The World Health Organization’s (WHO) Regional Director for the Eastern Mediterranean, Dr Hanan Balkhy, has argued that robust primary health care is the foundation of national health sovereignty, warning that geopolitical fragmentation, prolonged crises and shrinking external funding are forcing countries to rethink how they protect their populations.
In an editorial published in the Eastern Mediterranean Health Journal, Dr Balkhy defined health sovereignty not as the ability to produce medicines or vaccines domestically, but as the institutional capacity to finance essential services, govern supply chains, generate reliable surveillance data and withstand crises without systemic collapse. She argued that health sovereignty “must be understood as institutional capacity” and that it “encompasses the ability to finance and govern essential services sustainably, regulate medical products, maintain resilient supply chains, generate and share surveillance data, and respond to emergencies without systemic collapse.”
Dr Balkhy stressed that strengthening primary care through integrated service packages, workforce development, streamlined referral systems and accountable data platforms creates what she described as shock absorbers capable of protecting populations when multiple crises converge simultaneously.
She noted that official development assistance for health contracted by 9 percent in real terms in 2024, with the Organisation for Economic Co-operation and Development (OECD) projecting a further decline of between 9 and 17 percent in 2025. In half of low-income countries in sub-Saharan Africa, external financing accounts for one-third or more of total health expenditure.
The WHO Regional Director also highlighted converging crises across Africa and the Eastern Mediterranean, including conflict, displacement, climate shocks, economic strain and recurrent disease outbreaks, noting that in conflict-affected settings, hospitals and primary care facilities function not only as providers of care but also as anchors of social stability.
The editorial carries particular relevance for Africa at a moment when Ghana, under President John Dramani Mahama, chairs the African Union’s continental health sovereignty initiative. Ghana has championed domestically financed health systems, local pharmaceutical manufacturing and pan-African cooperation as strategic priorities, aligning directly with the principles Dr Balkhy has articulated.
Dr Balkhy called for regions that share epidemiological risks to deepen structured cooperation, arguing that “in regions where health threats cross borders, cooperation and strong primary health care systems are essential to protect populations and prevent resurgence.”
