Dr Richard Chivaka, Chief Executive Officer and Founder of Spark Health Africa, Zimbabwe, has called on African governments to reduce dependence on donor funding by strengthening domestic health financing mechanisms.
Chivaka also advocated for legal protection of revenues generated from sin taxes to enhance the sustainability of health systems across the continent.
He made the call in Abuja on Sunday ahead of the 4th International Conference on Public Health in Africa (CPHIA 2025), scheduled to hold from Oct. 22 to Oct. 25 in Durban, South Africa.
The conference will focus on the theme, “Moving Towards Self-Reliance to Achieve Universal Health Coverage and Health Security in Africa.”
Chivaka stressed that achieving sustainable health financing requires a leadership mindset that views health as an investment rather than an expense.
“The most practical way for African countries to reduce reliance on donors is to grow predictable domestic revenues and strategically channel them into health systems with strong accountability,” he said.
He urged African governments to honor the Abuja Declaration, which recommends allocating at least 15 per cent of national budgets to health.
According to him, countries like Rwanda and Ethiopia have shown that consistent domestic investment can build stronger and more resilient health systems.
Chivaka further encouraged governments to broaden their tax base by introducing and strengthening excise taxes on products such as sugary drinks, alcohol, and tobacco.
“Such measures not only generate revenue but also help reduce non-communicable diseases. For example, South Africa’s Health Promotion Levy on sugary drinks reduced consumption while generating billions in revenue — a win-win for both fiscal and health policy,” he explained.
He, however, cautioned that collecting sin taxes alone was insufficient without proper legal and administrative frameworks to ensure the funds are ring-fenced and spent on health.
He cited Botswana’s Alcohol Levy Fund, Zimbabwe’s AIDS and Health Levies, and Thailand’s Health Promotion Foundation as examples of successful models where tax proceeds are legally earmarked for health promotion and service delivery.
Chivaka also highlighted Ghana’s National Health Insurance Scheme, funded through a levy on value-added tax and payroll contributions, as a model for building strong national risk pools and reducing out-of-pocket spending.
“When funds from health-oriented taxes are diverted into general treasuries, public trust erodes and the health sector loses predictable financing,” he warned.
He urged African governments to consolidate fragmented health insurance schemes into national risk pools to improve equity, reduce administrative costs, and guarantee citizens access to uniform health services.
Chivaka also called for a shift from user fees to prepayment systems, where everyone contributes in advance to a shared fund, with targeted subsidies for those unable to pay.
He cited Rwanda’s community-based health insurance scheme, which subsidizes premiums for poor households, as a successful model that has significantly expanded healthcare access and improved equity.
Beyond revenue generation, Chivaka emphasized the importance of efficient spending through strategic purchasing and performance-based financing, where healthcare providers are paid based on measurable results rather than inputs.
“Rwanda’s performance-based financing model led to a 23 per cent increase in institutional deliveries and a 21 per cent rise in preventive care visits for young children,” he noted.
He concluded that achieving self-reliance in health financing would remain unattainable without transparent governance, efficient resource management, and strong leadership commitment.
“The health of the nation is the wealth of the nation. Africa must invest in its people’s health to achieve true development and resilience,” Chivaka said.
As the continent prepares for CPHIA 2025 in Durban, discussions on One Health and climate adaptation are expected to dominate the agenda, with experts urging African nations to build sustainable, home-grown solutions that promote self-reliance and health security.
