GFO Issue 461, Article Number: 7
Interview with Olivia Ngou, Executive Director of Impact Santé Afrique
ABSTRACT
In this interview, Olivia Ngou, Executive Director of Impact Santé Afrique, analyzes the impact of the US aid freeze and the US withdrawal from WHO on the fight against malaria in Africa. She highlights the challenges of international funding and underlines the urgent need for appropriate strategies to maintain progress in public health in the face of an unprecedented crisis.
In a global context marked by geopolitical and economic tensions, the global health ecosystem is facing unprecedented challenges. The freeze on US aid, the announced withdrawal of the United States from the WHO, and a general decline in international aid are jeopardizing progress in the fight against endemic diseases such as tuberculosis, HIV and malaria. In this uncertain climate, organizations like Impact Santé Afrique continue to fight to maintain and strengthen their efforts against malaria, particularly in Africa, where the disease remains a major cause of mortality.
To better understand the impact of these developments on the fight against malaria, we interviewed Olivia Ngou, Executive Director of Impact Santé Afrique, an organization that plays a key role in advocating and coordinating efforts to eliminate malaria in Africa. In this exclusive interview, Olivia Ngou shares her views on the current funding crisis, the future of the fight against malaria and the strategies her organization is putting in place to tackle this complex situation.
Through her answers, she takes stock of the challenges facing the global community and highlights the concrete actions needed to maintain the effectiveness of public health programs.
With the freezing of US aid and the announced withdrawal of the United States from the WHO, what concrete repercussions do these decisions have on malaria control efforts in Africa, particularly in terms of funding and international cooperation?
The consequences are dramatic, particularly for communities most vulnerable to malaria, such as children under 5 and pregnant women. It should be remembered that PMI funding (Editor's note: The President's Malaria Initiative is a U.S. federal government program to fight malaria) targeted high-impact interventions in eligible countries, in particular through effective malaria control tools, in areas of high prevalence or high mortality. These regions and provinces now find themselves in a critical situation. The abrupt cessation of interventions (prevention, testing, treatment) is leading not only to stock-outs of tests and treatments, but also to delays in the implementation of seasonal campaigns, which are crucial in the fight against the spread of malaria. As a result, we risk seeing an inexorable rise in deaths, even though these lives could be saved.
The eighth replenishment of the Global Fund is approaching, against a backdrop of falling international aid. What are Health Impact Africa's priorities for this replenishment, and how do you intend to mobilize resources in the face of this worrying trend?
Impact Santé Afrique hosts the GFAN Africa secretariat, in partnership with WACI Health. Together, we have developed a plan to mobilize communities affected by the three major epidemics, in collaboration with civil society organizations from across Africa. This initiative aims to make our voices heard. Through our One World, One Fight campaign, we seek to mobilize decision-makers and leaders in Africa, as well as those in Global Fund allied countries, to take firm decisions and mobilize the funds needed to save 23 million lives. We also call on world leaders to honor their commitments to eradicating these diseases, which threaten global health security. It's not just a question of funding; it's a humanitarian emergency, saving lives and eliminating global threats.
The Global Fund has enabled considerable progress in the fight against HIV, malaria and tuberculosis, but today we have the tools to go further and aim for elimination. However, if immediate action is not taken, we risk losing these gains and accelerating the resistance and spread of these diseases. We will continue to mobilize African leaders to strengthen domestic funding for health. Beyond funding, we face a real global threat, and unity is essential to roll back these epidemics and prevent the spread of resistance. HIV, malaria and tuberculosis will not wait for us. We're going to take targeted, joint action, in partnership with young people, parliamentarians, scientists and community leaders, to mobilize the funds needed to fight and save lives.
The main development agencies in Western countries appear to be reducing their support for global health. As a key player in the fight against malaria in Africa, what strategies are you putting in place to maintain the impact of your programs despite this reduction in funding?
We have always advocated increased domestic funding for malaria control and health in general. We have trained over 100 civil society leaders in health financing via domestic funds, as part of the Joint Learning Agenda for Health Financing in Africa program, which we coordinated for French-speaking Africa. We will continue to provide civil society with the necessary tools to master our countries' budgetary processes, identify key moments and actors, and influence the allocation of health funds, while supporting universal health coverage and the strengthening of health systems. This program is more crucial than ever. In 2024, the health ministers of the 10 countries most affected by malaria signed the Yaoundé Declaration, a strong commitment to increased local funding and improved management of the fight against malaria in their countries. Also in 2024, COPEMA, the coalition of parliamentarians for the elimination of malaria in Africa, was created and is currently finalizing an action plan with CS4ME (Civil Society for Malaria Elimination). Many African countries have also begun to mobilize the necessary co-financing for Global Fund programs, despite the economic crises. All this bears witness to the determination of African countries to put an end to malaria. This ecosystem is essential, not only for greater mobilization of funds, but also for an effective accountability mechanism with performance evaluations. Impact Santé Afrique will continue to support African ministries of health in implementing the necessary tactical adjustments in primary healthcare, universal health coverage and the sustainable fight against malaria.
Malaria remains one of the main causes of mortality in Africa. How are the economic and funding crises, exacerbated by the pandemic and global geopolitical developments, affecting your efforts to combat this disease in the field?
These crises seriously jeopardize years of progress against malaria and the investments already made, which risk being lost. In 2025, we have the solutions needed to fight this disease, but this global context prevents the use of existing tools to save lives. Every obstacle to achieving our goals, as well as the loss of talent and achievements in this fight, is a considerable brake on our efforts.
In this uncertain global context, what is your vision for the fight against malaria in Africa in the coming years? What adjustments or new strategies would be needed to maintain, or even reinforce, the progress made to date?
Eliminating malaria is possible, and we've been saying so for a long time. To achieve this, we need to increase domestic funding and strengthen community involvement, with a focus on the household as the central actor in the fight against malaria. It is also essential to adequately fund and guarantee full coverage of community health workers, while ensuring rapid management of malaria cases thanks to a high-performance health information system. We also need to focus on prevention, ensuring full coverage of malaria prevention tools. In addition, innovative approaches, such as a multi-sectoral commitment to the fight against malaria, are crucial. Malaria must no longer be seen as a problem for the Ministry of Health alone; all sectors must contribute: environment, agriculture, education, research, housing, town halls... The private sector also plays a key role in accelerating control efforts. While external funding remains important to complement local efforts, the arrival of new innovative tools and their rapid deployment will enable us to achieve our goal: to put an end to malaria.
In a global context marked by geopolitical and economic tensions, the global health ecosystem is facing unprecedented challenges. The freeze on US aid, the announced withdrawal of the United States from the WHO, and a general decline in international aid are jeopardizing progress in the fight against endemic diseases such as tuberculosis, HIV and malaria. In this uncertain climate, organizations like Impact Santé Afrique continue to fight to maintain and strengthen their efforts against malaria, particularly in Africa, where the disease remains a major cause of mortality.
To better understand the impact of these developments on the fight against malaria, we interviewed Olivia Ngou, Executive Director of Impact Santé Afrique, an organization that plays a key role in advocating and coordinating efforts to eliminate malaria in Africa. In this exclusive interview, Olivia Ngou shares her views on the current funding crisis, the future of the fight against malaria and the strategies her organization is putting in place to tackle this complex situation.
Through her answers, she takes stock of the challenges facing the global community and highlights the concrete actions needed to maintain the effectiveness of public health programs.
With the freezing of US aid and the announced withdrawal of the United States from the WHO, what concrete repercussions do these decisions have on malaria control efforts in Africa, particularly in terms of funding and international cooperation?
The consequences are dramatic, particularly for communities most vulnerable to malaria, such as children under 5 and pregnant women. It should be remembered that PMI funding (Editor's note: The President's Malaria Initiative is a U.S. federal government program to fight malaria) targeted high-impact interventions in eligible countries, in particular through effective malaria control tools, in areas of high prevalence or high mortality. These regions and provinces now find themselves in a critical situation. The abrupt cessation of interventions (prevention, testing, treatment) is leading not only to stock-outs of tests and treatments, but also to delays in the implementation of seasonal campaigns, which are crucial in the fight against the spread of malaria. As a result, we risk seeing an inexorable rise in deaths, even though these lives could be saved.
The eighth replenishment of the Global Fund is approaching, against a backdrop of falling international aid. What are Health Impact Africa's priorities for this replenishment, and how do you intend to mobilize resources in the face of this worrying trend?
Impact Santé Afrique hosts the GFAN Africa secretariat, in partnership with WACI Health. Together, we have developed a plan to mobilize communities affected by the three major epidemics, in collaboration with civil society organizations from across Africa. This initiative aims to make our voices heard. Through our One World, One Fight campaign, we seek to mobilize decision-makers and leaders in Africa, as well as those in Global Fund allied countries, to take firm decisions and mobilize the funds needed to save 23 million lives. We also call on world leaders to honor their commitments to eradicating these diseases, which threaten global health security. It's not just a question of funding; it's a humanitarian emergency, saving lives and eliminating global threats.
The Global Fund has enabled considerable progress in the fight against HIV, malaria and tuberculosis, but today we have the tools to go further and aim for elimination. However, if immediate action is not taken, we risk losing these gains and accelerating the resistance and spread of these diseases. We will continue to mobilize African leaders to strengthen domestic funding for health. Beyond funding, we face a real global threat, and unity is essential to roll back these epidemics and prevent the spread of resistance. HIV, malaria and tuberculosis will not wait for us. We're going to take targeted, joint action, in partnership with young people, parliamentarians, scientists and community leaders, to mobilize the funds needed to fight and save lives.
The main development agencies in Western countries appear to be reducing their support for global health. As a key player in the fight against malaria in Africa, what strategies are you putting in place to maintain the impact of your programs despite this reduction in funding?
We have always advocated increased domestic funding for malaria control and health in general. We have trained over 100 civil society leaders in health financing via domestic funds, as part of the Joint Learning Agenda for Health Financing in Africa program, which we coordinated for French-speaking Africa. We will continue to provide civil society with the necessary tools to master our countries' budgetary processes, identify key moments and actors, and influence the allocation of health funds, while supporting universal health coverage and the strengthening of health systems. This program is more crucial than ever. In 2024, the health ministers of the 10 countries most affected by malaria signed the Yaoundé Declaration, a strong commitment to increased local funding and improved management of the fight against malaria in their countries. Also in 2024, COPEMA, the coalition of parliamentarians for the elimination of malaria in Africa, was created and is currently finalizing an action plan with CS4ME (Civil Society for Malaria Elimination). Many African countries have also begun to mobilize the necessary co-financing for Global Fund programs, despite the economic crises. All this bears witness to the determination of African countries to put an end to malaria. This ecosystem is essential, not only for greater mobilization of funds, but also for an effective accountability mechanism with performance evaluations. Impact Santé Afrique will continue to support African ministries of health in implementing the necessary tactical adjustments in primary healthcare, universal health coverage and the sustainable fight against malaria.
Malaria remains one of the main causes of mortality in Africa. How are the economic and funding crises, exacerbated by the pandemic and global geopolitical developments, affecting your efforts to combat this disease in the field?
These crises seriously jeopardize years of progress against malaria and the investments already made, which risk being lost. In 2025, we have the solutions needed to fight this disease, but this global context prevents the use of existing tools to save lives. Every obstacle to achieving our goals, as well as the loss of talent and achievements in this fight, is a considerable brake on our efforts.
In this uncertain global context, what is your vision for the fight against malaria in Africa in the coming years? What adjustments or new strategies would be needed to maintain, or even reinforce, the progress made to date?
Eliminating malaria is possible, and we've been saying so for a long time. To achieve this, we need to increase domestic funding and strengthen community involvement, with a focus on the household as the central actor in the fight against malaria. It is also essential to adequately fund and guarantee full coverage of community health workers, while ensuring rapid management of malaria cases thanks to a high-performance health information system. We also need to focus on prevention, ensuring full coverage of malaria prevention tools. In addition, innovative approaches, such as a multi-sectoral commitment to the fight against malaria, are crucial. Malaria must no longer be seen as a problem for the Ministry of Health alone; all sectors must contribute: environment, agriculture, education, research, housing, town halls... The private sector also plays a key role in accelerating control efforts. While external funding remains important to complement local efforts, the arrival of new innovative tools and their rapid deployment will enable us to achieve our goal: to put an end to malaria.
