Africa Health and WaSH Futures: Thematic Futures

The report argues that Africa's health and WaSH sectors require a shift from donor dependency to domestic investment and institutional reform. It emphasizes the role of the Africa CDC in health sovereignty and the goal of producing 60% of vaccines locally by 2040. The document advocates for tailored strategies based on a typology of state capacities and the adoption of decentralized, solar-powered WaSH solutions to improve outcomes across the continent.

• Health financing in Africa is characterized by chronic underfunding and a heavy reliance on external donors, whose support is often fragmented because it focuses on disease-specific vertical programs for tuberculosis, malaria, and HIV/AIDS rather than core system-building.
• To achieve health sovereignty and reduce external dependency, the African Union has set a target to produce 60% of the continent's vaccines locally by 2040, with Egypt, Rwanda, Senegal, and South Africa currently investing in manufacturing capacity.
• The Africa CDC, established in 2017, is the primary institution for coordinating continental health policy, specifically in areas of public health workforce development, emergency response coordination, laboratory networks, and epidemic surveillance.
• Decentralized WaSH innovations, such as nature-based sanitation, off-grid filtration, and solar-powered boreholes, are effective alternatives to centralized infrastructure in peri-urban and rural areas; over 1,000 solar water-pumping systems have already been installed across Africa.
• Progress toward universal health coverage (UHC) is uneven across the region, with only a few countries, specifically Ghana, Kenya, and Rwanda, making significant progress through community-based or public schemes.

APA

Cilliers, J. (2026). Africa Health and WaSH Futures: Thematic Futures. Institute for Security Studies. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=07-conclusion

Chicago

Cilliers, Jakkie. Africa Health and WaSH Futures: Thematic Futures. Institute for Security Studies, 2026. https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=07-conclusion.

Wikipedia

{{cite report |last1=Cilliers |first1=Jakkie |title=Africa Health and WaSH Futures: Thematic Futures |publisher=Institute for Security Studies |date=29 March 2026 |url=https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=07-conclusion |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{cilliers2026africa, author = {Cilliers, Jakkie}, title = {{Africa Health and WaSH Futures: Thematic Futures}}, institution = {Institute for Security Studies}, year = {2026}, month = mar, url = {https://futures.issafrica.org/thematic/guide.pdf?thematic=05-health-and-wash&topic=07-conclusion}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }