Africa CDC takes another step toward greater autonomy

Efforts to give the Africa Centres for Disease Control and Prevention, or Africa CDC, autonomy from the African Union has been a work in progress for one and a half years. The process has involved African leaders agreeing to revise the statute of the pan-African health body, the organization hiring a new director general, and an ongoing effort to operationalize these changes. This month, African heads of state, ministers of foreign affairs, and members of Africa CDC’s new governance structure met in Nairobi to make decisions to realize this vision for the agency. This included granting Africa CDC the right to hire more staff and approving its new five-year strategic plan. It also marked the first time new members of its governance structures met. “[The changes are] giving us the opportunity to fulfill our mandate to build a stronger, more efficient organization, capable of tackling future health challenges across the continent,” the recently appointed director general of Africa CDC, Dr. Jean Kaseya, said in a press briefing following the Nairobi meetings. The events took place as part of the broader midyear African Union coordination meeting, which brought together government leaders, foreign ministers, and others to make decisions that affect how the AU operates. Hiring spree and new governance Africa CDC was launched in 2017 as a specialized technical institute of the AU, partially borne out of failures in the West Africa Ebola crisis response, as a way for countries across the continent to improve coordination during health emergencies. But it has been highly dependent on AU systems and approvals, which sometimes slowed it down and created inefficiencies. For example, it has not had ownership over its own procurement or human resources strategy, nor a legal instrument allowing it to work directly with governments. Because of this, in early 2022, African heads of state voted to grant Africa CDC greater autonomy from the African Union to give it more authority, flexibility, and speed to respond to public health emergencies. This led to a revised statute that called for a significantly different way for the entity to work. For example, the new director general can summon heads of state to discuss public health crises, which the previous director could not do. Since then, the organization embarked on a step-by-step transformation process, with important decisions taking place at biannual African Union meetings. The revised statute was approved in July 2022. This February, the first director general, Dr. Jean Kaseya, was appointed. And this month, African ministers of foreign affairs, who comprise the AU executive council, granted Africa CDC the ability to expand its staff size from 300 people to about 970, with regular positions increasing from 72 to 155. Kaseya said during the press conference that his teams aim to hire about 100 new regular staff members by the end of the year. As part of its efforts to transform, Africa CDC put new governance structures in place. The structure and composition of these groups changed with the revised statute of Africa CDC that granted it autonomy. Africa CDC has four governance structures: • The secretariat, led by Kaseya. • A council of heads of state and government that provides strategic advice and guidance to Africa CDC. It currently includes Benin, Niger, Botswana, Zambia, Burundi, Central African Republic, Ethiopia, and Mauritius, with two countries from northern Africa slated to join. • A governing board that provides strategic guidance to the secretariat and assists in resource mobilization, among other roles. • An advisory and technical council, with experts coming from across the continent to provide specialized support to the secretariat and governing board. New members of the advisory and technical council met in Nairobi and elected Dr. Eduardo Samo Gudo, scientific director at the National Institute of Health in Mozambique’s Ministry of Health, as its chair. The council includes 23 members, from national public health institutes, the World Health Organization, the Regional Integrated Surveillance and Laboratory Network, and the World Organisation for Animal Health, among others. Council members will serve a term of three years. In his address to fellow council members, Gudo emphasized their role is to serve as scientists, not politicians, in working to provide evidence-based guidance to Kaseya. The meetings in Nairobi also marked a turnover in membership of the governing board. The new board will include 19 members, including ministers of health, AU representatives, civil society, and members of the private, animal health, and environment sectors. Africa CDC said on Twitter that there will be a monthlong virtual regional consultation focused on electing more members. Zambia’s Health Minister Sylvia Masebo will serve as interim chair, while Kaseya will serve as its secretary. Strategic plan approved Kaseya said the governing board also approved Africa CDC’s strategic plan for 2023 through 2027. Africa CDC released two five-year strategic plans this year — one of which was scrapped. Before his appointment in February, Kaseya submitted a manifesto to the AU as part of his candidacy for the role of director general. In it, he said Africa CDC “suffers from a lack of accountability,” noting the organization hadn’t, at that point in time, published a new strategic plan. Before Kaseya formally took office this April, then acting director, Dr. Ahmed Ogwell Ouma, published a strategic plan which was backdated to last year. The organization said in a press release — which has since been removed along with Ouma’s plan — that Africa CDC had been implementing the strategy since last year, but only chose to make it public then. It said that the plan ran from 2022 to 2026. After he formally took office, Kaseya crafted his own five-year plan and it was approved in Nairobi this month. This was done in consultation with countries, partners, and others in the AU, according to Kaseya. Kaseya’s plan does not appear to be published online yet, and Africa CDC communications team had not responded to Devex’s requests for a copy of the plan at the time of publication of this article. Supporting vaccine manufacturing During the press briefing, Kaseya also spoke about continental efforts to increase vaccine manufacturing. He said Africa CDC attended the board meeting of Gavi, the Vaccine Alliance as an observer for the first time in June. Kaseya said as an observer, the organization could take part in the discussions when invited by the chair of the board. Vaccine manufacturing is a relatively nascent industry on the continent, and so the initial pricing of vaccines African manufacturers produce is not expected to be competitive with other parts of the world, such as the robust vaccines industry in India. Because of this, Kaseya said Africa CDC is pushing for Gavi to agree to pay 30% more for vaccines coming from African manufacturers for a period of about seven to 10 years. Kaseya said the Nairobi meetings were also an opportunity to ensure political leadership remained committed to vaccine manufacturing. To this end, Africa CDC appointed Kenyan President William Ruto as its champion for local vaccine manufacturing. Updated on Sept. 4, 2023: This article has been updated to reflect the Africa CDC staff size increase, based on a report released by the agency following Devex’s publication.