Africa’s Health Reset: WHO Vision 2035 Targets Stronger Systems, Local Production and Financing

WHO’s Vision 2035 seeks to transform health systems across 47 African countries through stronger primary care, digital health, domestic financing, local manufacturing and greater preparedness for outbreaks and climate shocks. The strategy calls for US$1.625 billion in investment through 2030, aiming to reduce dependence on imported medicines and external funding while creating opportunities for governments, development partners and private investors.

Africa's health systems are reaching a turning point as governments face rising healthcare demand, shrinking external support, disease outbreaks and growing dependence on imported medicines. The World Health Organization Regional Office for Africa (WHO AFRO) is responding through Vision 2035, a strategy covering 47 Member States and about 1.4 billion people. Developed through consultations involving more than 500 stakeholders, including governments, WHO country offices, development partners and civil society, the strategy calls for a shift from fragmented disease programmes towards stronger primary healthcare, resilient systems, digital technology, domestic financing and African production of essential health products.

The numbers highlight the scale of the challenge. The region's Universal Health Coverage Service Coverage Index remains below 44, while Africa accounts for about 70% of global maternal deaths. More than 60% of the population is under 25, creating enormous future demand for healthcare. At the same time, climate shocks, infectious disease outbreaks, noncommunicable diseases and shortages of health workers are putting additional pressure on already underfunded systems.

From Disease Programmes to Stronger Health Systems

One of Vision 2035's biggest policy shifts is its focus on building health systems rather than relying heavily on individual disease programmes. Initiatives such as PEPFAR, the Global Fund and bilateral programmes have produced major health gains, but WHO argues that they were not primarily designed to build comprehensive primary healthcare systems.

The consequences of structural weaknesses are increasingly visible. Around 70–80% of medicines and vaccines are imported, exposing African countries to global supply disruptions. Average outbreak response time exceeds 14 days, more than double the seven-day International Health Regulations benchmark, while only about 30% of Member States meet minimum IHR core-capacity scores.

Vision 2035 therefore combines four priorities: universal health, resilience, modernisation, and ownership and sovereignty. WHO wants primary healthcare to become a community-based platform covering maternal and child health, adolescent care, mental health and noncommunicable diseases. It targets DTP3 immunisation coverage of at least 90% and aims to ensure no country has a UHC Service Coverage Index below 45 by 2030.

Financing Health as an Economic Investment

For governments, financing may be the most difficult part of the transformation. WHO estimates that US$1.625 billion will be required across seven flagship programmes during 2026–2030.

The strategy calls for greater domestic resource mobilisation, social health insurance, strategic purchasing, innovative financing and blended finance. At least 20 countries are expected to introduce earmarked health taxes, while 25 countries should adopt a "1Plan 1Budget 1Report" approach. Out-of-pocket healthcare expenditure is targeted to fall by 20–30%, while financial protection coverage should rise from at least 23.7% to 40% or more.

For policymakers, the economic argument is important. Better health systems can reduce household financial shocks, limit expensive emergency responses and improve workforce productivity. With more than 60% of Africa's population below 25, achieving a demographic dividend will depend partly on keeping this generation healthy enough to learn, work and participate productively in the economy.

Development partners will also need to change how they operate. WHO is encouraging donors to move from fragmented programme funding towards longer-term system financing and align investments behind national plans and budgets. However, the transition must be carefully managed so that reduced vertical financing does not reverse progress against diseases already brought under greater control.

Manufacturing and Digital Health Open New Markets

Vision 2035 could create major opportunities for private investment. WHO wants regional manufacturing to supply at least 45% of priority health products by 2035, reducing Africa's heavy dependence on imported medicines and vaccines.

At least 15 Member States are expected to strengthen regulatory systems supporting quality-assured local manufacturing, while six or more pooled procurement mechanisms should become operational. Larger regional procurement markets could provide manufacturers with more predictable demand and make investment in African pharmaceutical and vaccine production commercially attractive.

Digital healthcare offers another opportunity. WHO wants at least 60% of Member States to develop interoperable digital-health systems and at least 28 countries connected to a Regional Health Data Hub. AI-enabled analytics are expected to support disease surveillance, planning and health decision-making.

This could generate demand for digital platforms, cloud infrastructure, cybersecurity, diagnostics, data analytics and AI solutions. But governments will need strong interoperability and data-governance rules to prevent fragmented systems, privacy problems and dependence on individual technology providers.

The Real Test Will Be Implementation

Vision 2035 will be implemented in three stages. During 2026–2027, attention will focus on governance, district primary healthcare, immunisation, surveillance, emergency preparedness and regional manufacturing coordination. In 2028–2029, countries are expected to expand integrated primary care, digital ecosystems, AI analytics, climate-resilient systems and manufacturing capacity.

Between 2030 and 2035, the goal is greater sustainability and sovereignty. Domestic financing should cover the majority of health-system costs, while African manufacturing should provide at least 45% of priority health products.

Governments will therefore need to translate regional ambitions into national budgets, regulations, procurement reforms and measurable projects. Development partners can support the transition through long-term financing, technical assistance and coordinated investment, while private companies have opportunities across pharmaceuticals, vaccines, digital health, infrastructure, insurance and workforce development.

The biggest risk is an implementation gap between ambitious regional targets and national capacity. Vision 2035 will succeed only if financing, workforce development, technology, regulation and manufacturing advance together. If that happens, stronger health systems could deliver benefits extending beyond healthcare, improving productivity, protecting households from financial shocks, supporting industrial development and strengthening Africa's long-term economic resilience and self-reliance.