The successful implementation of the PA is a critical necessity for Africa, given the continent’s unique pandemic vulnerabilities and weaknesses in its global health security capacities, thus it stands to gain the most from the accord [5]. This is due to several contextual and interrelated factors.
First, Africa is home to numerous high-threat pathogens, including the Ebola virus disease (EVD), yellow fever, cholera, mpox, and other diseases with epidemic and pandemic potential [6]. However, its pervasively weak health systems, particularly the fragile disease surveillance systems, inadequate emergency health workforce capacity, disrupted supply chain systems and limited domestic financing of healthcare among others continue to constrain the continent’s capacity to timely and effectively prepare for and respond to outbreaks of these diseases [7]. These challenges are further exacerbated by political instability, ongoing humanitarian crises, and inequities in access to the social and economic determinants of health which are prevalent in several African countries.
Second, the continent’s low capacity to meaningfully engage in and influence global negotiations around critical components of the PA such as PABS and technology transfer places it at a disadvantage. This has been evident in the protracted and polarized nature of the accord’s negotiation process, which pitted high-income countries against low and middle-income ones [3]. This underscores the complexity of implementing global health agreements in an unequal world. This calls for increased continental capacity to address sensitive issues such as sovereignty, vaccine nationalism, and geopolitical influence, all of which have historically marginalized the mostly low-income African countries in matters of global health governance.
Third, Africa’s public health governance system is characterized by a proliferation of regional and international public health initiatives and frameworks, many of which lack coordination or operate in silos. The overlapping mandates of regional public health institutions and regional economic communities (RECs) frequently complicate harmonization efforts and undermine regional efforts to negotiate global protocols. The implementation of the PA within such a fragmented environment will require deliberate alignment, coordination, and integration.
Fourth, the recent decline in global development and humanitarian assistance have further constrained the continent’s ability to manage public health threats [8]. The PA offers an opportunity to mobilize and consolidate regional efforts, reinforce regional health security mechanisms, and build resilient health systems to fill this growing gap. In the current context of a progressively narrowing multilateral landscape, effective implementation of the Accord also presents an opportunity to address longstanding inequities in access to life-saving pandemic-related products among African countries.
Lastly, the continent’s limited investment in infrastructure for public health research and development poses additional challenges [9]. Strengthening this capacity would be essential for the continent to participate in an equal footing and benefit from the PA’s provisions on innovation, knowledge sharing, and equitable access to pandemic products.