‘Think about Africa first before signing those MOUs,’ Aceng warns leaders

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Minister of Health, Jane Ruth Aceng, has urged African leaders to prioritise the continent’s interests before signing memoranda of understanding (MOUs) with external partners, warning that failure to do so risks perpetuating dependency and limiting Africa’s health sovereignty.

Speaking at the closing of the inaugural Community of Practice on Health Sovereignty, held from March 23 to 25 at the Serena Hotel in Kampala, Aceng called for African governments to take ownership of their health agendas, financing, and systems.

The three-day conference brought together officials from ministries of health and finance from Senegal, Kenya, Eswatini, Mozambique, Zambia, Tanzania, Botswana, and South Africa. Co-hosted by Uganda and the African Union Development Agency (AUDA-NEPAD), with support from Georgetown University, the forum focused on country-led solutions to the continent’s health challenges.

“It is time for us to set our own agenda with clear minds and objectives. The MOUs we sign must address our priorities, determined by Africans themselves, government-to-government. If we sit in fear, waiting for instructions, nothing will change. Yet too often we sit in fear, cringing, saying, ‘yes, Africa do this; yes, Africa do that; yes.’ For how long? Nobody will come from outside to teach us how to run our house,” she said.

Aceng reflected on Africa’s history of external dependency, noting that despite the continent’s wealth in natural resources and human capital, external interventions have often shaped local health systems and priorities. She recounted how Africa was once told it could not roll out antiretroviral therapies during the HIV epidemic, only to later prove capable of successfully managing widespread treatment programmes. Similarly, predictions during the COVID-19 pandemic underestimated Africa’s resilience, she noted.

“Many of us were told Africa could not do this, could not do that,” she said. “Yet, we survived, we innovated, and we adapted. Now is the time for deliberate action, for Africa to set its agenda and stand firm on its priorities.”

The minister highlighted key achievements across Africa in recent decades, including a reduction in child mortality from 93 to 38 deaths per thousand live births between 1990 and 2021, a decline in maternal mortality by over 40% from 2000 to 2023, and the halving of AIDS-related deaths since 2010. By 2021, nearly 29 million Africans were on antiretroviral therapy, and scientific progress included malaria and other vaccines.

Despite these gains, Aceng stressed that Africa faces persistent challenges, including rising non-communicable diseases, climate-related health risks, urbanisation pressures, workforce shortages, fragmented supply chains, weak regulatory and manufacturing capacity, poor digital infrastructure, high out-of-pocket spending, and governance constraints.

“In Uganda, we are developing a sovereignty bill, soon to go to Parliament. This is Uganda, we do as Ugandans do. Don’t tamper with our culture, our politics, or our systems. If you come to support us, do so on our terms. This must happen across Africa, because when we are united, we are stronger; we are a common market,” she noted.

Aceng also highlighted Uganda’s reforms aimed at strengthening domestic health systems. These include results-based financing mechanisms at primary health care facilities, integrating off-budget donor support into the national budget, and mainstreaming HIV/AIDS interventions across all government institutions.

Uganda has invested in local pharmaceutical manufacturing, medical tourism, health infrastructure, human resource development, and public-private partnerships, ensuring that health services are more efficient, sustainable, and responsive to local needs.

The Community of Practice, Aceng said, provides a platform for African countries to share experiences, learn from one another, and collectively advance health sovereignty.



The forum also received remarks from Ntokozo Linton Mchunu, technical advisor to the CEO of AUDA-NEPAD, who emphasised the need for health problems to be approached through financial, systemic, and supply chain sovereignty. He urged African countries to plan, procure, distribute, and regulate medicines, diagnostics, and medical technologies independently. Mchunu noted that translating bilateral agreements into actionable, country-led programmes is central to achieving health sovereignty.

“We want to appreciate and commend Uganda for taking the lead in creating a platform that is not only about dialogue but also about action and implementation. What we are seeing here is not an abstract policy conversation but real proposals for implementation, grounded in the realities of each country,” he added.

Vivian Tumwebaze, principal economics and health budget analyst at Uganda’s Ministry of Finance, underlined the government’s commitment to sustainable health financing, noting that allocations to human capital and health programmes have increased substantially over the years.

Despite declining external support, Uganda has strengthened primary health care, enhanced governance, and promoted private sector partnerships to bolster domestic health capacity.

“Let us convert the Accra reset from vision to delivery. Let us anchor health sovereignty in policy, finance, and practice, ensuring that the dignity, resilience, and prosperity of our people are secured. Our markets, our resources, our people – these are ours to prioritise. Let Africa stand up as Africa.”

The conference marked a significant step toward strengthening continent-wide collaboration in health governance, policy implementation, and sustainable financing, aiming to reduce fragmentation, enhance domestic capacity, and ultimately deliver better health outcomes for all Africans.