Africa CDC criticizes exclusion from Pandemic Fund

The Africa Centres for Disease Control and Prevention said its inability to serve as an “implementing entity” for the new Pandemic Fund cripples its ability to protect the health of African citizens. The Pandemic Fund, which is hosted by the World Bank, and is led from a technical standpoint by the World Health Organization, is a pool of public and private financing aimed at helping low- and middle-income countries in pandemic preparedness and response. But Africa CDC has not been accredited by the fund as an “implementing entity” — which is necessary for it to access this funding independently on behalf of African nations. “This has considerably constrained the ability of Africa CDC, in the context of the Pandemic Fund, to play its AU-mandated role as convenor and coordinator of health security in Africa,” the pan-African health agency wrote in a statement on Wednesday. Some of the fund’s already pre-accredited implementing partners include: the African Development Bank, UNICEF, World Bank, WHO, Gavi, the Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Coalition for Epidemic Preparedness Innovations. On Feb. 3, the Pandemic Fund governing board approved $300 million for a first round of financing, calling on countries and implementing entities to submit proposals for projects in areas including strengthening disease surveillance, laboratory, early warning systems, and health workforce. The Africa CDC can’t submit a proposal independently — but it argues it is well positioned to do so as the leading health agency of the African Union tasked with coordinating the continent’s disease prevention and control. In its statement, it offered its support in assisting African nations and other regional bodies in submitting their proposals. “We are not criticizing the fund, we are just unable — and we are very sad about it — we are unable to participate [in the initial funding call] because of the status that we have,” Dr. Ahmed Ogwell Ouma said during a press conference on Thursday. A spokesperson for the World Bank wrote in an email to Devex that Africa CDC can prepare and execute projects jointly with implementing entities, which allows it to submit a proposal "as co-investors and potential recipients of funds." The spokesperson added that Africa CDC is also an observer on the governing board, which is also "preparing an accreditation framework that will be used to accredit additional entities as implementing entities." Africa CDC, which launched in 2017, has grown substantially in recent years and has also risen in prominence due to its leadership of the continental COVID-19 response. One year ago, African heads of states agreed to allow it to transition from a specialized technical institution to an autonomous public health agency. This will give it greater autonomy from the African Union — making it more agile in responding to health emergencies and granting it more decision-making authority. It’s currently in the process of making these changes. As Devex previously reported, there has been resistance to Africa CDC taking on expanded roles in the global health infrastructure. WHO’s Regional Office for Africa said "more discussion, further analysis and a full consideration of its implications" was needed before Africa CDC took on greater responsibilities, such as declaring when there is a Public Health Emergency of Continental Security. Africa CDC Acting Director Dr. Ahmed Ogwell Ouma told Devex in December that the agency has received pushback at the global level to its “new way of working” on the African continent. He said ​​an overarching challenge as a new institution is it entered the public health arena where other well-established institutions, such as intergovernmental organizations, philanthropies, the private sector, and other nonstate partners, already had established ways of working. In a Thursday webinar on decolonizing global health hosted by the AIDS Vaccine Advocacy Coalition, Agnes Binagwaho, retired vice chancellor of the University of Global Health Equity, said Africa CDC’s success in managing health across the continent is driving fear of competition from other institutions in the global north. She said this is the reason why the agency has not been accredited as an implementing entity adding that it is “totally the white supremacist in action.” African heads of state gather this week in Addis Ababa for an AU summit in which a series of new frameworks around operationalizing Africa CDC’s newfound autonomy will be up for approval. Those familiar with the processes told Devex it’s expected the AU will make an announcement on who will take on the role of Africa CDC’s director general. The founding director, Dr. John Nkengasong left in May, and Ouma has served as acting director in the interim during the recruitment process. Update, Feb. 16 and 17, and July 28, 2023: This piece has been updated with comments from Africa CDC’s acting director, Agnes Binagwaho, and a spokesperson from the World Bank. It also has been updated to reflect that Africa CDC has not submitted an application as the application process to accredit additional implementing entities has not yet launched.