The 4th International Conference on Public Health in Africa (CPHIA 2025) concluded in Durban, South Africa, on October 25, 2025, with the momentous launch of “The Durban Promise.” This pivotal outcome document, developed through consensus among nearly 20,000 participants from across governments, academia, and civil society, is designed to be Africa’s definitive roadmap toward self-reliance, sustainability, and decisive leadership in global health. The conference, held under the galvanizing theme “Moving Toward Self-Reliance to Achieve Universal Health Coverage and Health Security,” solidified the continent’s commitment to driving its own health agenda amidst rising public health emergencies and declining external financing.
The foundational philosophy of the Durban Promise is a bold declaration of health sovereignty. It directly addresses the vulnerabilities exposed by global health crises, such as the COVID-19 pandemic, which highlighted Africa’s over-reliance on external supply chains and technologies. In his remarks during the conference, H.E. Dr. Jean Kaseya, Director-General of Africa CDC, emphatically stated, “For the first time, Africa is inspiring the world. The world is coming to learn from Africa. This reform of the global architecture means we are co-architects. We are 1.4 billion proud Africans making our own agenda. We are proud of that.” This quote encapsulates the spirit of the document: a shift from being passive recipients of aid to being strategic contributors and leaders.
A core pillar of the Promise focuses on strengthening domestic capacity in health manufacturing and innovation. Recognizing that a reliance on borrowed technologies is unsustainable, the document outlines strategies to accelerate the local production of vaccines, therapeutics, and diagnostics. Dr. Nhlanhla Msomi, President of AfricaBio, underscored this urgency, noting, “We know that our healthcare industry on the continent at large is using borrowed technologies, borrowed ideas, and borrowed science. Unless we move away and decouple from that, we’re not likely to win this battle.” The roadmap advocates for creating an environment conducive to research and development (R&D) and for aligning domestic investments with Africa CDC’s Continental R&D Prioritization Framework.
Equally critical is the commitment to innovative and sustainable health financing. The Durban Promise emphasizes the need to mobilize Africa’s own wealth for health, strengthening governance and accountability to ensure efficient resource deployment. Key priorities include reframing health expenditure as a strategic investment rather than a cost, fostering regional solidarity and market efficiency for bulk procurement, and actively seeking fair global health financing mechanisms. This financial self-determination is viewed as indispensable for achieving universal health coverage (UHC) and securing long-term health security.
Furthermore, the document commits to a robust reinvestment in Primary Health Care (PHC) and community systems. This track advocates for transforming PHC to be resilient, equitable, and technology-enhanced, leveraging innovations like digital health and Artificial Intelligence (AI) to reach underserved populations. The importance of local ownership and community-based solutions is highlighted as central to achieving UHC, ensuring that essential health services are accessible to every community across the continent. This shift aims to strengthen the frontline of Africa’s health defense against both endemic and emerging threats.
The timing of the Durban Promise is exceptionally strategic. Launched on October 25, 2025, the document is positioned to directly inform high-level policy discussions, particularly the G20 Health Ministers’ meeting set to take place in early November under South Africa’s G20 Presidency. Professor Olive Shisana, CPHIA 2025 Co-chair, highlighted this strategic link, saying, “This moment enables South Africa to carry the voice of the continent into the G20 deliberations—championing fair global health financing, resilient systems, and recognition of Africa as a strategic contributor, not a passive recipient.” This effort ensures that Africa’s self-defined health priorities are elevated to the global stage.
In essence, the Durban Promise is more than just a conference declaration; it is a unified political and scientific mandate for action. It articulates a future where Africa’s health is sustained by its own innovations, powered by its own people, and protected by its own resilient systems. The collective ambition, affirmed during the closing ceremony by leaders like Dr. Jean Kaseya, is to accelerate Africa’s journey towards sovereignty in health, making health equity, economic inclusion, and social justice the measurable outcomes of this historic commitment.
