Congolese Physician Jean Kaseya: “Africa Faces a Major Risk of Pandemic Emergence”

The collapse of USAID, the world’s largest development donor, along with the withdrawal of funds from other European nations, has brought Africa face-to-face with its dependence on foreign aid, particularly in health. These cuts signal a new era where African governments must redefine their priorities, according to Congolese doctor Jean Kaseya, 54, director of the African Union’s Centers for Disease Control and Prevention (Africa CDC).

For Kaseya, as for many African experts and leaders, this crisis also presents an opportunity to distance themselves from external agendas. He is optimistic but recognizes that the immediate consequences are already dire. “The abrupt cuts are a poor decision by Western countries because [African nations] are not prepared for the transition,” he remarked at the recent Mo Ibrahim Foundation’s annual conference in Marrakesh. He also cautioned that the shortage of healthcare resources heightens the risk of a new pandemic arising from Africa.

Question. The West has ceased its development aid. While estimates suggest millions of lives will be lost, many in Africa see it as a chance to gain independence from foreign agendas. Is that feasible?

Answer. In a crisis, one can choose to feel pity for oneself, or one can view it as an opportunity. Africa is severely impacted by the aid cuts, particularly due to the suddenness of the decision. In Africa, between 30% and 40% of the population pays for their healthcare out of pocket because they lack health insurance. External support represents the second source of health funding. It is vital as it finances essential programs, especially for HIV, tuberculosis, malaria, and mental and child health. [African] governments opted to outsource these programs.

Q. And what do African governments finance?

A. The national budget is the third source of funding, primarily used for health workers’ salaries but not contributing to health system investment.

Q. Until the cuts happened.

A. The cuts were sudden, but the sense that the aid system was nearing its end had been growing. My starting point was the outbreaks of monkeypox and the Marburg virus. I observed that some of our partners, who had once been proactive in providing support, were not stepping up.

Q. How can Africa fill the donor gap?

A. We still have middle-income countries contributing less than 5% to their healthcare systems and which could do more. We need to maximize the funds allocated to healthcare. For instance, the Democratic Republic of the Congo has decided to allocate 2.5% of citizens’ salaries to the healthcare system. South Africa has opted to tax tobacco and sugar. Healthcare was not prioritized by many governments, which allocated funds to other areas, including the military. But now we have to say: let’s reallocate some funds to healthcare. Based on my discussions with heads of state, I believe progress is being made in African countries.

Q. However, there are countries, such as Kenya, where taxes have sparked significant protests among the younger, disaffected generation.

A. It cannot be a top-down decision. People need to be involved and understand that the money raised from taxing sugar, for example, will be used for health. We must involve the population in management; we can’t continue with the poor governance of the past in Africa. The aid cuts highlight the need for better governance. We must tackle corruption and fraud and make the most of the limited funds that still arrive from external partners; we don’t need more than 30% of the foreign aid we currently receive.

Q. What do you mean when you discuss improving governance?

A. When we meet with ministers and ask about the health resources they require, most are unable to answer because external partners tell them: “We have money for you.” That’s a problem. Some countries were told, “don’t worry about the vaccine, or HIV.” We need to rethink the system and invest in health. We must tell our partners, “if you want to come to my country to invest or provide support, align with my vision.”

Some countries were told: don’t worry about the vaccine, or about HIV. We need to rethink the system and invest in health.

Q. That’s a medium-term objective, but in the meantime, key treatments, such as antiretrovirals, are being discontinued.

A. Indeed. In South Africa, for instance, the government isn’t acting swiftly enough, and in this void, many people are going to suffer immensely.

Q. There’s much talk about the next pandemic. Do funding gaps and the climate crisis increase the risk?

A. We face a substantial risk of a pandemic originating in Africa. First, in epidemiology, we’ve observed a 41% increase in outbreaks from 2022 to 2024 in Africa. Moreover, even in the first quarter of 2025, we expect to see double what we recorded in 2024. Monkeypox, cholera, Marburg, Ebola, measles…

Q. To what do you attribute this?

A. The first issue is the absence of basic supplies. We lack medicines, vaccines, and diagnostics. The second problem is the shortage of adequate human resources. The third challenge is the lack of a digital system; if countries and regions are not connected, you can’t know what’s happening. If there is an outbreak somewhere, but you have the information, you can contain it and delay a pandemic. If you’re unaware, the outbreak continues.

Q. Didn’t we learn anything from the Covid pandemic?

A. As outbreaks continue to grow, we keep depending on medical products from other countries. With cuts to aid, we are diminishing our capacity to acquire essential products and compensate our health workers, thus moving towards a pandemic. That’s why we’re fast-tracking our local manufacturing program for diagnostics, vaccines, and treatments.

Sign up for our weekly newsletter to receive more English-language news from EL PAÍS USA Edition