As the 78th World Health Assembly (WHA78) convened in Geneva, the global health community faced a critical inflection point. Discussions focused on what it will take to prevent the next pandemic, rebuild public trust and create more equitable health systems. For African countries, the answer lies in a fundamental, and often overlooked, pillar of health systems: the supply chain.
Supply chains determine whether vaccines reach clinics, whether essential medicines are available in rural areas and whether health workers can do their jobs. WHA78 marked a turning point in how these systems are perceived: no longer primarily operated by donors without strategic country leadership; supply chains are now viewed as a strategic foundation for resilience and equity. Here are some takeaways from WHA78.
1. A Global Network Must Work for Africa
Across the continent, stockouts of essential medicines in public health facilities remain alarmingly common. In the Democratic Republic of Congo, for example, up to 70% of rural health facilities reported stockouts during peak periods.
WHA78 endorsed the creation of a Global Supply Chain and Logistics Network (GSCL), coordinated by the World Health Organization (WHO), to support the equitable distribution of medical countermeasures during emergencies. For African countries, it is vital that this new architecture reflects regional realities, not one-size-fits-all assumptions. The GSCL has an opportunity to engage regional institutions like Africa CDC and build on pandemic-era investments in local infrastructure.
African voices must shape how the network functions, how decisions are made and how countries access support. This means ensuring the GSCL is grounded in the day-to-day needs of African logistics systems, not just designed for emergency response.
We believe governments are stewards of the health system. Through our Transitioning Well approach, we emphasize that all interventions must be co-created and aligned with government priorities to ensure sustainable, effective systems that reflect local realities.
2. Local Manufacturing Is Essential to Health Security
According to the African Union Development Agency, investing in local manufacturing could reduce medicine costs by 20–30% and create over 16 million jobs by 2030 if properly coordinated with regional procurement reforms.
WHA78 reaffirmed the need to expand regional manufacturing, particularly for vaccines, medicines, diagnostics and health commodities. For Africa, where over 90% of health products are imported, this is not just a development goal; it is a question of health sovereignty. Local production, coupled with regulatory harmonization and pooled procurement, will help reduce dependence on fragile global supply chains and ensure quicker, fairer access during health crises. Without robust local industry, African countries risk again being last in line. But scaling production means more than building factories; it requires market-shaping strategies, predictable demand, quality assurance and cross-border coordination. For instance, we supported the Ministry of Health in DRC by developing a Directory of WHO-certified manufacturers to strengthen procurement decisions and ensure quality. This underscores that local manufacturing must go hand in hand with regulatory excellence and public-private collaboration to improve access to safe, effective medicines.
3. Equity Requires Enforcement, Not Just Promises
During the pandemic, fewer than 2% of the 10 billion COVID-19 vaccine doses administered globally were initially delivered to Africa within the first six months of rollout. This stark inequity illustrates why enforceability, not intention, is essential.
The proposed Pathogen Access and Benefit Sharing (PABS) system commits manufacturers to allocate 20% of emergency production to global coordination. While encouraging, African countries know too well that equitable access is not guaranteed by declarations alone. COVID-19 vaccine delays and dose dumping made clear the need for binding norms. PABS gives advocates a platform to advocate for enforceable agreements and accountability mechanisms that prioritize public health over profit. This includes demanding legal frameworks and transparency in production allocation, delivery timelines and pricing agreements.
4. Financing Must Strengthen, Not Bypass, Country Systems
Less than 5% of many African national health budgets go to logistics and supply chain operations. Closing this financing gap is critical to sustaining supply chain reforms beyond donor project cycles.
WHA78 introduced a Coordinating Financial Mechanism to help operationalize the Pandemic Agreement, including supply chain reforms. This presents an opportunity for African governments to ensure new funding streams support and scale national logistics systems.
Donor financing must be aligned with country priorities and avoid creating parallel systems that undermine sustainability. Long-term system financing, not short-term procurement projects, will build real preparedness. Countries should be in the driver’s seat of how resources are used—with flexible funding models that allow for context-specific planning, innovation and ownership.
What We Must Now Take Forward
1. Prioritize Supply Chains in National Health Strategies
Strong supply chains require a professionalized workforce trained to manage complex logistics functions. Investing in supply chain education, career pathways and leadership development is essential for long-term system performance.
VillageReach supports this by partnering with governments to strengthen workforce capacity and develop sustainable models of supply chain leadership. Governments must elevate supply chain leadership, embed logistics in sector planning, and allocate domestic resources toward infrastructure, personnel and data systems. Ministries of Health should be capacitated with specialized logistics units, and supply chain functions must be integrated into routine program management and budgetary cycles.
2. Build and Operationalize Regional Capacity
Africa’s push for pooled procurement, regional regulatory harmonization and the establishment of the African Medicines Agency must continue. These efforts require dedicated investment and cross-country coordination. Regional production hubs should not compete but collaborate—focusing on complementary strengths from research and development to last-mile delivery. Strengthening institutions like the African Union Development Agency and Africa CDC will be key to building a shared platform for regional resilience.
3. Invest in Real-Time Data and Country Ownership
In order to address data visibility gaps, countries must invest in digital platforms that track product flows from central warehouses to health facilities. But beyond software, supply chain intelligence depends on national ownership—ensuring countries control, interpret and act on their own data. This principle of ownership must extend beyond data systems to all supply chain operations, including transport, storage and last-mile delivery. Outsourcing transport to locally based private companies, for instance, can strengthen performance while preserving local operational control. Real-time data can inform procurement planning, reduce stockouts and create accountability, but only if countries have the capacity to govern and sustain these systems holistically.
4. Stay at the Table
The Pandemic Agreement is not yet complete. Its annexes, operating frameworks and financing models are still under negotiation. African governments must stay actively engaged in these discussions to ensure implementation aligns with regional goals and equity principles. Representation must be continuous—not only during crises. African negotiators should build collective positions and alliances to ensure shared interests are reflected in emerging global health governance frameworks.
A Window for Action
WHA78 offered more than declarations. It offered a chance for countries to redefine their role in global health governance—and to design systems that work for their people. But this opportunity will only be realized through sustained advocacy, investment and leadership.
We must move from principles to practice. The building blocks exist; regional institutions, political momentum, growing local expertise and a community of supply chain professionals ready to lead. Now is the time to connect the dots.
If the next emergency is to meet a different outcome, we must act now. What Africa does with the momentum of WHA78 will shape the future of health supply chains and by extension, health equity for generations.