Africa CDC chief proposes state-led Ebola response strategy

International health agencies have traditionally shouldered the burden of coordinating responses to epidemics on the continent, a model that has drawn both praise for its speed and criticism for its paternalism. The latest debate centres on a proposal from Dr Jean Kaseya, the newly appointed director of the African Centre for Disease Control (Africa CDC), who argues that African governments must assume full ownership of the fight against Ebola. Kaseya’s call comes as the region grapples with a resurgence of the virus in the Democratic Republic of Congo, where recent case numbers have risen despite the presence of United Nations‑backed teams and substantial foreign funding.In a detailed briefing to the African Union’s health summit last week, Kaseya outlined a three‑part strategy designed to shift the balance of power from external donors to national authorities..

The first pillar calls for the establishment of sovereign Ebola response funds, financed through a mix of domestic taxation, regional insurance schemes and contributions from the private sector. “Reliance on ad‑hoc aid creates a vacuum of accountability,” he said, adding that locally sourced resources would compel governments to invest in surveillance, laboratory capacity and health‑worker training with a longer‑term perspective.The second element of the plan focuses on governance. Kaseya proposes a continent‑wide framework that would require each member state to develop a legally binding national Ebola preparedness act, modelled on the legislation that helped Rwanda achieve near‑zero transmission during the 2018–2020 outbreak..

Such legislation would mandate the rapid deployment of emergency teams, secure supply chains for personal protective equipment and the creation of transparent reporting mechanisms overseen by parliamentary committees. By embedding these responsibilities in law, Kaseya believes the continent can avoid the “react‑and‑wait” approach that has characterised many past interventions.The third and perhaps most contentious component calls for the re‑negotiation of existing partnerships with agencies such as the World Health Organization, Médecins Sans Frontières and the United States Agency for International Development. Kaseya does not advocate the abandonment of these actors but insists that their role be reframed as technical advisors rather than primary funders..

He argues that a shift in language – from “donor‑driven” to “partner‑supported” – would empower ministries of health to set priorities, allocate resources and evaluate outcomes without external pressure to meet donor‑specified targets.Supporters of the proposal point to the uneven success of past campaigns. During the West African Ebola crisis of 2014‑2016, for instance, the heavy reliance on foreign medical teams and cash grants was later critiqued for creating parallel systems that collapsed once the immediate threat subsided. In Liberia, a post‑epidemic audit revealed that only a fraction of the $1.2 billion in aid had been absorbed into the public health infrastructure, with much of the remainder diverted to short‑term logistics..

Proponents argue that a domestically financed response would not only improve financial stewardship but also foster community trust, as citizens would see their governments taking direct responsibility.Critics, however, warn that many African states lack the fiscal space to fund large‑scale emergency operations without compromising other essential services. The International Monetary Fund estimates that the average public health expenditure across sub‑Saharan Africa remains below 5 % of GDP, a figure far lower than the 15 % target set by the Abuja Declaration. In nations still recovering from conflict or severe debt burdens, diverting resources to an Ebola fund could spark political backlash and exacerbate existing inequalities..

Moreover, some analysts caution that the proposed legal mandates could become another layer of bureaucracy, slowing response times if not carefully integrated with existing health ministries.The debate has already sparked diplomatic activity. The African Development Bank announced a pilot programme to issue low‑interest bonds earmarked for epidemic preparedness, an initiative that could provide the seed capital Kaseya envisions. Meanwhile, the United Kingdom’s Department for International Development, which has been a leading donor in previous Ebola outbreaks, has signalled willingness to shift from grant‑based support to capacity‑building grants that align with national strategies..

In Washington, the Centers for Disease Control and Prevention’s Global Health Security Office is reviewing its contractual arrangements with African partners to ensure that future funding is contingent on demonstrable local leadership.On the ground, health workers in the DRC’s North Kivu province have expressed cautious optimism. “We have seen too many times when the teams leave and the supplies run out,” said Dr Amina Hassan, a senior nurse at a provincial treatment centre. “If the government can guarantee that we have the kits, the labs, and the training all the time, it will change everything.” Yet she also highlighted the need for realistic timelines, noting that building a resilient health system takes years, not months, and that any abrupt transition could leave critical gaps during ongoing outbreaks.International observers suggest that the success of Kaseya’s vision will hinge on political will as much as on financial engineering..

The African Union’s Commission on Health, Nutrition and Development has pledged to monitor progress and to convene an annual summit where member states must report on their preparedness budgets and legislative reforms. If the continent can demonstrate measurable improvements—such as reduced case‑fatality ratios, faster contact‑tracing times and higher vaccination coverage—it could set a precedent for how low‑ and middle‑income regions manage future pandemics, from Marburg to COVID‑19 variants.The conversation about ownership is part of a broader re‑examination of global health governance that has accelerated in the wake of the COVID‑19 crisis. Scholars argue that the pandemic systemic flaws in a model that privileges donor priorities over local realities..

Kaseya’s proposal, while ambitious, reflects a growing consensus that sustainable disease control must be rooted in national capacity, transparent accountability and regional solidarity. Whether African leaders can marshal the political capital and resources required to enact such a transformation remains to be seen, but the discourse itself marks a decisive shift toward self‑determination in the fight against Ebola..