When COVID-19 vaccines became available, Africa found itself at the back of the queue. The pandemic exposed a longstanding vulnerability: despite significant advances in public health, the continent remained heavily dependent on others for many of the products needed to protect its people. Yet that moment also highlighted another story, one that receives far less attention. Across Africa, necessity has repeatedly driven innovation, producing practical solutions that are increasingly informing global thinking about how health systems can become more equitable, resilient and sustainable.
For too long, global health conversations have positioned Africa primarily as a continent of need, a place where health challenges are studied and solutions are delivered. While the continent continues to face significant health challenges, this perspective does not tell the whole story. It overlooks the ingenuity, resilience and leadership that have characterised African public health for decades.
Those working across African health systems have long recognised that some of the continent's most enduring innovations emerged from the need to find practical solutions in resource-constrained environments. Today, many of these innovations are informing how countries around the world think about strengthening health systems.
As the global public health community prepares to gather in Cape Town for the World Congress on Public Health, there is an opportunity to recognise that Africa's contribution to global health is no longer simply one of implementation. Increasingly, it is one of innovation, leadership and ideas.
The African philosophy of Ubuntu provides an important lens through which to view this evolution. Rooted in the belief that our wellbeing is inseparable from that of others, it reflects a long-standing understanding that effective public health depends on solidarity, community engagement and shared responsibility. These principles underpin many of Africa's most enduring public health innovations.
South Africa's response to HIV is one such example. Faced with one of the world's largest HIV epidemics, the country has built the world's largest antiretroviral treatment programme. Its significance lies not only in the millions of people receiving life-saving treatment, but also in the health system innovations that made this possible: decentralised services, nurse-led models of care, community-based adherence support and differentiated service delivery. The lesson extends well beyond HIV. It demonstrates how health systems can successfully organise long-term care for millions of people living with chronic disease.
Innovation has also been driven by one of Africa's greatest constraints, the shortage of health professionals. Long before task sharing became part of the global health lexicon, countries such as Malawi and Kenya had developed cadres of mid-level medical workers capable of delivering essential clinical care, particularly in rural and underserved communities. Rather than representing a compromise, these models demonstrated how appropriately trained health professionals can safely expand access to care while strengthening health system resilience.
The COVID-19 pandemic also accelerated an African-led effort to build a continental health products manufacturing ecosystem. Led by the African Union and the Africa Centres for Disease Control and Prevention through the Partnerships for African Vaccine Manufacturing, this initiative brings together countries, regulators and manufacturers to strengthen regional manufacturing, regulatory harmonisation, technology transfer and pooled procurement. Senegal's new MADIBA vaccine manufacturing facility is one tangible example of this broader ambition. Together, these efforts recognise that manufacturing capacity is not simply an industrial ambition, it is a public health imperative. Stronger local production will improve health security while contributing to economic resilience and skilled employment. They also underscore the growing importance of South to South cooperation, with African countries increasingly sharing expertise, strengthening regional institutions and working collectively to address common public health challenges.
These examples, South Africa's antiretroviral programme, mid-level medical workers in East Africa and Africa's emerging health products manufacturing ecosystem, are not isolated success stories. Together, they illustrate how African health systems have responded creatively to complex challenges across service delivery, workforce development and health security. Their relevance extends well beyond the continent, contributing to a broader global exchange of ideas on building stronger, more equitable and more resilient health systems.
Underlying many of these innovations is a distinctly African way of thinking about health, not simply as the treatment of individuals, but as a shared responsibility rooted in solidarity, community and mutual care. It is a perspective that resonates strongly with the philosophy of Ubuntu and has increasing relevance in an interconnected world.
The journey from necessity to influence is far from complete. Significant challenges remain, including persistent health inequities, constrained resources and the need to strengthen health systems across many settings. Yet the trajectory is clear. African innovation is increasingly shaping thinking on primary health care, workforce development, community partnership and health security.
The World Congress on Public Health in Cape Town provides an opportunity to move beyond outdated narratives of dependency and deficit. It is a moment not only to recognise African leadership in public health, but to learn from it.