​In February 2019, a defining moment in Africa’s health financing journey was born. The African Union, in partnership with the Government of Rwanda, convened the inaugural Africa Leadership Meeting (ALM) – Investing in Health on the side lines of the 32nd AU Heads of State Summit in Addis Ababa. The message was clear: Africa must take ownership of its health priorities through increased domestic investment.

The outcome? The Addis Ababa Commitment Towards Shared Responsibility and Global Solidarity for Increased Health Financing, commonly known as the ALM Declaration was adopted to galvanise political and technical mechanisms that would enable countries to steadily increase investments in health and hold each other accountable.

Why ALM Matters

Despite nearly two decades of health progress since the Abuja Declaration, millions of people across the continent still lack access to essential services, with preventable diseases claiming far too many lives. At the heart of the ALM is a push to reverse this trend by enabling:

• Increased and sustained domestic health resource mobilisation
• Improved national health financing systems
• Reduced catastrophic out-of-pocket health spending
• Stronger coordination with development partners and the private sector

Key Mechanisms Driving Change

1. Health Financing Progress Tracker

To complement the AU Scorecard and track concrete health financing reforms, AUDA-NEPAD introduced a Health Financing Progress Tracker. This action-oriented tool supports Ministries of Health and Finance in refining public financial management and making strategic, equitable investments. It has been piloted in multiple Member States with promising results.

2. Regional Health Financing Hubs (RHFHs)

The RHFHs established in the Southern African Development Community (SADC) and  East African Community (EAC) regions are designed to serve as technical support centres, helping Member States improve health budget allocations, reduce inefficiencies, and expand private sector collaboration. Engagements have also begun in Economic Community of West African States (ECOWAS) and Intergovernmental Authority on  Development (IGAD) in Eastern Africa States, reinforcing ALM’s continental footprint.

3. Private Sector Engagement

Recognising the transformative role of business in health, AUDA-NEPAD developed a Private Sector Engagement Framework. Countries like Malawi have already begun domesticating this strategy to harness private capital and innovation in the health sector.

Tracking Progress: The Africa Scorecard

The Africa Scorecard on Domestic Financing for Health has now been digitised and made accessible in all five African Union languages. It tracks key indicators such as:

• Per capita health expenditure
• Progress toward the Abuja 15% target
• Trends in domestic resource allocation

The Path Forward

With coordinated action and accountability, ALM is not just a declaration, it is a living roadmap for transforming Africa’s health financing landscape.