GFO Issue 464, Article Number: 3
ABSTRACT
This article looks at the strong call from African civil society organizations to be fully involved in planning for future pandemics, after the global approval of the Pandemic Agreement. Based on expert views shared in a regional webinar held on 21 May 2025, it shows how CSOs help build trust, provide services, and keep governments accountable, especially during health crises. The article stresses that without strong, well-supported community involvement, health responses will not succeed. It also encourages civil society to take an active role in decision-making, funding, and global discussions to protect everyone’s health in the future.
In a rapidly evolving global health landscape, civil society across Africa is demanding a foundational realignment of power and participation in preparedness and response to pandemics. At the center of the discourse is the recently adopted Pandemic Agreement- a global milestone approved by 124 World Health Organization (WHO) member states in May 2025.African countries voted unanimously in favor of the agreement, signaling political will, but civil society actors are pushing for more: implementation, inclusion, and influence.
These issues took center stage in a high-level webinar titled “Enhancing CSO Involvement in Responding to Emerging Infectious Diseases in Africa,” organized by the AIDS Healthcare Foundation (AHF) Africa Bureau and the Resilience Action Network Africa (RANA) on 21 May 2025. Activists, public health leaders, and government officials from across the continent attended. A powerful consensus emerged: Africa’s pandemic response must be people-centered and civil society-led.
From the frontlines: The call to organize now
“This is an era of pandemics,” said Penninah Iutung, AHF Africa Bureau Chief, in her keynote address delivered just hours after the Pandemic Agreement was approved in Geneva. “Infectious diseases know no borders. We must be organized and prepared - because pandemics will not wait for us to get our act together.”
Iutung anchored her message in historical context: from the West Africa Ebola epidemic (2013–2016), to Uganda’s 2022 Ebola outbreak, to Rwanda’s 2024 Marburg outbreak, and the current Mpox outbreaks in multiple African countries. She emphasized that Africa knows pandemics all too well. “Civil society bridges the inequality gap,” she said. “During crises like Ebola in Sierra Leone, communities trusted civil society more than government channels. Our role is to keep governments accountable, to advocate, and to serve.”
The imperative: Centering civil society
Aggrey Aluso, Africa Director at the Pandemic Action Network, explained why civil society cannot be an afterthought. “Pandemics start and end with communities,” he said. “CSOs are the link between decision-makers and those communities. If we don’t embed civil society in pandemic planning, we risk repeating the mistakes of COVID-19 - delayed responses, mistrust, inequitable vaccine distribution.”
He underscored the roles CSOs play in early warning systems, community-based surveillance, and trust-building. CSOs also ensure government accountability. “Africa is awash with commitments,” he said. “But if a commitment doesn’t come with a political cost, it doesn’t get implemented. Civil society creates that political cost. Particularly in resource-constrained contexts, our best bet is to place communities at the center.”
Lessons from Sierra Leone: When community was left out
Sulaiman Lakoh, Director of Disease Prevention and Control at Sierra Leone’s Ministry of Health, reflected on his country's experience during the 2014–2016 Ebola epidemic. “We responded in silos - from a medical lens: build centers, treat patients, write guidelines, buy medication,” he said. “We failed to adopt an approach that included communities, civil society, and other sectors.”
He noted that the initial exclusion of civil society cost lives. “Only when we brought in all stakeholders were we able to contain the outbreak.” Sierra Leone has since adopted a One Health approach integrating human, animal, and environmental health systems. However, policy gaps persist. “Documents like the UHC Roadmap and the NAPHS don’t adequately reflect civil society participation,” he added.
AHF’s intersectional model: Empowering communities before crises
Oluwakemi Damasi (Kemi), AHF’s Director of Advocacy, Policy, and Marketing, stressed that waiting for a crisis is too late. “There is no public health without the public,” she said. “We don’t wait until crisis hits before empowering communities or creating space for them.”
She cited AHF’s work during the Ebola crisis in Sierra Leone: keeping clinics open, supporting treatment, and ensuring public trust. She introduced the "Community Power Voices" initiative, which boosts grassroots advocacy, strengthens policy engagement, and counters shrinking civic space.
Damasi also called for increased civil society representation on global health platforms such as the Pandemic Fund Board and the Global Fund NGO Delegation. “If we don’t reinforce the importance of the ‘public’ in public health, it becomes nearly impossible to get our voices heard,” she warned.
Positioning civil society in global platforms: G20, C20, and beyond
Norman Matara, from Southern African Doctors for Human Rights, emphasized that African civil society must be more assertive. “Civil society must join C20 working groups on global health, inequality, and sustainable development. That’s how you influence G20 outcomes,” he said.
He encouraged CSOs to engage with G20 sherpas, build regional coalitions, and develop evidence-based advocacy tools like shadow reports and scorecards. “We must be the watchdogs who ensure that commitments translate into action.”
Funding realities: Shrinking budgets, expanding opportunities
Underfunding remains a major barrier, especially for local CSOs. Damasi noted that while donors like the Global Fund, Gavi, and Africa CDC offer funding, many local CSOs are blocked by bureaucracy or lack of information.
She urged CSOs to diversify outreach. “We often send our reports to governments only. Why not share them with the private sector or philanthropists?” she asked. She also highlighted AHF’s Emergency Fund, which provided direct support to community-led organizations during COVID-19 - distributing food, PPE, and medicines.
The case for dedicated civil society emergency platforms
During the open floor, veteran activist Lydia Mungherera (Uganda) criticized CSO exclusion. “The Ministry of Health creates emergency committees - but we are not included,” she said. “We need permanent CSO-led pandemic structures.”
Peter Owiti raised another issue: the lack of community-owned surveillance tools. “We have tools for TB, but none for pandemics. By the time the Ministry hears, it’s too late,” he said.
Mobilize now, or pay later
With the Pandemic Agreement adopted, attention now turns to implementation. Aluso stressed the urgency: “If we don’t advocate for this agreement to be enshrined in national law, it will be just another piece of paper. We must drive political will and public awareness.”
For Africa’s civil society, the time to act is now. As Iutung warned, “Infectious diseases won’t wait for us to be organized.”
In a rapidly evolving global health landscape, civil society across Africa is demanding a foundational realignment of power and participation in preparedness and response to pandemics. At the center of the discourse is the recently adopted Pandemic Agreement- a global milestone approved by 124 World Health Organization (WHO) member states in May 2025.African countries voted unanimously in favor of the agreement, signaling political will, but civil society actors are pushing for more: implementation, inclusion, and influence.
These issues took center stage in a high-level webinar titled “Enhancing CSO Involvement in Responding to Emerging Infectious Diseases in Africa,” organized by the AIDS Healthcare Foundation (AHF) Africa Bureau and the Resilience Action Network Africa (RANA) on 21 May 2025. Activists, public health leaders, and government officials from across the continent attended. A powerful consensus emerged: Africa’s pandemic response must be people-centered and civil society-led.
From the frontlines: The call to organize now
“This is an era of pandemics,” said Penninah Iutung, AHF Africa Bureau Chief, in her keynote address delivered just hours after the Pandemic Agreement was approved in Geneva. “Infectious diseases know no borders. We must be organized and prepared - because pandemics will not wait for us to get our act together.”
Iutung anchored her message in historical context: from the West Africa Ebola epidemic (2013–2016), to Uganda’s 2022 Ebola outbreak, to Rwanda’s 2024 Marburg outbreak, and the current Mpox outbreaks in multiple African countries. She emphasized that Africa knows pandemics all too well. “Civil society bridges the inequality gap,” she said. “During crises like Ebola in Sierra Leone, communities trusted civil society more than government channels. Our role is to keep governments accountable, to advocate, and to serve.”
The imperative: Centering civil society
Aggrey Aluso, Africa Director at the Pandemic Action Network, explained why civil society cannot be an afterthought. “Pandemics start and end with communities,” he said. “CSOs are the link between decision-makers and those communities. If we don’t embed civil society in pandemic planning, we risk repeating the mistakes of COVID-19 - delayed responses, mistrust, inequitable vaccine distribution.”
He underscored the roles CSOs play in early warning systems, community-based surveillance, and trust-building. CSOs also ensure government accountability. “Africa is awash with commitments,” he said. “But if a commitment doesn’t come with a political cost, it doesn’t get implemented. Civil society creates that political cost. Particularly in resource-constrained contexts, our best bet is to place communities at the center.”
Lessons from Sierra Leone: When community was left out
Sulaiman Lakoh, Director of Disease Prevention and Control at Sierra Leone’s Ministry of Health, reflected on his country's experience during the 2014–2016 Ebola epidemic. “We responded in silos - from a medical lens: build centers, treat patients, write guidelines, buy medication,” he said. “We failed to adopt an approach that included communities, civil society, and other sectors.”
He noted that the initial exclusion of civil society cost lives. “Only when we brought in all stakeholders were we able to contain the outbreak.” Sierra Leone has since adopted a One Health approach integrating human, animal, and environmental health systems. However, policy gaps persist. “Documents like the UHC Roadmap and the NAPHS don’t adequately reflect civil society participation,” he added.
AHF’s intersectional model: Empowering communities before crises
Oluwakemi Damasi (Kemi), AHF’s Director of Advocacy, Policy, and Marketing, stressed that waiting for a crisis is too late. “There is no public health without the public,” she said. “We don’t wait until crisis hits before empowering communities or creating space for them.”
She cited AHF’s work during the Ebola crisis in Sierra Leone: keeping clinics open, supporting treatment, and ensuring public trust. She introduced the "Community Power Voices" initiative, which boosts grassroots advocacy, strengthens policy engagement, and counters shrinking civic space.
Damasi also called for increased civil society representation on global health platforms such as the Pandemic Fund Board and the Global Fund NGO Delegation. “If we don’t reinforce the importance of the ‘public’ in public health, it becomes nearly impossible to get our voices heard,” she warned.
Positioning civil society in global platforms: G20, C20, and beyond
Norman Matara, from Southern African Doctors for Human Rights, emphasized that African civil society must be more assertive. “Civil society must join C20 working groups on global health, inequality, and sustainable development. That’s how you influence G20 outcomes,” he said.
He encouraged CSOs to engage with G20 sherpas, build regional coalitions, and develop evidence-based advocacy tools like shadow reports and scorecards. “We must be the watchdogs who ensure that commitments translate into action.”
Funding realities: Shrinking budgets, expanding opportunities
Underfunding remains a major barrier, especially for local CSOs. Damasi noted that while donors like the Global Fund, Gavi, and Africa CDC offer funding, many local CSOs are blocked by bureaucracy or lack of information.
She urged CSOs to diversify outreach. “We often send our reports to governments only. Why not share them with the private sector or philanthropists?” she asked. She also highlighted AHF’s Emergency Fund, which provided direct support to community-led organizations during COVID-19 - distributing food, PPE, and medicines.
The case for dedicated civil society emergency platforms
During the open floor, veteran activist Lydia Mungherera (Uganda) criticized CSO exclusion. “The Ministry of Health creates emergency committees - but we are not included,” she said. “We need permanent CSO-led pandemic structures.”
Peter Owiti raised another issue: the lack of community-owned surveillance tools. “We have tools for TB, but none for pandemics. By the time the Ministry hears, it’s too late,” he said.
Mobilize now, or pay later
With the Pandemic Agreement adopted, attention now turns to implementation. Aluso stressed the urgency: “If we don’t advocate for this agreement to be enshrined in national law, it will be just another piece of paper. We must drive political will and public awareness.”
For Africa’s civil society, the time to act is now. As Iutung warned, “Infectious diseases won’t wait for us to be organized.”
