The Dakar Declaration on Health Sovereignty in Africa

Khadijah Aliyu -Nigeria

Preamble:

We, political leaders from civil society, youth, women, researchers, innovators, and partners, gathered in Dakar for the eighth edition of the Forum and the Prix Galien Africa 2025,
We are concerned about :

• The disproportionate health burden on the African continent, which bears more than

24% of the global disease burden with only 3% of the global health workforce and less than 5% of global health spending;

• The glaring strategic vulnerability of Africa, where more than 70% of essential medicines, basic healthcare products, and up to 99% of vaccines consumed are imported, exposing countries to supply difficulties, the presence of multiple intermediaries in the supply chain, which drives up the cost of medicines, shortages, therapeutic insecurity and unacceptable dependence, and the risks associated with the acquisition of medicines of dubious quality or even counterfeit medicines, as revealed during theCOVID-19 pandemic;

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• Persistent inequalities in access to healthcare, health technologies, and quality healthcare products, which deprive a significant portion of our population of their fundamental
right to health;

• The adverse effects of climate change and conflicts on the health, well-being, and dignity of African populations.
We are convinced that:

• Health sovereignty—defined as a continent’s ability to define its own health policies, equip itself with strategic health products to meet the needs of its population, and Guaranteeing equitable access for all is not an option, but a strategic imperative for Africa’s security, economic stability, and sustainable human development.

• This sovereignty must be based on a commitment at the highest level of our states, increased mobilisation of endogenous financing, and robust scientific, technological,
and industrial autonomy, fueled by innovation, the promotion of endogenous knowledge, and the training of a new generation of talent.

• New technologies and the emergence of young African experts in these fields are opportunities to be seized.

• Regional cooperation, economic integration, and regulatory harmonisation are essential multipliers of strength for creating a viable and attractive continental pharmaceutical market.

• Young people, women, and local communities are the agents of change and catalysts for a sustainable and inclusive transformation of the health ecosystem

Based on these findings, we reaffirm our commitment to work together to:
1.Make health sovereignty a top priority on national and continental political and economic agendas;
2.Invest ambitiously and sustainably in research and development, health innovation, talent development, local production, and critical infrastructure;

3.Strengthen governance, pandemic preparedness, and the resilience of our health systems systems, basing our actions on the principles of equity, intra-African solidarity, and
shared responsibility.

Consequently, we have jointly decided to commit to the following strategic priorities:

1.Accelerate Local Production, Innovation, and Intellectual Property:

•Create favourable environments (specialised economic zones, innovation clusters) to attract investment in local manufacturing of pharmaceuticals, vaccines, diagnostics,
and medical technologies.

•Establish an African Health Innovation Fund to co-finance R&D on new drugs and
vaccines to combat communicable and non-communicable diseases, neglected tropical diseases, and other continental health priorities.

•Promote and protect traditional and endogenous knowledge and encourage its
integration into modern health value chains.
•Develop a continental intellectual property strategy to balance access to innovation and patent protection, drawing on the flexibilities of TRIPS/OAPI.

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2. Mobilising Sustainable and Innovative Financing:
•Gradually increase national budget allocations for health to at least 15% of the national budget
budgets, as agreed in the Abuja Declaration (2001);

•Prioritise funding for priority health programs, as a sustainable alternative to subsidies, which are increasingly difficult to secure;

•Operationalise innovative financing mechanisms: taxes on products harmful to
health (tobacco, alcohol, unhealthy foods, etc.), solidarity taxes on airline tickets and financial transactions (mobile money transfers), health bonds, risk-sharing public-private partnerships (PPPs), and targeted investments from the diaspora;

•Engage civil society and, above all, African philanthropists to better support our governments’ policies.

3.Strengthen Governance, Regulation, and Human Capacity:

•Operationalise and strengthen the mandate of the African Medicines Agency
(AMA) as the single regulatory authority to harmonise and accelerate drug registration and ensure drug quality across the continent;
•Support Regional Economic Communities (RECs) for the coordinated implementation of regional pharmaceutical policies;

•Invest heavily in the training, equitable deployment, and retention of health personnel through attractive career plans and decent working conditions;

•Develop health leadership programs for young people and women.
•Establish multisectoral accountability at the country level under the leadership of
the head of government.

4. Ensuring Equity, Universal Access, and Community Engagement:
Systematically integrate a “health sovereignty” component into the national Universal Health Coverage (UHC)strategies.

Adopt active policies to reduce inequalities in access to healthcare, particularly for
rural, vulnerable, and low-income populations.

Strengthen supply and logistics distribution systems (cold chain, health informa-tion)to ensure that essential medicines reach the last mile.
Systematically involve communities, patients, and the media in the design,
Implementation, and monitoring of health policies for sustainable social change.

Strengthen the health-related skills transferred to local authorities to ensure effectiveness-
tive territorialization of public policies.

Promote financial risk protection mechanisms to reduce catastrophic expenditure and household impoverishment.

5. Placing Youth and Women at the Heart of Health Transformation:

Create incubators and dedicated funds to support health start-ups led by young
people and women;

Ensure meaningful participation (at least 30%)of young people and women in allhealth governance and decision-making bodies at the local, national, and regional levelse;

Prioritise women’s empowerment and strengthen literacy in rural areas;
Launch mentoring and scholarship programs for young researchers and women
entrepreneurs in health.

To this end, we urge:
The African Union and its member states are to adopt this Declaration as a roadmapand translate its commitments into concrete action plans with monitoring indicators;

International technical and financial partners to align their support with these continental priorities, promote technology transfer, and respect the principles of African
leadership;

The African and international private sector to invest ethically and responsibly in the African health ecosystem, in partnership with the public sector;

Civil society and academia to play their role as watchdogs, proposers, and mobilizers-for collective accountability.

Finally, we are committed to:

. Take the Galien Forum Africa as an annual accountability platform to assess progress in implementing this Declaration;

Publish an annual monitoring report presented to the African Union and regional bodies;

Meet again in 2026 for an in-depth assessment of progress and challenges.

Solemnly adopted in Dakar on October 31,2025.
The Dakar Declaration on Health Sovereignty in Africa

The Dakar Declaration on Health Sovereignty in Africa

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