African health leaders have called for stronger domestic financing, better governance and greater accountability to improve maternal and child health, warning that shrinking donor support, disease outbreaks, climate-related shocks and continued dependence on imported medical commodities are exposing weaknesses in Africa's health systems.

Lul Pout Riek, special advisor for the Eastern Africa Region at the Africa Centers for Disease Control and Prevention, said maternal and child survival must remain at the center of Africa's health security agenda.

"Africa's health security is measured in the lives of women, newborns, children and adolescents. Every preventable death reflects a gap in governance, financing, equity, access and accountability," he said, urging governments to move from commitments to implementation.

Ummy Mwalimu, advisor to Tanzanian President Samia Suluhu Hassan, said Africa already has proven interventions to reduce maternal and child deaths but now faces the challenge of implementing them at scale.

She said stronger accountability mechanisms and predictable domestic financing would help accelerate progress toward ending preventable maternal and newborn deaths while improving childhood immunization across the continent.

Diana Nambatya Nsubuga, head of Africa CDC's Division for Reproductive, Maternal, Newborn, Child and Adolescent Health, said Africa is facing declining external assistance, rising debt burdens and climate-related shocks, making greater domestic investment in health increasingly urgent.

She said the changing global financing environment makes it necessary for countries to strengthen primary healthcare, invest in digital health systems, expand local manufacturing of health products and increase domestic financing for essential health services.

"The transformation we seek is a shift from dependency to ownership, from vulnerability to resilience, and from commitments to measurable results," she added.