Africa Must Achieve Health Sovereignty Before the Next Pandemic

John Nkengasong

TORONTO – The first reports of an unknown respiratory infection spreading in Wuhan, China, came during the quiet days between Christmas and New Year’s Eve in 2019. 

At the time, I was director of the Africa Centres for Disease Control, the African Union’s public-health agency, and was trying to recharge after months spent fighting a deadly Ebola outbreak in the Democratic Republic of the Congo (DRC). But, recognizing the severity and urgency of this new virus, I summoned the Africa CDC team back to headquarters in Addis Ababa.

The Africa CDC had never confronted a crisis of this scale. Early worst-case projections from the United Nations Economic Commission for Africa suggested that up to 1.2 billion Africans could be infected and over three million could die from the disease now known as COVID-19. Coordinating a response for 55 AU member states, with a population of more than one billion people, required using all the expertise and skills at our disposal.

At first, we trained medical staff in the African countries with direct flights to China and created working groups led by African experts on laboratory medicine, public health, data science, and genomics. As COVID-19 spread, young epidemiologists who had been fighting Ebola in the DRC deployed to West Africa.

It soon became clear that the world was reverting to old patterns. The World Health Organization offered us only around two million COVID-19 tests, and wealthy countries stockpiled vaccine doses. To be sure, the motive was national self-preservation, not malice. 

But it demonstrated that Africa needed a different strategy, based on our own resources and institutions. We were determined not to repeat the experience of the AIDS pandemic, which left 12 million Africans dead in the decade it took for effective antiretroviral drugs to reach the continent after becoming available in the West.

A partnership with the Mastercard Foundation (where I now work) made a new strategy possible. Reeta Roy, then the Foundation’s President and CEO, approached us to ask whether $1 billion would enable a meaningful pandemic response and, if so, what that response would look like. 

After explaining that these funds would allow us to purchase and distribute vaccines, strengthen our institutional capacity, and support local vaccine manufacturing, the Foundation committed $1.5 billion to Saving Lives and Livelihoods, a three-year partnership with the Africa CDC that finished in December 2025.

That investment dramatically shifted how the world saw the Africa CDC. Raising money suddenly became easier. The World Bank, which had previously offered $10 million as part of a regional grant before the pandemic, committed $100 million to bolster public-health preparedness on the continent. The United Kingdom followed with £20 million ($27 million) in funding. By the time I left the Africa CDC in May 2022, the organization had mobilized about $1.8 billion.

The Saving Lives and Livelihoods program was based on trust in African leadership and institutions, which made it particularly effective. Empowered to make decisions and act quickly, the Africa CDC delivered more than 32 million vaccine doses to member states, supported the training and deployment of 37,000 health workers, and created nearly 23,000 jobs across 25 African countries.

The partnership with the Mastercard Foundation also helped lay the groundwork for Africa’s long-term health security by expanding the number of countries with genomic sequencing laboratories from seven to 46. These national systems can share data and function as a continental early-warning system.

Africa must now decide whether to build on the post-pandemic momentum and pursue health sovereignty or continue relying on Western capitals. My vision – forged during my time at the Africa CDC – is for a new, African-led public-health order. 

The continent has taken steps toward achieving this goal. Initiatives like the African STARS Fellowship Programme at Stellenbosch University are developing the next generation of African health leaders, while institutions such as Institut Pasteur Dakar are training the vaccine-manufacturing workforce.

With robust genomic networks, expanded vaccine-manufacturing capacity, and newly trained leadership, the Africa CDC is more capable of responding to future pandemics. Its capabilities will continue to expand as more local institutions are built and existing ones are strengthened.

Africa can no longer rely on Western aid budgets that rise and fall with electoral cycles. But achieving health sovereignty requires political will. African governments must treat health infrastructure as a top strategic priority and commit to long-term investment in it. When the next pandemic arrives, the continent must be prepared to lead its own response, or else risk being left behind in the recovery.

John Nkengasong, a former director of the Africa Centres for Disease Control, ambassador-at-large, US global AIDS coordinator, and senior bureau official for Global Health Security and Diplomacy during the Biden administration, is Executive Director of Higher Education, Collaboratives, and Strategic Initiatives at the Mastercard Foundation.

Copyright: Project Syndicate, 2026.
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