Strengthening Africa’s health security and sovereignty through public health capacity for disease detection, prevention, and response

Africa continues to face substantial infectious-disease threats while operating within persistent constraints in health financing, surveillance, laboratory infrastructure, emergency preparedness, and workforce capacity. Recent epidemics, including Ebola and COVID-19, have highlighted the importance of strengthening not only health security but also health sovereignty—the capacity of African countries to prevent, detect, and respond to health threats through sustainable nationally and regionally owned systems. This thematic narrative review synthesized peer-reviewed and grey literature published between 2000 and 2026. Searches were conducted across PubMed, Scopus, Web of Science, Google Scholar, African Journals Online, and the World Health Organization (WHO) Global Health Library. Following predefined eligibility criteria, Total 614 records identified, 222 reports met the eligibility criteria and were included after removal of 220 records before screening, exclusion of 117 during title and abstract screening, and exclusion of 55 following full-text assessment. The included evidence was synthesized using inductive thematic analysis across five domains: health-security frameworks, health sovereignty and capacity building, disease detection and surveillance, emergency response and coordination, and workforce development. Africa has made important but uneven progress in public-health capacity. Between 2021 and 2026, early detection and reporting improved substantially in several countries, led by Malawi, Uganda, and Senegal, while rapid-response capacity was strongest in Nigeria, Egypt, and Rwanda. In contrast, pathogen-prevention capacity remained comparatively weak and uneven, with substantial deficits and deterioration in several countries. By 2025, 42 African countries had established functional Public Health Emergency Operations Centers (PHEOCs), up from 10 in 2015. Digital surveillance platforms in countries such as Ethiopia, Kenya, and South Africa have improved outbreak detection times and reporting accuracy. The Field Epidemiology Training Program (FETP) has trained over 2,000 health professionals across more than 20 African countries. However, persistent barriers remain, including inadequate domestic financing, with most countries spending less than 5% of GDP on health, shortages of trained health workers, weak laboratory infrastructure, and inconsistent political commitment to global health frameworks including the International Health Regulations (IHR 2005) and the Global Health Security Agenda (GHSA). Strengthening Africa’s health security and sovereignty requires a holistic, multisectoral approach. Progress is evident in epidemic detection and response, digital surveillance, workforce training, PHEOCs, One Health systems, domestic resource mobilization, local production of medicines and vaccines, and regional collaboration through the African Union and Africa CDC. However, progress in prevention remains comparatively limited, and gains have not been uniformly sustained. Sustained investment in these areas can reduce dependence on external aid and build resilient health systems capable of effectively preventing, detecting, and responding to disease threats. The strategic priority should therefore shift from predominantly reactive outbreak management toward nationally owned and regionally interconnected systems capable of preventing threats before they emerge, detecting them before they spread, and responding before they become crises. Not applicable.