Cape Verde Stands Out as an Example in Health Financing in Africa, but Challenges Remain

KIGALI, Rwanda - During the Sixth Africa Health Agenda International Congress (AHAIC), held in Kigali, delegates discussed the challenges of providing healthcare in Africa with limited resources, such as the $40 per capita available to African health ministers, compared to $4,000 in many high-income countries. Cape Verde has emerged as a notable example on the continent, being one of only two countries - alongside South Africa - to fulfill the commitment of the 2001 Abuja Declaration, which states that 15% of the national budget should be allocated to health.

Aminata Wurie, project manager at Resilience Action Network Africa (RANA), pointed out during the congress that, despite efforts, only one of the 55 African countries allocated more than 5% of GDP to health this year, highlighting a significant gap in domestic funding. "Cape Verde is a model to be followed, but even with this progress, $40 per person is not enough to guarantee universal healthcare," said Wurie.

The CEO of Amref Health Group, Dr. Githinji Gitahi, emphasized the need to prioritize prevention over treatment as a short-term solution to managing these scarce resources. "The foundation of health is clean water, sanitation, access to nutritious food and immunization. If we prioritize these areas, we will drastically reduce future health costs," he explained. He also advocated greater investment in community health workers, rather than expensive equipment such as PET and MRI machines, stating: "Health is built in the home - hospitals are there to fix it."

To increase the health budget beyond $40, there is an urgent call for political action. Rwandan President Paul Kagame, the current African Union Champion for Domestic Health Financing, led a high-level conference in Addis Ababa last month, resulting in a mandate for the Africa Center for Disease Control and Prevention (Africa CDC) to develop a framework for domestic financing. Dr. Claudia Shilumani, from Africa CDC, confirmed that work is already underway, with a plan to be presented to heads of state in the coming months.

Cape Verde, with its strong tradition of health-oriented public policies, is well placed to contribute to this framework. The country has already demonstrated a commitment to resilient health systems, but faces challenges such as dependence on foreign aid, which has become less reliable due to funding cuts from the United States and Europe. In addition, public-private partnerships (PPPs) and innovative financing models are gaining attention, with companies such as Roche committing to expanding access to diagnostic tests in Africa, and the Serum Institute of India (SII) working with local manufacturers such as Aspen in South Africa and Vacsera in Egypt to promote local vaccine production.

Charles Okeahalam, chairman of the board of Amref, described the current challenges as "a call to action for the continent". "If we improve our systems by just 20%, we could see an 80% improvement in health outcomes. The challenge is real, but it's not insurmountable," he said.

For Cape Verde, the symposium in Kigali reinforces the need to continue investing in prevention, strengthening community workers and expanding partnerships to ensure that health remains a priority, even with limited resources. The country, with its leading position in the allocation of health resources, can inspire other African nations to follow suit, while facing population growth and global funding challenges.