Sudan's humanitarian crisis has left over 25 million people affected while African health leaders pressed world leaders at the 81st United Nations General Assembly for faster progress on maternal and child survival, Kenya's paediatric HIV response and stronger primary care systems. The continental push comes as nearly 178,600 women died from pregnancy and childbirth-related causes in African Union member states in 2023, accounting for 69 per cent of the estimated 260,000 maternal deaths worldwide that year.
The figures underscore a massive resource challenge. Kenya alone is investing about Sh12.5 billion in maternal and newborn health, including Sh4 billion for delivery and essential newborn care, Sh1 billion for lifesaving commodities, Sh2.5 billion for family-planning commodities and Sh5 billion annually for the recruitment of 5,000 nurses. Medical Services Principal Secretary Ouma Oluga said maternal and newborn survival requires action beyond the Health Ministry. "The survival of mothers and newborns is a shared responsibility across government," Dr Oluga said.
Nigeria's Neglected Disease Crisis
In northern Nigeria, doctors are treating noma, a neglected disease that can disfigure and kill children. Ibrahim Dalhatu was just 3 years old when he contracted the severe infection that destroys facial tissues and bones. He had his first facial reconstructive surgery five years ago at the Noma Children Hospital in Nigeria's Sokoto state. Since then, Ibrahim, now 8, has had six operations to help him recover.
The World Health Organisation classifies noma as a neglected tropical disease, meaning it receives little or no global attention and funding, despite its impact on victims. WHO has not updated its data on noma since 1998, when it estimated 140,000 cases per year with a 90% fatality rate. A study published two months ago in The Lancet Global Health journal, relying on data from the Sokoto hospital, reported over 50,000 noma cases across 12 northern Nigerian states between 1999 and 2024.
Doctors Without Borders, known by its French abbreviation MSF, is carrying out multi-stage operations free of charge as part of its efforts to tackle diseases. "I was very excited because I thought there was no solution to the disease," said Muhammad Dalhatu, Ibrahim's father, an Islamic teacher married to a trader. "Before, I was worried about the cost of the treatment, but when I was told it was free of charge, I was so happy."
The disease begins with gum inflammation in malnourished children living in polluted environments and quickly spreads to destroy soft tissues and bones. It mostly affects 2- to 6-year-old children, especially in poor communities. Early-stage treatment includes antibiotics, wound care and improved nutrition. But once the disease worsens, surgery is required.
At the specialist hospital in Sokoto, more than 500 children with noma from across northern Nigeria were treated within the last three years, according to data seen by the AP. Others are waiting for surgery at the three sessions MSF runs each year for the children whose bodies can take it. Nigeria has only two noma hospitals, including one in Abuja, built three years ago.
Maternal Mortality Falls Short of Targets
Maternal mortality across AU member states declined by 42 per cent between 2000 and 2023, from 666 to 388 deaths per 100,000 live births. But the global target is fewer than 70 deaths per 100,000 live births by 2030. Africa CDC estimates that if the current rate of decline continues, the maternal mortality ratio across AU member states would still stand at about 330 deaths per 100,000 live births in 2030.
"At the observed annual rate of reduction of 2.4 per cent, Member States will record approximately 330 deaths per 100,000 live births in 2030, close to five times the Sustainable Development Goal target," the report says. It adds that meeting the target would require the rate of decline to increase roughly ten-fold.
The burden is uneven across the continent. West Africa has the highest maternal mortality ratio at 682 deaths per 100,000 live births and accounts for 55 per cent of maternal deaths in Africa. Central Africa records 439 deaths per 100,000, East Africa 260, Southern Africa 162 and North Africa 50.
The agency's assessment also points to a problem beyond whether women reach health facilities. It identifies delays in receiving appropriate care, shortages of medicines and blood, staffing gaps and weak referral systems among the factors contributing to maternal deaths. Among countries that assessed whether maternal deaths could have been prevented, the estimated proportion of avoidable deaths ranged from 58 to 96 per cent.
Of the 34 AU member states whose maternal death review reports were examined, only 14 reported progress on recommendations from earlier review cycles. "Only one country both analyzed the three types of delay, assessed whether deaths were avoidable and tracked implementation of previous recommendations," the report says.
Child Survival and Primary Care Gaps
An estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to the latest United Nations child mortality estimates. Sub-Saharan Africa accounted for 58 per cent of global under-five deaths. Newborn deaths accounted for nearly half of all under-five deaths globally.
Africa CDC argues that the continent's challenge is not simply a lack of medical solutions. Its review identifies health financing, frontline care, skilled health workers, emergency referral systems, essential commodities, data and accountability as critical areas for action. The agency cites examples from countries including Tanzania and Rwanda where improvements in referral systems, financing and quality of care have been linked to reductions in maternal deaths.
Kenya launched its Every Woman Every Newborn Everywhere Acceleration Plan for the current plan period, targeting preventable maternal and newborn deaths in 26 high-burden counties. The national plan also targets stronger emergency referrals, skilled care and accountability, with a six-month Rapid Results Initiative focused on the 26 counties.
The World Health Organization Regional Office for Africa has also launched a new manual to help primary health care workers identify suspected breast cancer earlier. The publication, Evaluation and Workup for Suspected Breast Cancer Using a Primary Health Care Approach, is designed to support nurses, midwives, medical doctors and clinical officers in recognizing warning signs, conducting initial clinical assessments and helping patients navigate diagnostic and treatment services.
In 2022, an estimated 2.3 million women were diagnosed with breast cancer globally, while around 670,000 people died from the disease. In most countries across the African Region, more than 70% of breast cancer cases are detected at a late stage, limiting treatment options and reducing survival outcomes.
"Primary health care providers are often the first point of contact for women with breast symptoms," said Dr Benido Impouma, Director of the Health Promotion, Disease Prevention and Control Cluster at WHO Regional Office for Africa. He explained that strengthening frontline health workers' ability to recognize warning signs, conduct clinical assessments, provide counselling and facilitate referrals is essential to reducing diagnostic delays.
According to the guidance, delays of six months or longer between the emergence of symptoms and access to appropriate care remain common in many African settings. Such delays can contribute to advanced-stage disease and preventable deaths.
Why This Matters:
Africa's health crisis reveals the limits of international aid frameworks and the urgent need for sustainable, locally-financed health systems. Kenya's Sh12.5 billion investment demonstrates that national governments must take primary responsibility for health outcomes rather than relying on donor-dependent programs. The maternal mortality data shows that declarations and targets don't save lives — functional health infrastructure, skilled workers, and accountable systems do. Only 14 of 34 countries tracked progress on previous recommendations, suggesting weak institutional follow-through. The noma crisis in Nigeria, where only two hospitals exist for a disease affecting tens of thousands, illustrates how neglected tropical diseases persist when government capacity is limited. Private sector engagement, including partnerships like MSF's free surgical program, fills critical gaps but can't replace core government functions. The breast cancer manual's emphasis on primary care reflects a pragmatic approach: strengthening existing frontline systems rather than building costly specialized programs. Meeting 2030 targets would require a ten-fold acceleration in maternal mortality reduction, demanding not just more funding but fundamental improvements in service delivery, referral systems, and accountability mechanisms that only functional governance can provide.