As African leaders and global health experts prepare to convene for the World Health Summit Regional Meeting 2026, focus is shifting toward the future of health systems across the continent.
Professor of Psychiatry and Dean at Aga Khan University Medical College in East Africa, Lukoye Atwoli, says Africa’s health systems are at a critical turning point.
Over the past decade, many countries have made measurable gains in disease prevention, treatment access, and service delivery, largely supported by external funding.
However, global economic pressures, shifting donor priorities, and tightening development budgets are beginning to reshape the landscape.
“The question is no longer just how we respond to health crises,” Professor Atwoli said ahead of the summit. “It is how we build systems that are strong enough to withstand them.”
He argues that the next phase of health reform on the continent must be anchored on resilience, systems that are not only capable of treating illness but also able to endure shocks while continuing to deliver essential care.
In the African context, health system resilience refers to the ability of national systems to absorb shocks while maintaining core services. For Professor Atwoli, this goes beyond emergency preparedness.
“Resilience must be built into the system itself. It cannot be something we try to add in the middle of a crisis,” he noted.
Governments across the continent are facing mounting fiscal constraints, rapid population growth, and rising healthcare demands. These pressures make reactive approaches to crisis management increasingly unsustainable.
“What we need is a deliberate shift toward long-term system strengthening, where routine care, prevention, and treatment continue even during disruptions such as epidemics, economic shocks, or supply chain breakdowns,” he added.
Current global and domestic pressures are exposing longstanding weaknesses in many African health systems. Chief among them is fragile and unpredictable financing, with many countries still heavily reliant on external funding that fluctuates with global priorities.
Workforce shortages remain another persistent challenge. Even where training capacity has improved, the uneven distribution of health professionals continues to leave rural and underserved communities without adequate care.
Supply chain vulnerabilities also persist. Procurement inefficiencies and limited local manufacturing capacity often result in shortages of medicines, diagnostics, and essential equipment.
“There are deep structural issues that become more visible in times of crisis,” Professor Atwoli said. “Financing gaps, workforce imbalances, and supply constraints all point to the need for more coherent system design.”
Underlying these challenges is limited integration across health services. Fragmented governance and parallel delivery systems often hinder efficient deployment of resources, particularly during emergencies.
Professor Atwoli also points to the unintended consequences of program-driven health initiatives. While disease-specific interventions have been effective in addressing major public health threats, they can weaken national systems when implemented in isolation.
“Parallel systems may deliver short-term results, but over time they can erode national ownership and create dependency,” he explained.
Fragmentation also reduces flexibility. During crises, governments may struggle to reallocate resources quickly because funding streams and service structures are tied to narrow program mandates.
To address this, he advocates a transition toward more integrated health systems capable of delivering coordinated and system-wide care.
The upcoming World Health Summit Regional Meeting in Nairobi presents what Professor Atwoli describes as a pivotal opportunity to rethink health system strengthening across Africa.
“Many of our health challenges are not confined by borders. Regional dialogue is essential if we are to develop sustainable solutions,” he said.
The summit is expected to bring together governments, researchers, and development partners to share lessons on financing reforms, workforce development, and primary healthcare strengthening.
Crucially, it also offers a platform for African leaders to shape health policy based on local priorities rather than externally driven agendas.
“This is an opportunity for Africa to define its own path, align its strategies and build systems that are both equitable and resilient,” Professor Atwoli said.
If these discussions translate into coordinated action, he believes the continent can move decisively toward stronger, more inclusive, and shock-resistant health systems.
Governments, regional organizations, academic institutions, private sector players, civil society networks, and development partners are expected to participate in the 2026 World Health Summit Regional Meeting, scheduled for April 27 to 29 at the United Nations Office at Nairobi in Nairobi, Kenya
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