Zambia’s Advancing Health Reforms Applauded as Pan-African Parliament and Africa CDC Push for Stronger Accountability and Health Sovereignty

Zambia’s ongoing reform of its health system, marked by significant reductions in maternal and under-five mortality, strengthened disease surveillance, expanded primary healthcare, and growing investment in traditional medicine research, has received strong commendation from the Pan-African Parliament (PAP) and the Africa Centres for Disease Control and Prevention (Africa CDC).

A high-level Parliamentary Oversight Mission, led by Hon. Prof. Margaret Kamar, Chairperson of PAP’s Committee on Health, Labour and Social Affairs, was in Lusaka last week for a three-day joint mission with the Africa CDC Southern Africa Regional Coordinating Centre. The mission aims to evaluate Zambia’s implementation of national and AU health commitments, enhance parliamentary accountability, and accelerate action toward maternal, neonatal, and public health goals.

Zambia Reports Major Gains in Maternal and Child Health

Briefing the delegation, Zambia’s Minister of Health, Hon. Dr. Elijah Julaki Muchima, reported encouraging progress between 2023 and 2025 despite persistent system pressures.

Key improvements include:

• Maternal and child health gains, with maternal mortality steadily declining.
• Under-five mortality reductions driven by stronger immunization and primary healthcare.
• A skilled birth attendance rate of 95%, reflecting expanded midwifery and facility-based delivery services.
• Full staffing coverage, with every health facility now hosting at least one qualified health worker.

Dr. Muchima also highlighted Zambia’s growing investment in research on traditional medicine to complement conventional care, particularly for maternal, newborn, and community health in remote areas.

Budget allocations for health rose to K2.9 billion, with increased emphasis on public health emergencies and pandemic preparedness. The Minister further cited improvements in Zambia’s HIV response following a severe escalation in 2022, when infections surpassed 14,000 cases with a case fatality rate of 45%.

However, significant challenges remain, including:

• The triple burden of disease (communicable, non-communicable, and emerging health threats).
• Resurgence of communicable diseases such as cholera.
• Persistent underfunding, infrastructure gaps, and supply-chain weaknesses.

He stressed that Zambia’s progress has been made possible through strengthened WASH systems and robust partnerships with Africa CDC, the UN system, NGOs, and private sector partners.

“Despite these challenges, Zambia’s commitment to safeguarding the health of its people remains evident through continued cooperation and proactive measures,” Dr. Muchima affirmed.

Pan-African Parliament Commends Leadership and Calls for Stronger Accountability

Responding to the briefing, Hon. Prof. Kamar commended Zambia’s leadership for its strong commitment to regional and continental health goals, especially in the areas of maternal and neonatal health, public health security, and epidemic response.

She emphasized that the purpose of the oversight mission is not only to assess compliance with AU frameworks including the AU Health Strategy (2016–2030), Agenda 2063, the Continental RMNCAH-N Framework, and the Maputo Plan of Action, but also to strengthen the chain of accountability needed to turn AU decisions into measurable results.

“Access to quality, equitable, and affordable healthcare is not a privilege; it is a fundamental human right,” she stated. “Our mission strengthens the accountability chain that ensures our policies deliver impact on the ground.”

Prof. Kamar praised the Africa CDC’s leadership, particularly its role in COVID-19, Ebola, and Mpox responses, describing the institution as “a pillar of resilience and a true model of Africa-led public health excellence.”

Africa CDC Makes Strong Case for Africa’s Health Sovereignty

During the opening sessions, the Africa CDC Southern Africa Regional Office underscored the urgent need for Africa to build health sovereignty: the capacity to prevent, detect, and respond to health threats without overreliance on external systems.

Dr. Lul P. Riek, Regional Director, highlighted how recent outbreaks exposed vulnerabilities in diagnostics, supply chains, laboratory systems, and emergency response capacities. Strengthening domestic manufacturing, surveillance, community health systems, and coordinated parliamentary oversight is essential, he noted.

Africa CDC Presents Continental Progress on Reproductive Health

On December 4, Africa CDC presented a detailed update on continental progress in sexual, reproductive, maternal, newborn, child, and adolescent health (SRMNCAH&N).

Ms. Oketch Penina Achieng outlined key achievements, including:

• The Africa CDC Reproductive Health Strategic Priorities 2022–2026, endorsed by 42 Member States.
• Establishment of a continental pool of EmONC master trainers and procurement of training materials.
• Technical support to Member States such as Cameroon and Lesotho.
• Leadership training programmes and continental learning exchanges.

Despite progress, Africa continues to bear 69% of global maternal deaths, driven largely by haemorrhage, infections, and pregnancy-related hypertension. Ms. Achieng urged governments to allocate 10–15% of national health budgets to reproductive health priorities.

Zambia Highlights National Achievements But Warns of Persistent Gaps

The mission also received a national update on Zambia’s reproductive, maternal, newborn, and child health indicators, presented by Ms. Catherine Sanka of the Ministry of Health.

Progress includes:

• Maternal mortality reduction from 252 to 187 deaths per 100,000 live births.
• Total fertility rate decline from 4.7 in 2018 to 4.0 in 2024.
• 98.4% antenatal care coverage by skilled providers.

However, persistent obstacles threaten further progress:

• High adolescent pregnancy rate (27.6%), especially in rural areas.
• Shortages and uneven distribution of midwives.
• Stock-outs of essential commodities such as magnesium sulfate and oxytocin.
• Weak emergency referral and transport systems.
• Infrastructure deficits and reliance on paper-based data systems.

Zambia is responding through a national EmONC needs assessment, respectful maternity care training, a new labour care guide pilot, and expanded community outreach with UNICEF support.

PAP Calls for Sustainable Investments and Strengthened Legislative Oversight

The PAP Committee underscored the critical role of national parliaments in ensuring implementation of AU frameworks, improving budget allocations, and driving policy harmonization.

Key recommendations include:

• Increased investment in midwifery, EmONC services, and reproductive health supply chains.
• Prioritization of adolescent pregnancy as a national and continental emergency.
• Stronger multi-level partnerships between PAP, Africa CDC, Ministries of Health, and national parliaments.
• Harmonized monitoring under One Plan, One Budget, One Monitoring Framework.

The Oversight Mission will continue with field visits to health facilities, community programmes, and stakeholder consultations aimed at identifying implementation gaps and strengthening the continent’s collective health response.

Toward a Resilient and Health-Secure Africa

Across all engagements, one message resonated strongly: health security knows no borders. As Prof. Kamar put it, “An outbreak anywhere is a threat everywhere.”

The Lusaka mission marks a significant step toward deeper cooperation between national governments, parliaments, and Africa CDC, laying the groundwork for a more equitable, accountable, and resilient health system across Africa.