GFO Issue 463, Article Number: 5
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 calling for a fundamental realignment of power and participation in pandemic preparedness and response. At the heart of this discourse lies 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, signaling strong political will, yet civil society actors are demanding more: implementation, inclusion, and influence.
These were the core issues discussed during 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. Civil society activists, public health leaders, and government officials from across the continent attended. A clear consensus emerged: Africa’s pandemic response must be people-centered - and led by civil society.
From the frontlines: a call to organize now
“This is the 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 won’t wait for us to get our act together.”
Iutung grounded her argument in historical context. From the 2013–2016 Ebola epidemic in West Africa, to Uganda’s 2022 outbreak, to Rwanda’s 2024 Marburg episode, and the current Mpox flare-ups in several countries - Africa, she noted, is no stranger to pandemics.
“Civil society bridges the inequality gap,” she emphasized. “During crises like Ebola in Sierra Leone, communities trusted civil society more than government channels. Our role is to hold governments accountable, to advocate, and to serve.”
The imperative: putting civil society at the center
Aggrey Aluso, Africa Director at the Pandemic Action Network, emphasized that Africa cannot afford to treat civil society as an afterthought.
“Pandemics start and end with communities,” he said. “And CSOs are the bridge between policymakers and those communities. If we fail to embed civil society in pandemic planning, we risk repeating the mistakes of COVID-19: delayed responses, mistrust, inequitable vaccine distribution.”
He highlighted the role CSOs play in early warning systems, community-based surveillance, and trust-building - and stressed their importance in ensuring government accountability.
“We’ve seen countless declarations. Africa is flooded with commitments. But unless there’s a political cost to inaction, nothing happens. Civil society creates that cost,” he noted. “Especially in resource-limited settings like Africa, our best hope is to center communities in every initiative.”
Lessons from Sierra Leone: when community was left out
Sulaiman Lakoh, Director of Disease Prevention and Control at Sierra Leone’s Ministry of Health, offered a sobering reflection. His country has faced multiple epidemics, including the devastating 2014–2016 Ebola outbreak that claimed over 10,000 lives.
“We began our response in silos - focused purely on the medical angle: build treatment centers, issue guidelines, buy medicine,” he recalled. “It took us a while to realize we needed a more inclusive approach - bringing in communities, civil society, and other sectors.”
Excluding civil society early on, he acknowledged, cost lives. “Only once we brought in these different actors were we able to get the response under control.”
Since then, Sierra Leone has embraced a One Health approach integrating human, animal, and environmental health systems. However, gaps remain. “One major gap is that key policy documents barely mention civil society involvement in pandemic preparedness and response,” he said, referencing the country’s Universal Health Coverage (UHC) Roadmap and the National Action Plan for Health Security (NAPHS).
AHF’s intersectional model: empowering communities before crises
Drawing from her experience in advocacy and community engagement at AHF, Oluwakemi Damasi (Kemi), Director of Advocacy, Policy, and Marketing, stressed the urgency of proactive inclusion.
“There is no public health without the public,” she said. “We cannot wait for a crisis before empowering communities or creating spaces for their participation.”
Damasi highlighted AHF’s Ebola response in Sierra Leone, where it kept clinics open, ensured access to treatment, and built community trust. “It's nearly impossible to deliver care during emergencies without community buy-in.”
She introduced AHF’s ‘Community Power Voices’ initiative, which strengthens grassroots advocacy, improves policy engagement, and counters the shrinking civic space. “These groups can research, identify key issues and gaps, and bring them to decision-makers.”
Damasi also pushed for civil society representation in global governance platforms such as the Pandemic Fund Board and the Global Fund’s NGO Delegation. “Unless we emphasize the ‘public’ in public health, our voices won’t be heard in decision-making spaces.”
Elevating civil society in global platforms: G20, C20, and beyond
As Africa’s influence grows in global policymaking - including the African Union’s permanent seat in the G20 - civil society must help shape these agendas. Dr. Norman Matara, of Southern African Doctors for Human Rights, urged CSOs to mobilize and assert themselves.
“Civil society must engage with C20 working groups on global health, inequality, and sustainable development. That’s how you shape G20 outcomes,” he said.
He advised CSOs to build regional coalitions, engage with G20 sherpas, and develop evidence-based advocacy tools like shadow reports and scorecards. “We must be the watchdogs - ensuring that global declarations are turned into real action.”
Funding realities: shrinking budgets, expanding opportunities
A persistent concern was the chronic underfunding of CSOs, especially local ones. Damasi acknowledged the issue but urged innovation.
“Global Fund, Gavi, and Africa CDC all offer funding. But many local CSOs can’t access it due to bureaucracy or lack of information,” she explained.
She encouraged organizations to diversify their outreach. “Too often, we share our reports only with governments. Why not also target private sector partners and philanthropic networks?” she asked. “There are more resources than we think - we just need to position ourselves better.”
She added that AHF’s Emergency Fund had supported community-led organizations during COVID-19: “We backed groups providing food, PPE, and medicines. And we’re still doing it.”
The case for dedicated civil society emergency platforms
During the open floor session, Lydia Mungherera, a veteran civil society leader from Uganda, voiced frustration over CSO exclusion during crises. “The Ministry of Health always creates emergency committees - but we’re never included,” she said. “We need our own permanent CSO-led pandemic structures.”
Another participant, Peter Owiti, highlighted a major operational gap: the absence of community-owned surveillance tools. “We have tools for TB - but nothing for pandemics. By the time the Ministry hears about an outbreak, it’s often too late.”
Mobilize now - or pay later
With the Pandemic Agreement now adopted, attention shifts to implementation. Aluso issued a call to action: “If we don’t push to embed this agreement in national legislation, it will remain just another piece of paper. It’s on us to drive political will and raise public awareness.”
For civil society across Africa, the next chapter begins now - not at the onset of the next crisis. As Iutung warned: “Infectious diseases won’t wait for us to get organized.
In a rapidly evolving global health landscape, civil society across Africa is calling for a fundamental realignment of power and participation in pandemic preparedness and response. At the heart of this discourse lies 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, signaling strong political will, yet civil society actors are demanding more: implementation, inclusion, and influence.
These were the core issues discussed during 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. Civil society activists, public health leaders, and government officials from across the continent attended. A clear consensus emerged: Africa’s pandemic response must be people-centered - and led by civil society.
From the frontlines: a call to organize now
“This is the 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 won’t wait for us to get our act together.”
Iutung grounded her argument in historical context. From the 2013–2016 Ebola epidemic in West Africa, to Uganda’s 2022 outbreak, to Rwanda’s 2024 Marburg episode, and the current Mpox flare-ups in several countries - Africa, she noted, is no stranger to pandemics.
“Civil society bridges the inequality gap,” she emphasized. “During crises like Ebola in Sierra Leone, communities trusted civil society more than government channels. Our role is to hold governments accountable, to advocate, and to serve.”
The imperative: putting civil society at the center
Aggrey Aluso, Africa Director at the Pandemic Action Network, emphasized that Africa cannot afford to treat civil society as an afterthought.
“Pandemics start and end with communities,” he said. “And CSOs are the bridge between policymakers and those communities. If we fail to embed civil society in pandemic planning, we risk repeating the mistakes of COVID-19: delayed responses, mistrust, inequitable vaccine distribution.”
He highlighted the role CSOs play in early warning systems, community-based surveillance, and trust-building - and stressed their importance in ensuring government accountability.
“We’ve seen countless declarations. Africa is flooded with commitments. But unless there’s a political cost to inaction, nothing happens. Civil society creates that cost,” he noted. “Especially in resource-limited settings like Africa, our best hope is to center communities in every initiative.”
Lessons from Sierra Leone: when community was left out
Sulaiman Lakoh, Director of Disease Prevention and Control at Sierra Leone’s Ministry of Health, offered a sobering reflection. His country has faced multiple epidemics, including the devastating 2014–2016 Ebola outbreak that claimed over 10,000 lives.
“We began our response in silos - focused purely on the medical angle: build treatment centers, issue guidelines, buy medicine,” he recalled. “It took us a while to realize we needed a more inclusive approach - bringing in communities, civil society, and other sectors.”
Excluding civil society early on, he acknowledged, cost lives. “Only once we brought in these different actors were we able to get the response under control.”
Since then, Sierra Leone has embraced a One Health approach integrating human, animal, and environmental health systems. However, gaps remain. “One major gap is that key policy documents barely mention civil society involvement in pandemic preparedness and response,” he said, referencing the country’s Universal Health Coverage (UHC) Roadmap and the National Action Plan for Health Security (NAPHS).
AHF’s intersectional model: empowering communities before crises
Drawing from her experience in advocacy and community engagement at AHF, Oluwakemi Damasi (Kemi), Director of Advocacy, Policy, and Marketing, stressed the urgency of proactive inclusion.
“There is no public health without the public,” she said. “We cannot wait for a crisis before empowering communities or creating spaces for their participation.”
Damasi highlighted AHF’s Ebola response in Sierra Leone, where it kept clinics open, ensured access to treatment, and built community trust. “It's nearly impossible to deliver care during emergencies without community buy-in.”
She introduced AHF’s ‘Community Power Voices’ initiative, which strengthens grassroots advocacy, improves policy engagement, and counters the shrinking civic space. “These groups can research, identify key issues and gaps, and bring them to decision-makers.”
Damasi also pushed for civil society representation in global governance platforms such as the Pandemic Fund Board and the Global Fund’s NGO Delegation. “Unless we emphasize the ‘public’ in public health, our voices won’t be heard in decision-making spaces.”
Elevating civil society in global platforms: G20, C20, and beyond
As Africa’s influence grows in global policymaking - including the African Union’s permanent seat in the G20 - civil society must help shape these agendas. Dr. Norman Matara, of Southern African Doctors for Human Rights, urged CSOs to mobilize and assert themselves.
“Civil society must engage with C20 working groups on global health, inequality, and sustainable development. That’s how you shape G20 outcomes,” he said.
He advised CSOs to build regional coalitions, engage with G20 sherpas, and develop evidence-based advocacy tools like shadow reports and scorecards. “We must be the watchdogs - ensuring that global declarations are turned into real action.”
Funding realities: shrinking budgets, expanding opportunities
A persistent concern was the chronic underfunding of CSOs, especially local ones. Damasi acknowledged the issue but urged innovation.
“Global Fund, Gavi, and Africa CDC all offer funding. But many local CSOs can’t access it due to bureaucracy or lack of information,” she explained.
She encouraged organizations to diversify their outreach. “Too often, we share our reports only with governments. Why not also target private sector partners and philanthropic networks?” she asked. “There are more resources than we think - we just need to position ourselves better.”
She added that AHF’s Emergency Fund had supported community-led organizations during COVID-19: “We backed groups providing food, PPE, and medicines. And we’re still doing it.”
The case for dedicated civil society emergency platforms
During the open floor session, Lydia Mungherera, a veteran civil society leader from Uganda, voiced frustration over CSO exclusion during crises. “The Ministry of Health always creates emergency committees - but we’re never included,” she said. “We need our own permanent CSO-led pandemic structures.”
Another participant, Peter Owiti, highlighted a major operational gap: the absence of community-owned surveillance tools. “We have tools for TB - but nothing for pandemics. By the time the Ministry hears about an outbreak, it’s often too late.”
Mobilize now - or pay later
With the Pandemic Agreement now adopted, attention shifts to implementation. Aluso issued a call to action: “If we don’t push to embed this agreement in national legislation, it will remain just another piece of paper. It’s on us to drive political will and raise public awareness.”
For civil society across Africa, the next chapter begins now - not at the onset of the next crisis. As Iutung warned: “Infectious diseases won’t wait for us to get organized.
