When the U.S. abruptly paused key foreign aid streams earlier this year, including funding to PEPFAR, USAID, and global health agencies, the ripple effects were immediate. Clinics went dark. Programs halted. Frontline staff faced layoffs. UNAIDS warned that eight countries, including Kenya, Nigeria, and South Sudan, were at risk of running out of HIV medication. And as the President’s Malaria Initiative faced proposed budget cuts, analysts projected up to 13 million new malaria cases across the continent.
For those of us leading programmes, building partnerships, or steering strategic capital across Africa, these were not abstract shifts. They were reminders of a truth we’ve long understood; aid volatility is no longer an anomaly; it’s a structural feature of the current global order.
But the story doesn’t end there. In fact, I believe this is Africa’s strategic moment to lead, not only to respond.
Aid volatility is now a business imperative
Traditional aid models, often siloed, donor-dependent, and Western-led, are increasingly out of sync with today’s reality. In 2025 alone, aid programmes were frozen and partially reinstated under U.S. Executive Order 14169. Abrupt disruptions may have claimed an estimated 307,900 lives globally, with many of those losses occurring in Africa. But beyond the headlines and humanitarian costs lies a deeper issue; the business of development is shifting.
If African economies are to thrive amid global funding uncertainty, health systems must become investment-ready, innovation-driven, and resilient by design. This is not a charitable response; it is a strategic imperative.
It’s time to broaden the table
Donor fatigue is real, but so is African ingenuity. We can no longer rely exclusively on bilateral or philanthropic aid. Instead, we must activate a new era of financing rooted in African agency. This begins with domestic resource mobilisation, where governments design strategic policies to unlock internal capital, such as health-specific digital levies, value-based taxation, or outcome-based social bonds. At the same time, it’s critical to mobilise impact capital from African institutional investors, pension funds, sovereign wealth vehicles, and philanthropic entities, who increasingly recognise health and human capital as long-term economic investments. Lastly, we must deploy blended finance structures that align public resources with private-sector expertise, creating scalable partnerships that balance risk and reward. These are not merely financial tools; they are pathways to resilience, autonomy, and sustainable systems.
Regional ownership is operational
The recent relocation of key UN agency headquarters to Nairobi has been described by some as logistical. In truth, it’s transformational. It marks a turning point in the decentralisation of global governance and recognises Africa not just as a beneficiary but as a centre of gravity for health and development innovation.
Our response must go further. Strengthening the African CDC, empowering regional research hubs, and advancing cross-border health data harmonisation are not policy options; they are operational imperatives. Africa must own its narrative, shape its health architecture, and design systems for its people by its people.
Health innovation is a growth sector
Africa is not waiting. Across the continent, private health innovators are filling the gaps. Kenya’s diagnostics networks, Nigeria’s digital health accelerators, and South Africa’s vaccine trials reflect the rise of healthcare as both a social good and a viable business sector.
Let’s build;
Pharmacity hubs for distributed vaccine and diagnostic manufacturing Cold-chain infrastructure with telecom and logistics partners Healthtech ecosystems with scalable data tools, AI-enabled diagnostics, and ESG-aligned funding. These are not passion projects. They are the future of inclusive economic growth, and business leaders, not only policymakers, must sit at the table.
Africa at the global table
This moment calls for more than internal reform. It demands global representation and influence.
Africa must be present, not performatively, but substantively, in the global arenas where priorities are set, funding directed, and frameworks designed. This includes G20 health task forces, DFI and philanthropic investment boards, and multilateral health architecture labs. Participation alone is not enough; our presence must translate into influence, ownership, and agenda-setting.
Our role as business leaders
To my fellow African business leaders, those guiding capital, strategy, or public-private alliances, this is not a predictable downturn. This is a strategic pivot. And you are not a bystander.
You are a stakeholder in systems resilience. A co-investor in long-term equity. A convener of the networks and institutions that will carry us through the next disruption and shape what happens after it.
Are you funding scalable health and social infrastructure?
Are you partnering with public actors to accelerate African-led solutions? Or
Are you using your influence to localise procurement, design, and innovation pipelines?
This is not the work of government alone; it is our work as builders of markets and architects of ecosystems.
Closing thought
When the winds of global aid shift, we can’t merely rebuild what was. We must redesign with intelligence, ownership, and foresight. This is Africa’s moment to evolve from an aid recipient to a systems innovator with global influence.
And if we lead with clarity, strategy, and partnership, we won’t only weather the next storm. We’ll set the standard for how resilience is built.