate cure or treatment, prevention saves lives. Preventive practices such as handwashing with soap, physical distancing, clean water access, regular cleaning of public spaces, mask wearing, and targeted health education have proven effective not just in COVID-19, but in reducing transmission of other infectious diseases like cholera, influenza, and Ebola【1】.

According to a WHO study in 2023, countries that implemented community hygiene programs and behavioral interventions early in the pandemic experienced up to 40% fewer infections than those that relied mainly on pharmaceutical responses【2】. Moreover, the cost of preventive hygiene interventions per capita is estimated at under $5 annually, compared to the $40–$100 cost of managing a single case of COVID-19 in clinical settings【2】.

Yet, these basic but powerful approaches receive only a fraction of the funding that goes to high-tech solutions.

Dr. Jean Kaseya, Director General of Africa CDC, recently emphasized: “Africa needs to increase its health spending to at least 5% of GDP, not just for emergencies, but to build resilient systems capable of protecting public health year-round”【3】.

Current Spending Trends: Too Much on Vaccines, Too Little on Systems 💉💸🔬

Despite Africa Center of Diseases Control (Africa CDC) push to grow health budgets, much of the recent funding is still funneled into emergency responses, particularly vaccination campaigns for diseases like COVID-19 and MPOX. In 2023 alone, over $1.7 billion was allocated through COVAX and bilateral initiatives for COVID-19 vaccines in Africa【4】. By comparison, investments in national WASH (Water, Sanitation, and Hygiene) programs were under $250 million across 25 countries during the same period【7】.

Vaccines are undoubtedly important—but they should not overshadow system-wide investments in diagnostics, hygiene, and disease surveillance.

Vaccines alone are not a scalable public health solution in low-resource settings. As novel viruses emerge, the cost and logistics of developing, purchasing, and delivering a vaccine for every possible threat becomes unsustainable.

Moreover, relying on external suppliers and public aid to maintain immunization programs places African countries in a vulnerable and unpredictable position【4】.

Diagnostics and Hygiene: Strategic Long-Term Investments 🧪🧼📊

Building up diagnostic capacity is a long-term investment with broad returns. Tools such as rapid antigen tests, point-of-care diagnostics, and mobile labs allow health systems to monitor both healthy and sick populations, across seasonal, epidemic, and chronic disease contexts【5】. A 2022 analysis by the African Society for Laboratory Medicine found that countries with decentralized diagnostic systems were able to detect outbreaks 30% faster and reduce case fatality rates by up to 25%【6】.

Investing in diagnostic systems costs approximately $3–$10 per capita annually, far less than the estimated $25–$40 per capita cost of emergency response interventions during major outbreaks【6】.

Meanwhile, investments in public hygiene infrastructure—from sanitation and water systems to infection prevention in healthcare facilities—have been shown to reduce the burden of communicable diseases by up to 60% in rural communities【7】. According to UNICEF, every $1 invested in WASH systems yields $4–$7 in economic return, through avoided healthcare costs and improved productivity【7】.

These interventions are affordable, locally scalable, and culturally adaptable, making them ideal targets for health spending.

The Vaccine Dilemma: A Question of Scale and Strategy 💉📉🧭

Vaccines remain a crucial tool in public health—but they should not be viewed as the default response to every health crisis. Africa’s dependency on external vaccine donations during COVID-19 exposed deep inequalities in global health access.

Although initiatives to build local vaccine manufacturing are welcome, there is still a need to prioritize which vaccines are necessary and cost-effective. For instance, building a full-cycle mRNA vaccine facility can cost between $50 million and $100 million, and operational costs can quickly outpace national health budgets without guaranteed long-term procurement plans【8】.

Diseases like MPOX and COVID-19, while urgent during their peaks, may not constitute Africa’s top long-term public health concerns compared to endemic conditions like malaria, Tuberculosis, diarrheal diseases, or maternal health【8】.

As Dr. Ayoade Alakija, African Vaccine Delivery Alliance co-chair, stated in 2023: “We cannot outsource our health future. We must build systems that prioritize prevention, equity, and sustainability”【9】.

From Crisis Management to System Strengthening 🛠️🌱📈

Africa’s health systems should not be built on a crisis-to-crisis model. Instead of funneling limited resources into reactive strategies, African countries must shift toward evidence-based, preventive, and system-wide investments. That means prioritizing hygiene, diagnostics, and targeted R&D, while making smarter, selective use of vaccines.

Health spending is not just an expense—it’s an investment in people, productivity, and the continent’s future. Let’s make sure it counts. 🌍

Sources 📚🔍📝

1. WHO - Community-Based Preventive Strategies for Infectious Diseases (2023)

2. Global Health Security Index – Comparative Impact of Preventive vs. Pharmaceutical Interventions (2023)

3. Africa CDC – Statement by Dr. Jean Kaseya, African Union Summit (2024)

4. Gavi, the Vaccine Alliance – COVID-19 Lessons Learned Report (2023)

5. African Society for Laboratory Medicine – Policy Brief on Diagnostics in Africa (2022)

6. McKinsey & Company – Diagnostic Infrastructure and Early Warning Systems (2022)

7. UNICEF – WASH and Health Outcomes in Sub-Saharan Africa (2021)

8. WHO – Global Health Estimates by Disease Burden (2023)

9. Alakija, Ayoade – Public Health Leadership Forum Keynote (2023)

Missing Data ❓📉🔬

• National breakdown of health budgets: % spent on prevention vs. emergency response

• Cost-effectiveness comparisons of hygiene vs. vaccine interventions

• Current investments in public health diagnostics by country

• Long-term impact data of WASH programs on epidemic resilience

• Evaluation of local vaccine manufacturing projects and their scalability