Engaging the Influence of Global Private Actors in Health in Sub-Saharan Africa

Document Type : Viewpoint

Authors

1 Training and Research Support Centre, Harare, Zimbabwe

2 School of Law, University of Warwick, Coventry, UK

Keywords


Introduction

 

Global powerful private actors (PPAs), such as private financial institutions, transnational corporations (TNCs), private (philanthropic) foundations, global accountancy and consultancy firms, and ultra-wealthy individuals contribute diverse resources for improved health. However, these actors can also negatively impact on health and constrain public health improvements.1 ...(Read more...)

  1. Loewenson R, Godt S, Chanda-Kapata P. Asserting public health interest in acting on commercial determinants of health in sub-Saharan Africa: insights from a discourse analysis. BMJ Glob Health. 2022;7(7):e009271. doi:1136/bmjgh-2022-009271
  2. Loewenson R, Sekalala S, Chatikobo T. Power, influence of and response to global private actors in health in Sub-Saharan Africa. TARSC website. https://www.tarsc.org/publications/documents/Accountability%20of%20PPAs%20in%20health%20in%20SSA%202024.pdf. Accessed October 11, 2025. Published 2024.
  3. Machemedze R, Wade H, Were N, Kiiza A. Local production of essential health products in East and Southern Africa. SEATINI, EQUINET. 2024. https://equinetafrica.org/sites/default/files/uploads/documents/EQdiss128%20EHP%20local%20production%20Nov22.pdf. Accessed October 21, 2024.
  4. Lambrechts K, Darimani A, Kabemba C, Olaleye W. Breaking the curse: How transparent taxation and fair taxes can turn Africa’s mineral wealth into development. https://taxjusticeafrica.net/sites/default/files/publications/breaking-the-curse-march2009_0.pdf. Accessed February 17, 2025. Published 2009.
  5. African Biodiversity Centre. Dictatorship of UPF food companies over African diets and food markets. African Biodiversity Centre; 2024. https://acbio.org.za/wp-content/uploads/2024/02/UPF-Africa-3-Dictatorship-of-companies-over-African-diets-food-markets.pdf. Accessed October 18, 2024.
  6. Food Systems 4 people. Let’s reclaim our food sovereignty and reject the industrial food system. https://foodsystems4people.org/africa-responds-to-the-un-food-systems-summit/.  Accessed February 2, 2026. Published 2021.
  7. Loewenson R. Engaging with an Industrial Pandemic: Drivers of and Responses to the Expansion of Ultra-Processed Foods in East and Southern Africa. Recent Prog Nutr.2025; 5(3): 018. doi:21926/rpn.2503018
  8. Chanda-Kapata P. Public health and mining in East and Southern Africa: A desk review of the evidence. EQUINET. 2020. https://equinetafrica.org/sites/default/files/uploads/documents/EQ%20Diss121%20Mining%20and%20health%20April2020.pdf. Accessed February 17, 2025.
  9. Di Mento M. Warren Buffett has given $50.7 billion toward historic pledges to the Gates Foundation and others. Associated Press. June 23, 2023. https://apnews.com/article/warren-buffett-donations-gates-foundation-c2f6981e46c6211b16ada2704433d3c0. Accessed October 10, 2024.
  10. Loewenson R, Mukumba C. Recovering lost tax to meet the health financing gap for universal public sector health systems in East and Southern Africa. BMJ Glob Health. 2023;8(Suppl 8):e011820. doi:1136/bmjgh-2023-011820
  11. Milsom P, Smith R, Baker P, Walls H. Corporate power and the international trade regime preventing progressive policy action on non-communicable diseases: a realist review. Health Policy Plan. 2021;36(4):493-508. doi:1093/heapol/czaa148
  12. Roby C. Africa's $66B health financing gap requires private sector power, experts say. Devex. February 13, 2019. https://www.devex.com/news/africa-s-66b-health-financing-gap-requires-private-sector-power-experts-say-94269. Accessed October 11, 2024.
  13. Sekalala S, Chatikobo T. Colonialism in the new digital health agenda. BMJ Glob Health. 2024;9(2):e014131. doi:1136/bmjgh-2023-014131
  14. Cobham A, Faccio T, Garcia‐Bernardo J, Jansky P, Kadet J, Picciotto S. A practical proposal to end corporate tax abuse: METR, a minimum effective tax rate for multinationals. Global Policy. 2021;13(1):18-33. doi:1111/1758-5899.13029
  15. Kampala Initiative. Kampala Declaration on cooperation and solidarity for health equity within and beyond aid. https://www.medicusmundi.org/wp-content/uploads/2020/01/KI-basics-Declaration.pdf. Accessed October 15, 2024. Published 2020.
  16. African Commission on Human and Peoples’ Rights (ACHPR). Resolution on States’ Obligation to Regulate Private Actors Involved in the Provision of Health and Education Services. ACHPR/Res. 420 (LXIV). 2019. https://achpr.au.int/en/adopted-resolutions/420-resolution-states-obligation-regulate-private-actors-involved-prov. Accessed October 11, 2025.
  17. International Federation of Pharmaceutical Manufacturers and Associations, Federation of African Pharmaceutical Manufacturers Association, Southern African Non-Communicable Diseases Alliance, et al. Call to Heads of State of the African Union to Ratify the African Medicines Agency Treaty. https://www.ifpma.org/wp-content/uploads/2023/01/i2023_AU-Summit-AMA-Treaty-Ratification-Statement-in-Eng_.pdf.  Accessed October 10, 2024. Published 2019.
  18. African Union Economic Commission for Africa. Report of the High-Level Panel on Illicit Financial Flows from Africa. Commissioned by the AU/ECA Conference of Ministers of Finance, Planning and Economic Development. https://au.int/en/documents/20210708/report-high-level-panel-illicit-financial-flows-africa. Accessed October 18, 2024. Published 2014.
  19. African Development Bank Group (ADBG). African Development Bank to support HealthTech Hub Africa’s blueprint to fast-track health tech innovations across Africa. ADBG Press Release. January 12, 2024. https://www.afdb.org/en/news-and-events/african-development-bank-support-healthtech-hub-africas-blueprint-fast-track-health-tech-innovations-across-africa-67615. Accessed October 18, 2024.
  20. United Nations. Guiding Principles on Business and Human Rights: Implementing the United Nations ‘Protect, Respect and Remedy’ Framework. United Nations; 2011. https://www.ohchr.org/sites/default/files/documents/publications/guidingprinciplesbusinesshr_en.pdf. Accessed October 23, 2024.
  21. Amri M, Sam O, Anye M, Zibwowa Z, Karamagi HC, Nabyonga-Orem J. What opportunities exist for the governance of private sector engagement in mixed health systems in the African Region? J Glob Health. 2025;15:03038. doi:7189/jogh.15.03038

Articles in Press, Corrected Proof
Available Online from 10 March 2026
  • Received Date: 14 October 2025
  • Revised Date: 12 February 2026
  • Accepted Date: 09 March 2026
  • First Published Date: 10 March 2026
  • Published Date: 10 March 2026