What’s more to come: The African Union paradigm shift in public health cooperation.

Abstract

Background: The COVID-19 pandemic, Ebola outbreaks marked a turning point in Africa’s public health policy, exposing deep structural vulnerabilities in health systems and catalysing unprecedented regional cooperation. In response, the African Union (AU) has embarked on a paradigm shift toward health sovereignty and continental solidarity.

Methods: This paper draws on AU policy documents, institutional decisions and declarations, and implementation plans reports from 2020 to 2024. It uses policy analysis and trend review methodologies to distil five major directions shaping the AU’s future health agenda.

Results: Five interlinked trends define the AU’s evolving approach to health governance: (1) investment in local vaccine production, (2) people-centered community health systems, (3) institutional consolidation under Africa CDC and AMA, (4) digital and data-driven health transformation, and (5) growing political leadership and domestic investment in health. These trends reflect a new public health order based on regional autonomy, solidarity, and evidence-driven leadership.

Conclusion: For the AU’s public health paradigm to be sustained and scaled, institutional governance, financing, market reform, and leadership development must be systematically strengthened. Coordinated actions between the AU, Regional Economic Communities (RECs), and Member States, backed by clear accountability frameworks, will be essential to achieving long-term resilience and equity in Africa’s health systems.

Keywords: African Union, public health, Africa CDC, vaccine manufacturing, health financing, digital health, political will, data sovereignty, pandemic preparedness.