How Africa CDC's newly approved autonomy can actually happen

The Africa Centres for Disease Control and Prevention is slated to become a fully autonomous agency by the end of 2022.

“We are quite confident that we should be able to see a fully operational Africa CDC before the end of the year,” said Dr. Ahmed Ogwell Ouma, acting director of Africa CDC, during a press briefing on Thursday.

Last weekend, the African Union executive council approved the revised statute of Africa CDC during the AU’s midyear coordination meetings in Zambia. This made official Africa CDC’s transformation from a specialized technical institution of the AU to an autonomous public health agency, giving it more independence and making it more flexible in responding to health emergencies.

The initial decision to make Africa CDC more independent was made by heads of state in February, but a bureaucratic process followed within the AU in order to formally revise its statute. The executive council approval was the final stage in the process.

“The autonomy decision is a milestone — a huge milestone in global health security, not just for Africa,” Ouma said, adding that the continent now has direct ownership of its own health care agenda.

Devex reported in June that the World Health Organization’s regional office for Africa objected to part of these revisions, including empowering Africa CDC to declare and coordinate health emergencies, advocating instead for further discussions, as this would overlap with functions WHO already performs. WHO had briefed many government representatives across the continent on this position.

Countries are allowed to declare outbreaks within their own borders and WHO declares public health emergencies at the international level, but there has been a gap between when an emergency is declared at the country and global levels. But at the meeting on Saturday, the AU executive council granted Africa CDC the power to declare emergencies that are of continental concern.

“We now, as Africa, can be able to assess the outbreaks on the continent,” Ouma said. “If it goes beyond one country, then Africa CDC now has the authority to step in, assess the situation and make a declaration.”

“We take this authority with a lot of sensitivity and seriousness, so that the continent does not end up lagging behind in terms of response,” he said, adding that these declarations will be done in close collaboration with countries, WHO, and other stakeholders in order to assure there is alignment in responses.

The revised statute also elevates the organization’s director to a “director general,” and Africa CDC is now governed by two heads of state from each of the continent’s five regions. This implies that Africa CDC can now report information on outbreaks directly to heads of state, rather than through the AU.

In order to achieve full autonomy by the end of the year, there are a number of things that need to happen, Ouma said. Africa CDC will need to establish support systems, such as human resources, finance, administration and procurement, to keep it from being dependent on the AU for these functions. The AU Commission has been asked to provide Africa CDC with the necessary infrastructure so it can stand on its own as an institution, he said. 

Until Africa CDC’s own systems can become operational, he called on the AU Commission to increase the speed at which it offers support, so that Africa CDC can respond more quickly to outbreaks. Lacking offices in each country, Africa CDC — based in Ethiopia — uses the commission’s systems to engage with countries.

A new director general must also be recruited. The founding director, Dr. John Nkengasong, recently left the institution to lead the United States President's Emergency Plan For AIDS Relief. Ouma is currently standing in as acting director during this recruitment phase.

In February, heads of state also supported the establishment of an epidemic fund for the continent, and last weekend, the executive council granted approval for the AU to move forward with it. There is an “advanced draft” on this fund, and within the next two months, Africa CDC is expected to submit the draft to the policy organs including the AU’s Permanent Representatives Committee. Next February, Ouma said, it will be presented for approval to the executive council  at the AU’s annual summit of African heads of state.