When the 2014 West African Ebola epidemic killed more than 11,000 people, African leaders drew a hard lesson: a continent of more than a billion people could not keep waiting for Geneva, Atlanta or London to decide when an outbreak mattered. Two years later they voted to build their own public health agency. Today, as eastern Congo fights a Bundibugyo Ebola outbreak with shrinking American help, that agency, the Africa Centres for Disease Control and Prevention, is being tested as never before.
Born from Ebola
African leaders first agreed on the need for a continent-wide public health body in 2013. The West African epidemic turned the idea into urgency. The African Union's Assembly of Heads of State formally established Africa CDC in January 2016, and the agency was launched in Addis Ababa, Ethiopia, on January 31, 2017. In 2022 the African Union made it an autonomous public health agency, able to declare continental emergencies and act on them in its own name.
From the start it was meant to be more than a branch office for foreign donors. Its founding principles stress "leadership," "ownership" and "delegated authority" for African member states: Africans setting priorities for African health.
Who Runs It, and Where
Africa CDC's founding director was Dr. John Nkengasong, a Cameroonian virologist who built the agency from a small office inside the African Union Commission into a continental institution before leaving in 2022 to lead the U.S. global AIDS program. Since 2023 it has been led by Director-General Dr. Jean Kaseya, a Congolese physician and public health specialist chosen by African Union heads of state. Kaseya has made "health sovereignty," African control over African health money, medicines and data, the agency's central message.
The agency is headquartered in Addis Ababa, home of the African Union. In January 2023 it moved into a new purpose-built headquarters campus there, with an emergency operations center and laboratory and training space. It works through five Regional Coordinating Centres, one for each region of the continent: Abuja, Nigeria (West); Cairo, Egypt (North); Libreville, Gabon (Central); Lusaka, Zambia (Southern); and Nairobi, Kenya (East). All 55 African Union member states belong to it.
More Than Ebola: A Decade of Emergencies
Ebola gave Africa CDC its reason to exist, but most of its work has been about other diseases.
- COVID-19 (2020–2022). Africa CDC convened health ministers before the continent's first cases were confirmed and wrote a joint continental strategy in February 2020. Its Partnership to Accelerate COVID-19 Testing expanded testing in member states, and the African Union's vaccine task team and the African Vaccine Acquisition Trust, built with Afreximbank, bought vaccines for African countries while rich nations hoarded doses. The African Medical Supplies Platform let governments buy tests and protective gear together.
- Genomic surveillance. Through the Africa Pathogen Genomics Initiative, launched in 2020, the agency helped dozens of countries build the capacity to read the genetic code of viruses at home. South African and Botswanan scientists who identified the Omicron variant in November 2021 showed what that capacity can do.
- Mpox (2024–2025). On August 13, 2024, Africa CDC declared mpox a Public Health Emergency of Continental Security, the first such declaration in its history, and coordinated testing and vaccine delivery to Congo, Burundi and neighboring countries.
- Marburg, cholera and more. The agency has supported responses to Marburg virus in Equatorial Guinea and Tanzania in 2023 and Rwanda in 2024, to cholera outbreaks across southern and eastern Africa, and to Lassa fever, measles and other recurring threats.
- Long-term threats. It runs continental programs on antimicrobial resistance and laboratory standards, and it backs the African Union goal of producing 60 percent of Africa's vaccines on the continent by 2040, up from about 1 percent when the goal was set in 2021.
Doctors, Nurses and a Multinational Corps
Africa CDC does not run hospitals or treat patients itself. National health ministries, hospitals and research institutes do that work; Africa CDC coordinates, trains, funds, supplies and sends in reinforcements. Its staff is drawn from across the continent, and in emergencies it deploys experts from its African Volunteer Health Corps, a roster of epidemiologists, laboratory scientists, clinicians, nurses and logisticians from many member states who can be sent across borders. During the 2024 mpox emergency it deployed staff from headquarters, the regional centres and that roster to Congo.
Its research strength also lies in its network. Laboratories such as Congo's National Institute for Biomedical Research in Kinshasa, Senegal's Institut Pasteur de Dakar and the Nigeria Centre for Disease Control carry out the testing, sequencing and clinical trials, while Africa CDC links them, sets standards and shares the data.
The need is enormous. The World Health Organization projects a shortfall of about 6 million health workers in Africa by 2030. That is why the agency has pushed governments to train and pay community health workers, the nurses and outreach workers who find sick people in villages before an outbreak grows.
Where the Money Comes From
For most of its life Africa CDC has depended heavily on outside partners: the World Bank, which has financed its regional investment program, the European Union, the Gates Foundation, the Mastercard Foundation and, until 2025, the U.S. government. Kaseya's argument is that this model cannot hold.
The agency also draws on African money. African Union member states fund its core operations through their assessed contributions to the Union's budget. An African Epidemics Fund pools African and partner money to pay for outbreak response quickly. And Kaseya has pressed governments to raise domestic health spending and find new sources, such as health taxes and regional financing from African development banks, so that the continent is not left waiting when a donor changes its mind.
The 2026 crisis has tested that promise. In May, Kaseya warned that donor pledges had fallen from almost $500 million to about $290 million. In June, an African Union high-level meeting raised $910 million in pledges, including $80 million from African member states themselves, which Africa CDC called "a strong signal of continental solidarity." By September the agency reported $1.7 billion pledged, while Congo's response plan grew from $240 million to $1.3 billion. Africa CDC also warned that "emergency funding alone is insufficient," pointing to the lack of local diagnostics, protective gear and the ability to make and stockpile medicines before crises hit.
Money and Accountability
The agency's growing power has brought harder questions. In October, the Associated Press reported that Kaseya said $962 million from international donors had been disbursed for the Congo response, but only about $200 million had been accounted for by organizations on the ground. Accountability is not a sideshow. A continental agency asking for sovereignty has to show where every dollar goes.
Why It Matters
For most of the last century, outbreaks in Africa were managed by outsiders who arrived with money and left with data. The withdrawal of U.S. aid in 2025 showed how fragile that model was. Africa CDC is an attempt to build something that does not disappear when a foreign government changes its mind. Its success or failure in eastern Congo will shape whether Africans control their own health future.
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