Welcome Remarks by Claver Gatete at the High-Level Forum on Sustainable Health Financing

58^TH SESSION OF THE CONFERENCE OF AFRICAN MINISTERS OF FINANCE, PLANNING AND ECONOMIC DEVELOPMENT

High-Level Forum on Sustainable Health Financing

Theme:

Investing in Africa's Health

Welcome Remarks

By

Mr. Claver Gatete

United Nations Under-Secretary-General and

Executive Secretary of ECA

1 April 2026,

Tangier, Morocco

H.E. Mahamoud Ali Youssouf, Chairperson, African Union

H.E. Nadia Fettah Alaoui, Minister of Economy and Finance of the Kingdom of Morocco,

H.E. Dr. Jean Kaseya, Director-General, Africa CDC,

Honourable Ministers,

Distinguished Delegates,

Ladies and Gentlemen,

It gives me great pleasure to welcome you to this High-Level Forum on Sustainable Health Financing, convened under the theme: "Investing in Africa's Health."

I wish to express sincere appreciation to His Majesty King Mohammed VI, Prime Minister H.E. Aziz Akhannouch, and the Government and people of Morocco for hosting us in Tangier, a city that embodies Africa's vibrant openness, trade and connectivity.

I also extend our sincere appreciation to all our distinguished partners for their steadfast support and collaboration in advancing this important agenda.

Excellencies,

We meet at a moment when the foundations of health financing in Africa are shifting - rapidly and irreversibly.

As we speak, global financial conditions are tightening, the cost of capital is rising and fiscal space is narrowing.

Development assistance - once a reliable pillar of health financing - is declining and increasingly uncertain, both in scale and predictability.

At the same time, domestic pressures are intensifying.

In 2022, Africa spent approximately US$145 billion on health, yet less than half came from public financing.

The rest was borne largely by donor resources and households which pushed many into poverty.

Meanwhile, public debt across the continent now hovers around 63% of GDP on average, with debt service in several countries surpassing health expenditure.

This is the reality we confront: rising health needs in the midst of shrinking fiscal space.

However, within this constraint lies a defining opportunity, not simply to finance health differently, but to transform how our systems are structured, scaled and sustained.

And that scale, Excellencies, is provided by the African Continental Free Trade Area.

Too often, AfCFTA is viewed as a trade agreement. But it is far more than that.

It is a development architecture - one that provides a market of 1.5 billion people, a combined GDP of over US$3.4 trillion and a platform to move from fragmented national systems to integrated continental solutions.
Nowhere is this transformation more urgent than in health.

Today, Africa imports over 70% of its pharmaceuticals, leaving us exposed to external shocks, supply disruptions and high costs.

But we are beginning to see progress.

Morocco and Algeria have emerged as regional pharmaceutical hubs. Rwanda is building new manufacturing capacity. And South Africa continues to anchor regional supply.

Through the AfCFTA, these isolated gains can become a continental system - linked, scaled and competitive.

We can build regional value chains. We can harmonize regulatory standards. And we can pool procurement and reduce costs.

So, the question is not whether the opportunity exists. We know they do.

The question is whether we will act at the scale it demands.

In this regard, allow me to highlight four priorities for our consideration.

First, we must redesign how we finance health systems.

We cannot finance 21st-century health systems with 20th-century models.

The era of aid as the primary source of health financing is behind us.

What was once a foundation is now diminishing.

As such, we must strengthen domestic resource mobilization by broadening the tax base, improving efficiency and reducing leakages.

In addition, we must deploy innovative instruments including blended finance, debt-for-health swaps and risk-sharing mechanisms to mobilize additional resources and crowd in private capital.

Here again, AfCFTA strengthens the investment case.

Larger, integrated markets reduce risk, attract capital and enable scale.

Because financing is not only about mobilizing resources; it is about structuring them to deliver impact.

Second, we must expand health insurance and risk pooling.

No health system can be sustainable when households or governments carry the burden alone.

And we have seen what works. Ghana's National Health Insurance Scheme has expanded access.

Rwanda's community-based insurance model has achieved broad coverage, even in constrained settings.

The lesson is clear: when risks are pooled at scale, systems become more affordable, predictable and equitable.

But coverage across Africa remains uneven. And this must change.

We must expand insurance systems, integrate private providers and protect the most vulnerable through targeted subsidies.

Under AfCFTA, we can go further by exploring regional approaches to risk pooling, portability of coverage and cross-border service delivery.

This is how scale drives affordability.

Third, we must deepen private sector participation across the health value chain.

Public financing alone will not meet the scale of our needs.

Across Africa, the private sector is already a major provider - from hospitals in Nigeria to diagnostics in Egypt and digital health platforms in Kenya.

But its full potential remains underutilized.

The AfCFTA changes this equation.

By creating a larger, more predictable market, it lowers risk and attracts investment into pharmaceuticals, logistics, infrastructure and digital health.

But capital does not respond to intention. It responds to incentives.

We must therefore strengthen regulatory frameworks, deploy blended finance and build effective public-private partnerships.

A stronger private sector will not replace the state; it will complement it.

Fourth, we must invest in capacity.

Financing without capacity does not deliver the required outcomes.

Across the continent, shortages of skilled health workers, weak supply chains and inadequate infrastructure continue to limit impact.

We must therefore invest in people, institutions and systems.

We must leverage digital technologies from data systems, telemedicine and digital health platforms to extend reach and improve efficiency.

Moreover, we must build resilience before the next crisis. And we have the lessons from Ebola to COVID-19, to warn us: preparedness is not optional; it is indispensable.

Excellencies,

As we launch the #InvestInHealthAfrica campaign, we affirm a fundamental but enduring truth:

Health is not expenditure. Rather, health is investment - in people, in productivity and in prosperity.

Africa's greatest asset is its people.

If we invest in their health, we unlock their potential. If we fail, we constrain our own future.

The question before us is not whether we can act.

It is whether we will act - at the scale and speed this moment demands. And that time is now.

The Economic Commission for Africa stands ready to support Member States through policy, partnerships and financing solutions to translate this vision into action.
I thank you.