World Bank targets scale and speed in West Africa health overhaul with $1bn push
The World Bank has unveiled an ambitious strategy to transform health systems across Western and Central Africa, committing more than $1bn in grant financing as it seeks to reposition healthcare as a cornerstone of economic growth and resilience.
Presenting the framework in Accra on Monday, Dr. Rifat Hasan, Practice Manager for Health, Nutrition and Population at the World Bank Group, said the region must move beyond incremental gains and embrace a “scale and speed” approach to deliver universal health coverage and strengthen human capital.
The strategy, anchored on three pillars “frontlines first”, “fixing finance” and “future fit” aims to expand access to quality primary healthcare, improve funding efficiency, and build systems capable of withstanding climate shocks and future pandemics.
“We are not starting from zero,” Dr. Hasan noted, pointing to measurable progress over the past decades, including a 55 per cent decline in under-five mortality and a 39 per cent drop in maternal mortality since 1990. However, she cautioned that these gains remain fragile in the face of rising demographic and environmental pressures.
Central to the new approach is a shift in financing models. Governments are being urged to prioritise health spending within national budgets while improving execution and aligning donor support around essential service packages. The World Bank also warned against overreliance on uncertain revenue sources, stressing the need for sustainable domestic financing.
To drive implementation, the strategy introduces “health compacts” — country-led platforms designed to harmonise efforts among governments, development partners and financiers. Nigeria, Sierra Leone and Côte d’Ivoire are already participating, while Ghana and Senegal are in advanced stages of adoption.
The initiative is further backed by $100m in technical assistance and structured through multi-phase programmatic approaches aimed at strengthening primary healthcare systems across the region.
Beyond healthcare delivery, the strategy places strong emphasis on economic linkages. The World Bank estimates that the health sector could generate up to 1.4 million skilled jobs, including doctors, nurses and midwives, alongside tens of thousands of roles in pharmaceutical manufacturing.
Dr. Hasan argued that healthier populations translate directly into higher productivity, citing evidence that improved health outcomes can significantly reduce absenteeism and boost earnings.
The strategy also highlights cross-sector investments, including plans to connect up to 30,000 health facilities to electricity, alongside improvements in water, sanitation and digital infrastructure.
The renewed focus comes amid shifting public sentiment across Africa, where health has overtaken unemployment as the top policy priority, according to Afrobarometer data. Citizens are increasingly demanding universal access to healthcare, even at the cost of higher taxes.
With the region projected to experience the fastest growth in youth population globally, the World Bank warns that failure to invest in health systems could undermine prospects for a demographic dividend.
“The opportunity is clear,” Dr. Hasan said. “But without decisive action, it could quickly become a missed one.”
