25 Mar The Role of the African Union in Sustained Domestic Financing for Health:

How Advocacy and Accountability Are Driving Sustainable Health Financing Solutions.

In February 2025, at the African Union (AU) Heads of State and Government Summit, leaders from across the continent reaffirmed their commitment to ensuring Africa’s health security and self-reliance by adopting the AU Roadmap to 2030 & Beyond: Sustaining the AIDS Response, Ensuring Systems Strengthening and Health Security for the Development of Africa. This landmark framework builds on decades of policy commitments—including the Abuja Declaration of 2001 and the 2019 Africa Leaders Meeting-to prioritise health financing as a pillar of Africa’s development agenda.

The adoption of this roadmap comes at a critical juncture, as the global financial landscape for health is shifting. With external funding declining, the urgency for African governments to strengthen domestic resource mobilisation (DRM) has never been greater. Sustainable health financing is not just a technical issue—it is a political commitment, a governance priority and a human rights imperative.

Why the African Union’s Roadmap Matters.

The AU Roadmap to 2030 & Beyond provides a strategic vision for ensuring that Africa’s health responses are owned and led by its people. Among its core objectives is the need to increase domestic health financing, ensuring that national health priorities are shaped by domestic needs rather than external donor conditions. In focusing on DRM, the roadmap envisions:

• Strengthening national health budgets to achieve the 15% health financing target set in the Abuja Declaration.
• Investing in universal health coverage (UHC) to protect vulnerable populations, including adolescents, women, and children.
• Expanding social protection schemes, such as national health insurance programmes, to create risk-pooling mechanisms.
• Encouraging innovative financing strategies, including debt swaps for health, sin taxes, and levies on luxury goods.
• Enhancing governance and accountability, ensuring that resources are allocated efficiently and transparently.

Advocacy as a Catalyst for Action

Policy frameworks like the AU Roadmap are essential, but implementation requires political will, continuous advocacy, and strong accountability mechanisms. Civil society, youth, faith based and other community leaders, and health advocates play a significant role in ensuring that commitments translate into action. Advocacy helps to:

• Sustain political momentum by keeping DRM at the forefront of national and regional policy discussions.
• Hold governments accountable for their financial commitments to health.
• Mobilise diverse stakeholders, including the private sector and international partners, to support sustainable financing solutions.

The African Union has an important role to play in fostering this advocacy and accountability. By championing the One-Stop-Shop Approach– One Plan, One Budget, One Approach– the AU is promoting efficiency, reducing fragmentation, and ensuring that domestic investments in health lead to sustainable and resilient health systems.

A Call to Action

The adoption of the AU Roadmap to 2030 & Beyond signals a new era in Africa’s health financing agenda. However, the work is far from over. It is now up to governments, policymakers, and advocates to translate commitments into tangible investments.

We invite you to explore the full AU Roadmap and learn more about how we can collectively drive sustained domestic financing for health. As we engage with this roadmap, we must recognise that advocacy is a shared responsibility. Each of us—within our communities, workplaces, and networks—has a role to play in ensuring these commitments move from paper to action. Let us use every opportunity to share, amplify, and uphold the commitments made by our African leaders, ensuring that they are held accountable for real progress.

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