The new framework, developed by the Ministry of Health with support from the Africa Centres for Disease Control and Prevention (Africa CDC) and the World Health Organization (WHO), marks a major milestone in Eswatini’s journey towards a resilient, responsive, and community-centred health system.

The EBS Guidelines come at a critical time for Eswatini, a nation that has recently faced several public-health challenges, including outbreaks of cholera, measles, and COVID-19, as well as sporadic cases of anthrax and influenza-like illnesses. These events have underscored the urgent need for early detection and rapid-response mechanisms that transcend traditional health-facility surveillance.

“The launch of the Event-Based Surveillance Guidelines is a critical step in ensuring that no outbreak catches us unprepared,” said Honourable Mduduzi Matsebula, Minister of Health. “These guidelines will enable health workers and communities to detect and report events early, helping us respond faster, save lives, and protect livelihoods.”

Eswatini’s EBS approach is uniquely adapted to its national context and builds upon the lessons learned during recent outbreaks, he added.

“These guidelines are a home-grown solution, tailored to Eswatini’s unique context, reflecting our collective commitment to protecting the public health of the people of the Kingdom of Eswatini,” said Honourable Matsebula.

The EBS system operates by collecting and verifying reports of unusual health events from diverse sources, such as media reports, community observations, schools, and even social networks. This approach complements traditional indicator-based surveillance systems, providing real-time intelligence that can trigger early public-health action.

The introduction of EBS aligns with broader continental and global frameworks aimed at strengthening epidemic preparedness. It supports Africa CDC’s New Public Health Order, which calls for stronger surveillance, workforce development, and resilient national public-health institutions.

Dr Lul Riek, Regional Director for Southern Africa at Africa CDC, hailed Eswatini’s achievement as a model of regional cooperation and proactive health security.

“EBS is a core pillar of Africa CDC’s vision for a safer, healthier, and more resilient Africa,” said Dr Riek. “Through event-based surveillance, we move from passive data collection to active, real-time intelligence gathering, anticipating and stopping outbreaks before they escalate. This is what the New Public Health Order envisions: African-led, data-driven action to protect our people.”

Globally, the initiative reinforces Eswatini’s obligations under the International Health Regulations (IHR 2005), which require Member States to establish and maintain the capacity to detect, assess, report, and respond to public-health events of international concern. The EBS system provides the infrastructure to meet these requirements through improved event verification, timely notification, and community engagement.

Eswatini’s EBS launch follows similar initiatives in Namibia, Botswana, Zimbabwe, Lesotho, Malawi, and Zambia, as part of a coordinated regional effort supported by Africa CDC to harmonise surveillance across Southern Africa. The goal is to build a networked, interoperable early-warning system capable of sharing data, expertise, and alerts across borders, ensuring that no country is left behind.

“Regional health security depends on the strength of each country’s surveillance capacity,” said Dr Susan Tembo, WHO Country Representative to Eswatini. “With these guidelines, Eswatini is demonstrating leadership in advancing community-centred surveillance. WHO remains committed to supporting this journey in line with the IHR and the Global Health Security Agenda.”

At its core, the EBS approach empowers communities to become active participants in safeguarding public health. Health workers, local leaders, and citizens will receive training to identify and report unusual health events, transforming communities into the first line of defence against outbreaks.

The Ministry of Health has outlined plans to integrate EBS into the national disease-surveillance system, strengthen coordination among ministries and partners, and deploy digital tools to enhance reporting and verification.

“Our aim is to build resilience at the community level so that citizens become active participants in safeguarding national health security,” said Minister Matsebula.

With these guidelines, Eswatini is now better positioned to operationalise a community-centred, evidence-driven approach to epidemic intelligence, one that not only responds to outbreaks but also prevents them. The initiative embodies the spirit of collaboration championed by the African Union, Africa CDC, and WHO, demonstrating that regional solidarity and early action are key to achieving health security for all.

As Eswatini strengthens its surveillance infrastructure, it sets a powerful example for other nations, showing that investment in early-warning systems is not just a technical exercise but a moral imperative to protect lives, livelihoods, and the future of public health in Africa.

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Rift Valley Fever (RVF) is the latest zoonotic disease outbreak in Africa, invoking One Health interventions that align health responses across human, animal and environmental sectors. The outbreak was declared in Senegal on 21 September 2025.

As of 16 October, there were 171 confirmed human cases and 20 deaths, while 128 individuals have recovered. Contact tracing is ongoing, with 90 individuals listed, according to Dr Ngashi Ngongo, Principal Advisor to the Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC).

“There are also ongoing outbreaks in animals,” he said. “Twenty-one cases have been reported — no deaths yet — but vaccination is already underway.”

To date, over 11,600 animals have been vaccinated in Senegal. Dr Merawi Tegegne, an epidemiologist and Head of the Surveillance and Disease Intelligence Division at Africa CDC, told a weekly press briefing that RVF has been endemic in northern Senegal since the 1980s.

He said RVF reflects a broader rise in mosquito-borne diseases such as dengue, driven by climate change and livestock movement. The virus circulates at a low level during non-outbreak seasons, but outbreaks are becoming more frequent.

“It is becoming more frequent these days — not only in Senegal, but across Eastern Africa and beyond. These diseases are closely linked with climate change and extreme weather events,” he said. “If you see torrential rain followed by floods, then sunny days, expect RVF in the coming days — these are favourable conditions for the vectors.”

The current outbreak in Senegal is concentrated in four hotspots across three regions: Richard Toll, Saint Louis, Dagana and Pete.

“When we look at the profile of those most affected (in Senegal), it’s mainly men,” said Dr Ngashi. “Males make up 55% of cases. And in terms of age group, those aged 15 to 35 account for 61% of all cases.”

Senegal’s Minister of Health and Public Hygiene, Ibrahima Sy, said the immediate priority is to strengthen medical infrastructure to ensure timely and effective treatment for patients, particularly those in critical condition, in order to save lives and contain the epidemic’s spread.

In Mauritania, an alarming rise in RVF infections has been recorded, with the Ministry of Livestock reporting 19 active outbreaks across 16 departments in eight regions. The country’s veterinary services launched an early detection operation in August, which initially confirmed two outbreaks. Since then, 334 samples have been analysed, with 90 testing positive for the virus.

Mauritania has experienced eight RVF epidemics in 38 years — from 1987 to 2025 — averaging one outbreak every four to five years. The most recent major epidemic was in 2022, with 47 confirmed cases and 23 deaths.

First identified in East Africa’s Rift Valley in 1931, this mosquito-borne illness, endemic in parts of Africa, affects both livestock and humans, and continues to cause major outbreaks across the region, impacting health, food security and livelihoods.

RVF is caused by a Ribonucleic acid (RNA) virus transmitted through bites from infected mosquitoes and exposure to infected animal fluids, especially during slaughtering, birthing or veterinary procedures. In East Africa, El Niño events drive outbreaks, while in West Africa, prolonged rains and alternating wet–dry spells are key factors. Common symptoms include fever, headache, muscle pain and fatigue. While most cases are mild, delayed treatment can lead to haemorrhagic complications, which may be fatal.

An RVF epidemic in 1987–88 killed more than 200 people in Senegal and Mauritania. Since then, Senegal has reported only minor outbreaks. The current resurgence coincides with other health emergencies across the continent: 23 countries are affected by cholera, and the situation is expected to worsen with the rainy season. The Democratic Republic of the Congo is battling Ebola in its Kasai province, mpox continues in 26 countries, and Lassa fever persists in four.

“We are dealing with multiple concurrent outbreaks that are putting a lot of pressure on resources,” said Dr Ngashi. “The vast majority are zoonotic spillovers.”

Africa CDC is collaborating with Ministries of Health, Agriculture, Environment and Wildlife to strengthen One Health coordination mechanisms, enabling data sharing and joint preparedness to prevent the transmission of diseases from animals to humans.

“Climate change and increased human–animal interaction are contributing to this trend,” said Dr Ngashi. “We need to anticipate, prevent and respond faster.”

He cited the strengthening of community-level surveillance and the enhancement of laboratory capacity as key priorities under the One Health framework.

RVF symptoms typically appear two to six days after infection and include flu-like fever, muscle and joint pain, headache and loss of appetite. While most people recover without treatment, a small percentage develop severe complications such as vision loss, meningoencephalitis or haemorrhagic fever.

There is currently no specific antiviral treatment or approved human vaccine. In 2024, 12 cases were reported across Mauritania, Kenya, Senegal and Uganda, with no deaths.

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Priority actions include finalising the MoU, developing a joint workplan and performance framework, operationalising the Public Health Emergency Operations Centre (PHEOC), and conducting regional simulation exercises.

The agreement, reached following a high-level strategic meeting in Naivasha on 29–30 September 2025, is expected to accelerate collaboration, finalise the institutional framework for partnership, and align Kenya’s health security priorities with Africa CDC’s New Public Health Order.

“Kenya remains a committed partner and regional leader in advancing the New Public Health Order for Africa,” said Mary Muthoni, Principal Secretary, State Department for Public Health and Professional Standards. “Through this partnership, we are strengthening our collective resilience and building a self-sustaining health security system for the region.”

A joint steering committee and operational framework will be established to guide coordinated implementation, monitoring, and accountability.

Other discussions focused on accelerating surveillance integration, advancing One Health adoption, and implementing the 7-1-7 Strategy for epidemic prevention, preparedness, and response.

Kenya was endorsed as a regional hub for laboratory science, workforce development, and field epidemiology training, alongside ongoing efforts to standardise and expand a rapid-response workforce.

During the meeting, plans were made to install Africa CDC–donated PHEOC equipment and expand Kenya’s national laboratory network into a regional reference system.

As Africa grapples with limited local manufacturing capacity for vaccines and diagnostics, participants underscored the need to improve access to finance and boost production. Emphasis was placed on leveraging Kenya’s growing pharmaceutical sector to advance regional self-sufficiency in vaccines, therapeutics, and diagnostics through regulatory harmonisation and innovative financing mechanisms.

The meeting also called for sustainable financing, allocating at least 0.5% of national health budgets to epidemic preparedness, alongside increased investment in data governance, One Health integration, and climate-resilient health systems.

The Ministry of Health reaffirmed Kenya’s full commitment as host country, pledging to expedite the MoU to guide implementation of the agreed priorities, said Principal Secretary Muthoni.

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Lacking standardised processes, clinical trials, and regulatory oversight, most traditional medicines remain confined to informal use, their potential largely unrealised. Often misunderstood or dismissed, some are still relegated to the realm of folklore. But that perception is shifting, and the mpox outbreak is contributing to the change.

Now in its second year, the outbreak has resulted in 270 confirmed deaths and more than 54,000 cases across 30 African countries. Amid a shortage of vaccines and the complexity of managing multiple clades, where behavioural factors are also at play, researchers across the continent are working to transform traditional remedies into scientifically validated treatments for mpox and other emerging diseases.

From 17–19 September, the Africa Centres for Disease Control and Prevention (Africa CDC) convened more than 100 researchers, policymakers, and traditional medicine experts in Kampala, Uganda, to accelerate the development of natural therapeutics. The gathering was co-hosted by Uganda’s Makerere Lung Institute (MLI-ICER), the Ministry of Science, Technology and Innovation, and the Democratic Republic of the Congo’s (DRC) CREPPAT Laboratories.

“The mpox crisis presents both a challenge and an opportunity to demonstrate the efficacy of African-led research and development models,” said Dr Mosoka Fallah, Acting Director of Science and Innovation at Africa CDC. “Despite the widespread reliance on traditional medicine, Africa has yet to fully leverage its potential for epidemic response.”

Delegates validated several promising natural compounds with the potential to become effective treatments and agreed to launch multi-country clinical trials. They also endorsed a Continental Framework for Natural Therapeutics Research and Development to guide the next phase of collaboration.

The idea that traditional remedies could be refined into effective treatments is not new. Still, the meeting illustrated the extent of the work underway to convert such remedies into modern medicines.

Uganda’s Clinical Trials on Natural Therapeutics (CONAT) programme, led by Professor Bruce Kirenga, demonstrated how traditional herbal preparations can undergo rigorous clinical evaluation. The model integrates traditional healers, scientists, and regulators in the same research ecosystem, an approach that is now being scaled up across the continent.

From the Democratic Republic of the Congo, Professor Constantin Bashengezi recounted a 40-year journey to develop Dubacil, a broad-spectrum antiviral that has shown potential against mpox. Meanwhile, ongoing collaborations — such as work between PROMETRA Senegal and METRAF Canada — are already repurposing natural products like MoMo30 to treat mpox and other viral infections.

One of the meeting’s most impactful contributions came from Professor Fidele Ntie-Kang of the University of Buea in Cameroon, who unveiled an African Natural Product Database containing more than 11,000 compounds from 1,700 species. His team uses molecular docking and cheminformatics to identify compounds that may inhibit mpox viral enzymes, a pioneering example of data-driven drug discovery on African soil.

Dr Firehiwot Teka from the Armauer Hansen Research Institute (AHRI) in Ethiopia co-developed the Continental Framework for Natural Therapeutics Research and Development. She explained that the framework rests on five pillars: verifying plant sources, assessing safety, standardising formulations, harmonising regulations, and strengthening research capacity.

Professor Nicholas Gikonyo from Kenya’s National Phytotherapeutics Research Centre outlined how traditional medicines are being repurposed for neglected tropical diseases and malaria. His colleague, Professor Samuel Wayizafrom the DRC’s CREPPAT Laboratories, shared how three natural therapeutic products were successfully added to the national drug list, a milestone in integrating traditional medicines into formal health-care systems.

Professor Don Jethro Mavungu Landu from the University of Kinshasa shared updates on Rosandre®, a natural treatment for sickle cell disease. He said two crucial steps are still needed: testing how well it works and how safe it is compared with the more commonly used remedy, hydroxyurea, and ensuring it is affordable and available to all Africans who need it.

Despite this momentum, significant challenges remain in harnessing traditional remedies. Regulatory barriers are complex and differ from country to country. Funding for clinical trials is scarce, and while Africa has the raw materials — ranging from medicinal plants to human talent — infrastructure and manufacturing capacity are still lagging behind.

To tackle these gaps, participants launched the African Network of Natural Therapeutics Scientists, designed to connect laboratories, share data, and build skills across borders.

Uganda’s Minister of Science, Technology and Innovation, Dr Monica Musenero, pledged government support, including office space and staffing for the network. She framed natural therapeutics as a strategic asset for Africa’s health security. “This collaborative effort positions natural therapeutics as a priority for reducing dependency on external sources and championing a Pan-African approach to health security,” she said.

Participants also visited DEI Biopharma, Uganda’s first biotech and pharmaceutical research company, where Africa CDC pledged support to help local manufacturers achieve international accreditation.

The meeting concluded with a multi-phase action plan. Within six months, Africa CDC will operationalise the new continental framework, supported by a secretariat to coordinate implementation. The first milestone will be launching multi-country clinical trials for the most promising mpox treatments, potentially a first for traditional medicine in Africa.

Over the next 18 months, focus will shift towards funding and harmonisation. Partners, including the African Development Bank and Gavi, the Vaccine Alliance, have signalled readiness to invest in laboratory infrastructure, accreditation of manufacturers, and training of scientists. The long-term goal is to integrate validated natural therapeutics into national health systems and secure World Health Organization (WHO) pre-qualification for African-made products.

“Africa’s strength lies in its biodiversity, its people, and its resilience,” said Dr Fallah. “What we need now is to translate that strength into science, and science into sovereignty.”

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The Africa Centres for Disease Control and Prevention (Africa CDC) and the World Health Organization (WHO), together with the Kingdom of Morocco, launched the Health Emergency Leaders Network in Rabat, Morocco, in September.

The Network brings together, for the first time, health leaders from the African and Eastern Mediterranean regions to forge stronger regional defences that also reinforce global health security.

“No nation can protect itself alone. We must come together for stronger emergency preparedness, readiness, and response. Improving efficiency and effectiveness by working across national and regional borders through connected leadership is especially important in this time of declining resources and growing needs,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

The African and Eastern Mediterranean regions face some of the world’s highest burdens of humanitarian and health emergencies. Twenty-seven countries — almost half of all countries across both regions — are classified as fragile, conflict-affected, and vulnerable by the World Bank. Cholera is the most urgent and widespread threat across both regions. Mpox is also being reported in several countries, while the re-emergence of Ebola in Africa has highlighted the urgency of better cross-border collaboration.

“Africa CDC’s journey since 2017 has been rooted in the vision of a New Public Health Order for Africa, with leadership and partnerships at its core,” said Dr Raji Tajudeen, Acting Deputy Director-General, Africa CDC.

“Through initiatives such as the Joint Emergency Preparedness and Response Action Plan with WHO, we have shown the power of connected action in responding to outbreaks such as mpox. Beyond systems, the real difference in any emergency is made by people — and by leaders who act together in solidarity to protect communities,” said Dr Tajudeen.

The meeting — ‘Connecting Health Emergency Leaders to Advance Health Security’ — brought together deputy ministers and senior health emergency leaders from Ministries of Health in Africa and the Eastern Mediterranean regions, alongside development partners, donors, and international institutions.

Over three days, participants defined the Network’s vision, strategic value, priorities, and operational plans. The meeting concluded with the adoption of the Rabat Statement of Intent, a collective bi-regional commitment to build trust, foster solidarity, and accelerate collaboration across borders.

“When crises transcend borders, so must our response — seamlessly, efficiently, and with one voice. The Network’s value is clear: trust, operational alignment with global efforts, and a mechanism to share lessons and advance cross-regional opportunities before emergencies erupt. But its success will depend on the trust built among Member States. It must be country-driven, sustained, and rooted in shared responsibility,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean.

Dr Mohamed Yakub Janabi, WHO Regional Director for Africa, underlined the urgency of the Network. “Africa and the Eastern Mediterranean face some of the toughest emergencies in the world. By bringing our leaders together, we are creating the relationships and readiness spirit that will make responses faster, stronger, and ultimately lifesaving.”

“The greatest shield against future emergencies is not walls or borders, but the trust we build across our leaders and countries. The North Africa region stands as the vital link between Africa and the Eastern Mediterranean, where our shared vulnerabilities demand shared strength,” said Dr Wessam Mankoula, Regional Director, North Africa Regional Coordinating Centre, Africa CDC.

Representing Morocco, H.E. Amine Tahraoui, Minister of Health and Social Protection, said that under the leadership of His Majesty King Mohammed VI, Morocco has turned major health crises into powerful lessons in resilience and drivers of solidarity.

“COVID-19 and other recent global crises have shown the world that no nation can stand alone, and that lasting health security can only be achieved through shared responsibility, solidarity, and cooperation. This meeting creates the momentum to move beyond short-term and crisis-driven responses to advance sustainable preparedness and to build robust health systems capable of protecting future generations,” he said.

The Health Emergency Leaders Network is a cornerstone of a regional flagship initiative to strengthen the emergency health workforce for the Eastern Mediterranean region and beyond. It also forms a central part of the Global Health Emergency Corps (GHEC), established in May 2023 with support from the Bill & Melinda Gates Foundation in the wake of the COVID-19 pandemic. By linking Africa and the Eastern Mediterranean more closely with each other and with global mechanisms, the Network will ensure that countries are better prepared, better connected, and better aligned with international efforts to strengthen health security worldwide.

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LC16m8 — a third-generation smallpox vaccine that is also used for mpox — is a live-attenuated vaccine produced by the Japanese manufacturer KM Biologics, a Meiji Group company. The vaccine has been licensed in Japan for decades against smallpox and has been used during previous mpox outbreaks, where it has been shown to be safe and effective, including in people with well-controlled HIV. The World Health Organization (WHO) granted Emergency Use Listing (EUL) for the LC16m8 mpox vaccine in 2024.

LC16m8 is now being rolled out for emergency use in the DRC, alongside another licensed mpox vaccine, in response to the outbreak. Three million doses of LC16m8 are being donated to the DRC by the Government of Japan to protect at-risk populations from the virus.

Mpox (formerly monkeypox) is a contagious infectious disease caused by the mpox virus, which is a member of the poxvirus family. There are two known clades of the mpox virus — clade I and clade II. Most people infected with mpox experience flu-like symptoms such as fever, headache, muscle aches, low energy, and swollen lymph nodes, as well as a skin rash featuring pus-filled lesions or blisters. In severe cases, it can be fatal.

“The vaccination campaign in the DRC provides us with a vital opportunity to gather insights into how effective the well-established LC16m8 vaccine is at preventing mpox disease in a high-transmission setting, including in children,” said Dr Richard Hatchett, CEO of the Coalition for Epidemic Preparedness Innovations (CEPI), which is funding the study.

“This could help guide how the vaccine can be used to have the greatest impact in the future. The research will also strengthen local scientists’ experience in rapidly generating real-world data during outbreaks, which could support faster and more efficient responses to future epidemic threats in the region,” he added.

Pending regulatory and ethics approvals and follow-up agreements for the study, an international research consortium will leverage the vaccination campaign to generate real-world evidence on the safety and effectiveness of the vaccine against mpox in affected populations in sub-Saharan Africa, including infants and children aged one year and above.

CEPI is providing up to USD 10.4 million to support the study, which is expected to launch before the end of 2025. The International Vaccine Institute (IVI) will serve as the study sponsor, while the Institut National pour la Recherche Biomédicale (INRB) in the DRC will act as co-sponsor. Supported by the DRC’s Ministry of Health and the Institut National de Santé Publique (INSP) — which regulates mpox outbreak research — the INRB will also assume the role of principal investigator, with the Japan Institute for Health Security (JIHS) as co-investigator.

“It is through scientific research with our different partners that we will be able to highlight the scientific evidence on the effectiveness of the LC16m8 vaccine against mpox. The results generated by this study will serve as an effective guide for future mpox outbreaks,” said Professor Jean-Jacques Muyembe, Director-General of the INRB and Principal Investigator.

A team of experts will assess the effectiveness of the LC16m8 vaccine by examining how many people become infected with mpox after being vaccinated in selected health zones considered hotspots for mpox cases in Équateur Province, north-western DRC. Additional data on the vaccine’s safety will be collected by monitoring a subset of participants taking part in the observational study.

The data generated are expected to inform vaccination and mpox management strategies in the DRC and other mpox-endemic regions, including, for example, the age groups that may benefit most from the vaccine and could be prioritised for vaccination. The findings could also provide evidence for policy and regulatory decisions on the use of LC16m8 in other countries.

The new research supports recommendations from the DRC’s Ministry of Health, the World Health Organization (WHO), and Africa CDC to prioritise the collection of additional data on the safety and performance of mpox vaccines during outbreaks.

“This study is a vital step in protecting Africa’s most vulnerable — especially children — from mpox. By turning science into action, we are building the evidence needed to guide vaccination and strengthen health security across the continent,” said Dr Jean Kaseya, Director-General of Africa CDC.

“The epidemiological data on mpox have enabled us to support the response with vaccination of the population. With this collaborative research, the DRC will be the first African country to collect essential field data on the use of the LC16m8 vaccine against mpox,” said Samuel Roger Kamba, Minister of Health of the DRC.

Dr Manabu Sumi, Director-General of the Department of Infectious Disease Prevention and Control at the Ministry of Health, Labour and Welfare of Japan, said that as the world’s only mpox vaccine currently approved for use in children, Japan’s LC16m8 has the capacity to help protect people of all ages.

“Building on the findings of this trial and Japan’s accumulated experience, the Ministry looks forward to working with international partners to further enhance LC16m8’s contribution to global preparedness and response efforts against mpox,” said Dr Sumi.

Africa CDC and the WHO declared the ongoing outbreak of mpox to be both a continental and global health emergency in August 2024. The WHO’s declaration of a Public Health Emergency of International Concern (PHEIC) was the second time in two years that mpox had been classified as an international emergency. As of September 2025, the WHO and Africa CDC confirmed that mpox remains a continental health emergency in Africa.

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“We warmly welcome the United Kingdom’s decision as a trusted and longstanding partner of Africa. This milestone is not only a recognition of the extensive reforms we have undertaken, but also an affirmation that Africa CDC today stands as a capable and accountable steward of resources for Africa’s health security,” said Dr Jean Kaseya, Director-General of Africa CDC.

This achievement would not have been possible without the steadfast support of the UK Permanent Mission to the African Union, led by Ambassador Darren Welch, Deputy Ambassador Adam Drury, and their teams, he said.

Since 2023, Africa CDC has undertaken sweeping institutional reforms, which include full alignment with African Union Financial Rules and Regulations, the appointment of high-calibre professionals, the establishment of an Office of Internal Oversight, and the adoption of comprehensive Environmental, Social and Governance (ESG), risk management, and anti-fraud policies.

Reinforced by regular independent audits, these reforms have stress tested Africa CDC’s systems and transformed the institution from reliance on third-party implementing partners into a continental agency fully capable of directly receiving and managing donor resources with accountability and transparency.

“We are equally grateful to colleagues at the Foreign, Commonwealth and Development Office (FCDO) in London — notably Mark Smith, Penny Innes, Uzoamaka Gilpin, Tino Lenton, and their teams — for their invaluable role in this process. I thank the Government of the United Kingdom for its confidence and partnership, and I call on all our partners to follow this example, placing their trust in the robust fiduciary and governance systems we have built — systems that reflect African ownership, African leadership, and global accountability,” said Dr Kaseya.

The UK’s approval follows the confidence already expressed by African Union Member States and other global health partners such as the World Bank, Gavi, CEPI, and the European Union (HERA), who have entrusted Africa CDC with the direct financial management of major programmes. Collectively, these endorsements affirm Africa CDC’s role as the continent’s recognised Public Health Agency.

Africa CDC remains firmly committed to upholding the highest standards of transparency, accountability, and performance, ensuring that the trust placed in it by African citizens and the international community is continuously strengthened.

This achievement forms part of Africa CDC’s broader mandate as the Public Health Agency of Africa, endorsed by the African Union Assembly. By securing direct financing, Africa CDC ensures that resources flow with speed, transparency, and impact — directly to where they are needed most: Member States and their communities.

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Voices like this set the tone for the Regional Risk Communication and Community Engagement (RCCE) Capacity Strengthening Workshop, held in Kampala from 9 to 12 September 2025 under the Saving Lives and Livelihoods initiative — a partnership between Africa CDC and the Mastercard Foundation. The workshop brought together health promotion directors and RCCE focal persons from 13 Eastern Africa Member States, along with partners from the International Federation of Red Cross and Red Crescent Societies, Uganda Red Cross Society, and the UK Public Health Rapid Support Team.

Representing the Director-General, Ministry of Health, Uganda, Dr Joseph Okware welcomed participants, recalling lessons from Ebola, COVID-19, and mpox. “Communities are not just recipients of information; they are partners in the response. When we listen to them, our health systems become stronger,” he said.

“Health systems are only as strong as the trust they earn. When we listen to communities, understand their fears, and act with empathy and evidence, we do more than deliver interventions — we save lives and transform societies,” echoed Dr Mazyanga Lucy Mazaba, Africa CDC Eastern Africa RCCE Regional Director.

A panel of Community Health Extension Workers (CHEWs) — frontline health-care providers who work in their local communities to deliver essential health services, provide health education, and serve as a crucial link between communities and formal health systems — brought those words to life during the workshop. CHEWs supervise Village Health Teams, conduct household mapping, and support referral pathways for severe cases of malaria, pneumonia, and diarrhoea. “We mobilise families for immunisation, screen for hypertension and diabetes, conduct nutrition checks for pregnant mothers, and offer psychosocial support, including mental health screening with PHQ-9 tools — a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression,” one CHEW said.

Others, in the course of their duties, have responded to outbreaks — going door to door with Village Health Teams to educate communities about mpox or Ebola, and teaching simple infection prevention practices. “I am their neighbour first and a health worker second,” one CHEW said, showing the bonds created through working with communities.

Alongside these stories, participants strengthened their skills in collecting, analysing, and applying social and behavioural data, learning how these insights can be used to design trusted, evidence-based health programmes. They also explored how to integrate gender into RCCE, recognising the barriers women and vulnerable groups face and the need for gender-responsive approaches to improve vaccine uptake.

The first Eastern Africa RCCE Community of Practice Regional Committee members were elected by participants, ensuring that the region’s realities and innovations help shape the continental RCCE agenda. The committee will be led by Kenya’s Wycliffe Matini as Chair, with Uganda’s Tabley Bakyaita serving as Vice-Chair and Djibouti’s Abdillahi Aye Samod as Secretary. They are joined by Seychelles’ Betty-May Bibi and Somalia’s Khadar Mohamud as members, while Uganda’s Edward Muganga will take on the role of Monitoring and Evaluation Officer. Together, this team reflects the region’s collective commitment to strengthening health promotion, risk communication, and community engagement for social and behavioural change.

Participants moved from theory to practice on the final day. At the National Public Health Laboratories and Diagnostic Services, they saw how Uganda’s electronic Community Health Information System (eCHIS) links over 21,000 community health workers, including CHEWs, to national platforms for real-time data and decision-making. At the Ministry of Health Call Centre, they observed how the 24-hour, seven-day-a-week service provides health information, manages rumours, and captures community feedback, closing the loop between citizens and the health system.

By the close of the workshop, participants agreed that the lessons shared and witnessed extended far beyond immunisation. “We all face different challenges, but the principles are the same. This exchange showed us how we can adapt ideas and strengthen RCCE in our own contexts,” said one delegate from Seychelles.

The workshop confirmed that resilient health systems are built on the trust between communities and those who serve them. At the centre of that trust are Uganda’s Community Health Extension Workers — frontline staff who carry the weight of both professional responsibility and neighbourly care. “The use of social and behavioural data in health programmes, drawn directly from community voices, is what ultimately makes interventions trusted and effective,” said Dr Mazaba.

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Working in unison, teams from the Africa Centres for Disease Control and Prevention (Africa CDC) and UNICEF are painting a clearer picture of the status of community health workers in Africa. At least 69% of Member States have community-based data integrated into their national health information systems, and 63% have a master list identifying where community health workers are deployed. Fifty-one per cent of 26 Member States pay community health workers between USD 10 and USD 300 per month, with a median of USD 50.

This newly gathered data on community health workers tell → (tells) a remarkable story of progress, but there is still work to be done.

Africa CDC convened the Continental Coordination Mechanism (CCM) Taskforce Meeting on Community Health, bringing together Ministers of Health from African Union Member States, principals of institutions supporting community health on the continent, senior government officials, and global health leaders to accelerate the implementation of community health priorities across Africa, on the sidelines of the 80th United Nations General Assembly (UNGA) in New York.

Examining the data at hand, one strong proposal emerged: prioritisation of domestic funding and integration of community health workers’ remuneration into national wage bills, while exploring innovative financing options to ensure programme sustainability.

Effective utilisation of every pound (or dollar) will come from strengthening national community health strategies and coordination mechanisms to promote accountability, harmonise regulations, and operationalise the principles of One Budget, One Implementation Plan, and One Monitoring and Evaluation Framework.

“Community health workers are the backbone of Africa’s health systems. This Taskforce Meeting underscores our commitment to strengthen and expand community health programmes to reach every household and leave no one behind,” said Dr Jean Kaseya, Director-General of the Africa CDC.

UNICEF’s Deputy Executive Director, Dr Omar Abdi, reinforced the need to increase domestic financing whilst enhancing efficiencies in health expenditure as a sustainable solution to strengthening and scaling national community health programmes.

The principals of the meeting emphasised expanding and strategically deploying the CHW workforce, harmonisingtraining and certification frameworks, and investing in continuous capacity building to ensure CHWs can meet evolving public health needs. Leveraging interoperable digital tools and community health information systems to strengthen real-time decision-making, service delivery, and monitoring of CHW programmes will help drive the 2017 African Union decision to train, deploy, and sustain two million community health workers across the continent.

The Continental Coordination Mechanism (CCM) Taskforce provides strategic leadership for Africa’s community health agenda. It sets the continental agenda, mobilises political and financial support, and engages key stakeholders — including principals of institutions supporting community health, funders, and high-level influencers — to strengthen policies, partnerships, and funding for sustainable community health programmes across the continent.

The Taskforce highlighted progress in Africa’s community health systems as indicated by the 2024 Africa CDC–UNICEF Community Health Survey, covering workforce, policy, and financing.

In 2024, there were 1,042,441 CHWs deployed in 48 African countries, with 50.5% being women. This represents a significant milestone toward the continental target of two million CHWs, set by the African Union in 2017.

CHWs deliver a broad range of services — from community-based surveillance and health promotion to basic curative care, nutrition, and mental health. Despite this scale, the average CHW density remains 7.4 per 10,000 population, highlighting the need for continued investment and strategic deployment.

Forty-three Member States (84%) have a national community health strategy, with 35 (78%) costed — up from 47% in 2022. Forty-nine Member States (96%) have designated entities responsible for community health programmes, most supported by government-led coordination platforms to align stakeholders and resources.

Only 51% of community health budgets are funded, primarily from external sources. Just six countries finance over 80% of CHW programmes domestically, while 18 countries rely on donors for 90% or more of their budgets. Africa CDC and UNICEF estimate that an additional USD 3.65 billion (USD 720 million annually over five years) is required to achieve the full deployment of two million CHWs across Africa.

Dr Kaseya said the findings of this survey will inform critical next steps to sustain the Community Health Programme on the continent.

As these findings highlight both progress and the critical bottlenecks that must be addressed collectively at continental and national levels, Africa CDC and UNICEF are finalising the report for a high-level launch and dissemination.

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Today, the IWGHSS, a youth-led global network advancing equity and governance in health systems, continues its mission of co-developing and creating a collective space for young people to reimagine how health systems can function.

“We define ourselves as a community of action,” said Dr Bettina Buabeng-Baidoo, IWGHSS Co-Executive Director. “We convene emerging changemakers to catalyse efforts towards health system strengthening. Our mission is a world in which the next generation of changemakers are equipped to imagine and co-create equitable solutions for global health system strengthening. Our vision is a world where emerging voices are included.”

In its quest to become a leading global think tank and policy institute that centres the voices of young people at all levels of the health system, IWGHSS has joined hands with Africa CDC to ensure that young people in Africa have a space at the table in global health governance.

Among the programmes led by the Africa CDC Youth Programme is the Africa CDC Bingwa Plus initiative, in which IWGHSS is an active partner.

During a webinar held as part of Africa CDC Youth Week, Buabeng-Baidoo said the group is focused on creating youth-led policies and research led by and for young people working in the health space.

“We are also involved in advocacy, through campaigns at different levels of the health system, and a very big focus for us is capacity strengthening. These webinar sessions form part of our efforts to strengthen capacity. But we also speak critically to the fact that the Global South faces a major research gap,” she said.

Buabeng-Baidoo added that much research is not conducted by researchers from the Global South or by young people themselves. The advent of artificial intelligence and digital health offers opportunities to close that gap.

“One of our aims is to equip young people with the ability to use new technology to create cutting-edge research,” she said.

“Under the Africa CDC Bingwa Plus programme, we will be leading a Youth and Global Health Governance Report,” she explained. “Through this report, we want to show that the world’s population is over 30 per cent young people, 60 per cent in Africa, a number expected to rise to 75 per cent by 2030. Yet their presence in global health governance remains largely tokenistic, even though they are widely recognised as changemakers.”

Buabeng-Baidoo said a preliminary report will be released within three months, drawing on publicly available data. The team will start with a scoping review of existing literature and an analysis of youth engagement strategies, such as the Africa CDC Youth Engagement Strategy and the UN 2030 Youth Report, to identify synergies, gaps, and measurable impact.

Some of the indicators being developed include youth representation in staffing, the existence of youth advisory boards, youth engagement strategies, youth participation in policy decision-making, and institutional commitments to youth inclusion.

“We want to know: what is Africa CDC’s commitment to youth inclusion? What targets does the organisation aim to achieve, and how is it monitoring and evaluating progress?” she said.

Dr Chrys Promesse Kaniki, Africa CDC Youth Lead, said the agency already has a strategy to engage young people, aligned with the Agenda 2063, the Africa CDC Strategic Plan, and the African Youth Charter, currently under review with the African Union Commission Youth Division.

“Young people are playing a crucial role in Africa’s public health, and it’s equally crucial to ensure that we include and meaningfully engage them,” said Dr Kaniki.

He added that inclusive policy is essential to integrate young people in all processes and ensure long-term success.

“Young people are more likely to leverage digital skills. They are tech-savvy, and we must ensure that from application to telemedicine, they are driving the digital transformation of healthcare delivery on the continent,” he said.

Ezinne Onwuekwe, an independent Digital Health Strategist, noted that policy and governance for youth remain critical gaps.

“With the digital health evolution, many of us have taken courses and gained technical skills — coding, app development, creating solutions — but there is often a lack of grounding in policy frameworks, regulatory processes, and governance structures,” she said.
“We forget that, without policy, all those innovative solutions cannot be implemented effectively.”

Dr Kaniki added:

“Young people can identify problems in their communities and develop solutions. What Africa CDC is doing is creating a platform to support them, including mechanisms to mobilise resources and fund their innovations at community level.”

As Africa CDC strives to give youth a space at the table in global health governance, the continental health agency already has a Youth Advisory Team serving from 2023 to 2025 and looks forward to onboarding a new advisory team in November.

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