Zubeidah Kananu President Kenya Editors Guild. / PHOTO ; Courtesy
As donor funding for health continues to shrink across Africa, Kenya is reimagining its path toward a more self-reliant future.
The conversation is shifting from dependency to determination, from waiting for aid to building resilient, efficient health systems from within.
This spirit of reinvention defined the Kenya Editors’ Guild’s Thought Leadership Dialogue Second Edition, where policymakers, journalists, and health experts gathered virtually to unpack the ripple effects of declining Official Development Assistance (ODA).
But unlike many discussions that dwell on loss, this dialogue carried a tone of resolve, a call to build health systems that reflect African agency, innovation, and accountability.
A Moment of Reckoning and Redefinition
For Zubeidah Kananu, President of the Kenya Editors’ Guild, this moment represents a turning point for Africa’s health agenda.
“The world is tightening its purse strings, global health aid is shrinking, even as our health needs continue to grow,” she said.
Her reflection underscored a stark reality: from pandemics and non-communicable diseases to maternal health challenges and climate-induced emergencies, African health systems are under immense pressure.
Yet, Kananu argued, the solution lies not only in more money but in better systems that are transparent, equitable, and locally driven.
She recounted conversations from a recent health meeting in Zambia, where the topic of decolonizing health resonated deeply.
“It’s not about rejecting partnerships,” she explained.
“It’s about reclaiming agency, moving from dependency to dignity, from externally imposed agendas to systems grounded in African realities, data, and innovation.”
Kananu pointed to encouraging reforms already underway across the continent, from Kenya’s new health insurance framework to Nigeria’s Basic Health Care Provision Fund, and the establishment of continental institutions such as the Africa CDC and the African Medicines Agency.
Her message was clear: Africa’s health future must be designed by Africans, for Africans.
“This dialogue is not just about bridging funding gaps,” she said.
“It’s about reframing the narrative, building systems that are locally grounded, ethically governed, and nationally owned.”
From Catastrophe to Course Correction
When Dr. Catherine Kyobutungi, Executive Director of the African Population and Health Research Center (APHRC), spoke during the virtual event, she invited participants to rethink the very framing of Africa’s current funding dilemma.
“We need to shift the narrative from what I would call initial catastrophizing,” she began. “Sometimes the catastrophe is simply a course correction.”
Her presentation explored two competing narratives: the Western media’s depiction of a looming crisis and the African perspective, which sees opportunity as a chance to reclaim independence and build resilience.
“So how can there be such a dichotomy about the same event?” she asked. “What is the truth?”
Citing data from nine major donor countries, Dr. Kyobutungi explained that aid cuts have accelerated over the past five years, particularly affecting maternal and child health, water, and sanitation sectors.
Yet she emphasized that the real danger lies not in the cuts themselves, but in the precedent of abrupt decision-making, a reminder that Africa’s health future cannot depend on unpredictable external forces.
Beyond the numbers, she raised deeper concerns: shrinking space for science, atta
cks on multilateralism, and restrictions on the language of equity and inclusion in some donor countries.
“Imagine doing science while policing what you can say,” she noted. “That’s deeply concerning.”
For Dr. Kyobutungi, the way forward is through introspection and reform, both structural and psychological.
“Global health has been repairing a leaky roof without fixing the foundation,” she said.
“It’s time to rebuild from the ground up to reform systems, behaviors, and mental models rooted in coloniality and dependency.”
Her call was unmistakable: Africa must seize this moment to define the next chapter of its health journey on its own terms.
Financing Health, the African Way
Dr. Daniel Mwai, Health Economist and Health Advisor to the President of Kenya, echoed that sentiment, grounding it in decades of experience in health financing.
“When I joined the National AIDS Program years ago, donor money was so abundant that our challenge was how to spend it,” he recalled.
“Today, the reality is very different, and that’s not necessarily a bad thing.”
For too long, he explained, African governments saw health as a donor-funded sector. That perception, he believes, is finally changing.
“This moment presents an opportunity,” he said. “It allows governments to take ownership, to prioritize efficiency, and to ensure every shilling delivers maximum value.”
He was candid about the cultural shift needed to sustain progress.
“Why must every policy discussion require an expensive workshop outside the city?” he asked.
“Those practices made sense when donors paid the bills. Today, governments must recalibrate and live within their means.”
Dr. Mwai underscored the need for innovation in domestic financing from tax-based systems to contributory models and hybrid approaches. But he also warned that efficiency must never come at the expense of equity.
“Donor-funded programs have historically reached the most marginalized sex workers, people who inject drugs, and adolescent girls. As funding transitions, governments must not leave these populations behind.”
He also addressed a silent crisis: the skyrocketing cost of medical commodities.
“We’ve found markups as high as 7,000%,” he revealed. “If we don’t fix that, we can forget about sustainability.”
To him, the path forward lies in integration and prevention.
“We need to end fragmentation where one community health worker comes today for malaria, another next week for HIV,” he said.
“Integration will save costs and lives. And prevention remains our most sustainable investment.”
Toward a Self-Reliant Future
The dialogue concluded with a renewed call for African-led, locally financed, and ethically governed health systems.
Speakers agreed that while the decline in donor aid poses real risks, it also offers a once-in-a-generation opportunity to build systems anchored in resilience, innovation, and accountability.
As Kenya and other African nations rethink health financing, one message rang clear:
The future of Africa’s health will not be donated; it must be designed, financed, and sustained by Africans themselves.
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