The Bellagio Report: Catalyzing Action on Health Financing in Africa

Key Takeaways

• Health financing in Africa is at a decisive turning point as traditional global aid models decline, making continued dependence on external funding unsustainable and accelerating the need for health financing reform in Africa.
• Health financing sovereignty is essential. Health financing must be reframed as a strategic, sovereign investment that supports economic growth, national wellbeing, and resilient health systems in Africa, rather than being treated solely as a social sector expense.
• Fragmented, donor-driven programs undermine health system strengthening. Disease-specific and vertically funded initiatives weaken Africa health systems financing and limit long-term resilience.
• A whole-of-government approach is required. Sustainable health outcomes depend on coordinated action across finance ministries and non-health sectors such as infrastructure, education, water, energy, and digital connectivity.
• Community-led and tech-enabled health systems are critical. Digital health systems in Africa and community-based delivery models are essential to expanding access, efficiency, and equity at scale.
• Africa must redefine global health partnerships. The continent’s future role in global health should be as an equal partner, with aligned and predictable funding models that strengthen national health systems rather than parallel donor programs.

Executive Summary

This report captures outcomes from a high-level convening at the Rockefeller Foundation’s Bellagio Center focused on transforming health financing in Africa. Against the backdrop of declining global aid, participants emphasized that Africa has reached a turning point and must take ownership of its health agenda through sustainable health financing and domestically driven investment models. Framed by insights from Dr. Donald Kaberuka, discussions positioned health financing in Africa not as a social cost but as a strategic investment critical to economic growth, resilience, and national well-being.

The convening highlighted the limitations of fragmented, donor-led, and vertical programs, calling instead for long-term health system strengthening anchored in strong domestic institutions. Participants stressed that health outcomes depend on whole-of-society action, with finance ministry leadership and coordination across non-health sectors playing a central role. The report concludes that Africa must move from aid dependency toward health financing sovereignty and interdependence by designing Africa-led health financing models rooted in local innovation, strategic domestic investment, and sustainable global health partnerships.