Africa: Why the New Public Health Order is Essential for Africa's 2025-2027 Health Goals

Africa CDC headquarters.
28 August 2024

Addis Ababa — African Centres for Disease Control and Prevention (Africa CDC) has remained vigilant throughout the year, despite an ongoing mpox epidemic across the continent. In early August, the WHO and Africa CDC declared an international health emergency after the surge in cases associated with a new strain of mpox in the Democratic Republic of Congo. For Africa CDC, this declaration marks a significant milestone, as it aims to address the escalating crisis through a new public health order.

The Africa CDC organization hosted an editors' roundtable under the theme "Building a Strong and Effective Media Engagement Partnership for Africa CDC" aimed at fostering a stronger media engagement partnership to effectively communicate its mandate, strategic vision for 2023-2027, and the New Public Health Order. The roundtable gathered media stakeholders to discuss strategies for improving public awareness of the Africa CDC's role in protecting the health of the continent.

"Media play a fundamental role in managing health crises," according to Dr. Raji Tajudeen, Head of Public Health Institutes and Research.

"The COVID-19 pandemic and the mpox outbreak have shown us the significant impact of misinformation and disinformation. Media is now a critical pillar in emergency preparedness and response. Engaging the media effectively is essential for community involvement and outbreak control, as every disease outbreak starts and ends in the community. The diversity present here today, from across Africa and various institutions, highlights the wealth of perspectives and knowledge we can leverage in this workshop," he said.

"Drawing from our COVID-19 response experience, our goal is to develop a structured mechanism for collaboration, ensuring that information shared with Africa's 1.4 billion people is data-driven and evidence-based. With the upcoming UN General Assembly in September focusing on antimicrobial resistance - a critical issue impacting health and development in Africa - we must present a unified African position, as mandated by our leaders," said Dr. Tajudeen.

"Health cannot function in isolation. Over 70% of emerging and re-emerging infectious diseases today originate from animals," he said. "So we further underscore the need for the health sector to work closely with environment, agriculture, and other key sectors to be able to address some of these issues on the continent of Africa."

Margaret Muigai Edwin, Director of Communication and Public Information at the Africa CDC, discussed ongoing efforts to contain the mpox outbreak.

"We have a team in the DRC right now working closely with the Minister of Health," Muigai said. "We did come up with a strategic plan from 2023 to 2037 that would help address and accelerate the implementation of the new public health order. "Our vision," she said, "is to foster a safe, healthy, and prosperous Africa, where all 55 member states are equipped to prevent, detect, and respond effectively to health threats."

"The mission of Africa CDC is to strengthen African public health institutions and system capacity, capabilities, and partnerships. The aspiration is to become "a world-class institution that addresses and champions Africa's health security," setting the continent's public health agenda and leading coordinated efforts through the One Health approach," she said.

Health systems need to be strengthened across Africa, while proactive surveillance, intelligence gathering, and early warning systems need to be developed. Muigai identified these factors as key enablers. She said that efforts are being made to expand health product innovation through local manufacturing.

To achieve the Africa we want, we're implementing strategies outlined in Agenda 2063, the health strategy, and the new public health order.

Muigai said the guiding document shaping Africa CDC's work, includes the Agenda 2063, which promotes "the Africa we want" through various strategies. The Africa Health Strategy and the New Public Health Order are central to their efforts, alongside the Sustainable Development Goals, the Maputo Plan for Action on maternal and child health, the Pharmaceutical Manufacturing Plan, and the Health Research and Innovation Strategy.

Africa's Bold Vision for Public Health

Africa Centres for Disease Control and Prevention launched its strategic plan in 2023 for enhancing surveillance, emergency response, and infectious disease prevention. The main goal was to strengthen Public Health Emergency Operation Centers (PHEOCs) in Africa and the Eastern Mediterranean region. The five-year strategic roadmap, spanning 2023 to 2027, outlined priorities to reinforce health surveillance systems and establish disease intelligence centers for more informed public health decisions. The plan is projected to be implemented in at least 50 African nations, significantly advancing health preparedness and response capabilities. The plan builds on the experiences and lessons from the first strategic plan (2017-2021), incorporating organizational assessments and successful regional health initiatives across the continent. The New Public Health Order for Africa is designed to lay out a plan for developing a self-reliant public health system and correcting past mistakes.

"The new public health order in Africa's strategy for 2025-2027 is crucial for several reasons. It aims to ensure the continuous strengthening of health systems across the continent, which faces more frequent outbreaks than other regions," said Munyaradzi Makoni, a Senior Advisor and Science Writer at Africa CDC.

"These documents must be in place to make sure that there is a need to continuously strengthen the health systems across the continent," said Makoni. "Africa is one continent that faces several outbreaks every year as compared to other continents in the world."

"To address these challenges effectively, there is a critical need for strong surveillance, intelligence gathering, and early warning systems," he said. "Africa CDC is actively supporting African countries in establishing their own emergency cooperation centers to enhance surveillance efforts. Robust emergency preparedness and response capabilities, along with the expansion of clinical and public health laboratory systems, are also crucial."

"One significant area of focus is the integration of the One Health approach, which considers the interconnectedness of human, animal, and environmental health. Africa CDC is working to expand knowledge and practices in this area, recognizing that many institutions and laboratories have yet to fully integrate One Health into their operations. There is a pressing need for the industrialization of health products, technology, innovation, and manufacturing.

"Based on lessons learned from past crises such as Ebola, Lassa fever, and mpox outbreaks, the strategy emphasizes equitable and just public health landscapes, strong local leadership, and innovation. In addition, it calls for significant investments in public health infrastructure to promote self-reliance, a need highlighted during the COVID-19 pandemic, which revealed flaws and underfunding in Africa's health systems."

He said that some countries already benefit from infrastructure set up during COVID-19 when it comes to maintaining resilient health systems during and after crises.

The Africa CDC works through several divisions to accomplish the goals outlined in its strategic document, including Public Health Institutes and Research, Control and Prevention, Policy and Health Diplomacy, Communication and Public Information, Management and Administration, Emergency Operations, Laboratory Systems and Networks, Preparedness and Response, Partnerships for African Vaccine Manufacturing, Science Office, Institute of Pathogen Genomics, Institute for Workforce Development, and the Journal of Public Health in Africa hosted in South Africa.

From Import to Invent

"Local manufacturing is one of the pillars of excellence for Africa CDC, aimed at enhancing Africa's ability to operate independently," said Yared Yiegezu Zegiorgis, a Senior Research Data Analyst at Africa CDC. "As part of the 2063 Agenda, which calls for a new public health order, local manufacturing is a key pillar," he said. "During the peak of the COVID-19 pandemic, the continent faced limited access to available vaccines and related input materials. This situation led to the establishment of Partnerships for African Vaccine Manufacturing (PAVM) in April 2021, to enable Africa to develop, produce, and supply over 60% of its vaccine needs by 2040, up from just 1%."

"We have an ambitious target to meet 30% of the continent's demand by 2030," said Zegiorgis. "To achieve this, PAVM has developed a strategy called the Framework for Action, which outlines the roadmap for this initiative. The PAVM taskforce has identified eight bold programs, including market design, access to finance, regulatory strengthening, technology transfer,  research and development (R&D), and talent development."

"Currently, Africa produces only 30% of its pharmaceutical demand, meaning over 70% is imported," he said. "Even within this 30%, production is concentrated in just eight countries, and our energy capabilities are under 2%. When it comes to vaccines, the situation is even worse, with only 1% being produced locally, and this capacity is limited to five countries - Ghana, South Africa, Senegal, Botswana, and Rwanda - mostly focused on fill-and-finish operations."

A majority of vaccines are publicly funded and supplied through GAVI, a global alliance of nearly 40 countries that supports developing countries' vaccine access.

"In the past two years, we've supported about five frontrunner companies by conducting gap assessments and providing resources based on the identified needs," said Zegiorgis. "For example, in South Africa, we've supplied medical and lab equipment essential. We're currently reviewing documents from other companies in the second batch and organizing resources to support them as well."

"Our recent assessment revealed that there are 23 vaccine manufacturing facilities in different stages, with nine frontrunner manufacturers ready to produce their final products. Over the next two to three years, from 2024 to 2026, we expect to see 808 vaccines produced by African manufacturers."

Africa CDC, Bavarian Nordic Team Up

Danish biotech company, Bavarian Nordic, has joined forces with Africa CDC to create capacity within Africa for vaccine manufacturing. This partnership will ensure that 2 million doses of vaccine will be available this year, on top of existing orders.

This move is seen as critical for the continent's health security.

"Africa CDC is taking strategic steps to advance vaccine production in Africa, beginning with technology transfer initiatives," said Zegiorgis. "We need to enable technology transfer, but it's logical to start with fill-and-finish production."

Currently, Bavarian Nordic produces over 15 million doses annually, and Africa CDC views this partnership as pivotal.

"Bavarian is ready to support African manufacturers," he said. "This collaboration is seen as a critical action point, especially as Africa CDC looks to secure an additional two million doses this year, building on the 10 million already required."

This collaboration aligns with the African Union's expanded mandate for Africa CDC, which now includes not just vaccines but also diagnostics and therapeutics. The initiative rebranded as the Platform for Immunized African-Based Manufacturing (PHARM), reflects a broader commitment to health self-sufficiency. Kenyan President William Ruto, appointed as the champion for local manufacturing, underscores this commitment by leading efforts to build pharmaceutical capabilities across the continent.

"Together we can realize our ambitious target," said Zegiorgis.

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