Nairobi Declaration on African Health Security and Collaborative Disease Surveillance  

Issued by civil society and community organisations convened on the sidelines of the World Health Summit Regional Meeting, Nairobi, Kenya, 30 April 2026

PREAMBLE: THE MOMENT WE ARE IN

We, civil society and community organisations from across Africa, welcome the growing political attention to epidemic preparedness, collaborative surveillance, and health system resilience across the continent. We acknowledge the leadership in these areas already shown by African institutions, health workers, clinicians, researchers, community responders, parliamentarians, media, women-led organizations, youth movements, and local civil society networks. Yet, significant gaps persist. Outbreaks are still detected too late. Surveillance systems remain fragmented. Financing for preparedness, especially for surveillance, is insufficient, unpredictable, and overly reliant on external partners. These challenges are compounded by climate change, conflict, and displacement, which put further pressure on both formal and informal health systems.

We recognise that surveillance is not just a technical issue, but a social contract that yields the highest return on investment in prevention when strengthened through early warning systems. It depends on trust, inclusion, and meaningful community engagement – ensuring communities are seen, heard, protected, and informed in time, and incorporating traditional and indigenous knowledge systems that have long supported early warning and resilience.

This moment calls for accelerated action to build surveillance and health security systems that are community-centered, domestically financed, and collaboratively governed across borders.

OUR SHARED PRINCIPLES

We reaffirm the following principles:

Health is a human right, and health security is a public good. It cannot remain a peripheral technical issue or a donor-defined project.

Communities, including informal providers and clinicians, are central to detection and protection. They are first responders and trusted partners in early warning and response.

Preparedness must strengthen collaborative systems, not fragment them. Community surveillance, primary care, laboratory systems, digital reporting, and emergency response should function as one coherent system.

Civil society has a legitimate role in governance and collaboration on surveillance, which must work across borders through interoperable systems, timely data sharing, trusted institutions, and joint action across neighboring countries and regional platforms.

Domestic ownership of surveillance and health security is essential, supported by predictable national financing, aligned with country priorities, with accountability ensured through dedicated budgets, timelines, and public reporting.

OUR COLLECTIVE VISION

We envision an Africa where no outbreak goes undetected — where every community has the tools, trust, skills, and channels to raise the alarm early and enable rapid, coordinated response. 

We seek collaborative surveillance systems that are community-centered, integrated across all levels of the health system, interoperable across borders, nationally led, domestically financed, and regionally coordinated so that outbreaks are detected earlier and managed faster. This vision depends on leadership, financing, and accountability from African leaders to turn preparedness into a sustained public responsibility.

CALLS TO ACTION

• To African Heads of State and Government

We call on Heads of State and Government to elevate health security and collaborative surveillance to the highest level of political leadership and treat preparedness as a national development, economic, and security priority – reflected in laws, plans, budgets, and spending. We urge governments to honour and publicly report on domestic health financing commitments. This requires going beyond the Abuja Declaration target of allocating at least 15% of the national budget to health, and leveraging other multisectoral sources to establish dedicated, ring-fenced budget lines for surveillance, laboratories, preparedness, and rapid response.

• To the African Union, Africa CDC, WHO AFRO, Regional Economic Communities, Regional Health Regulators, and National Public Health Institutes

We call on continental and regional bodies to urgently operationalise collaborative surveillance across borders, including harmonised standards, interoperable systems, agreed alert thresholds, joint simulation exercises, cross-border focal points, and stronger links between national systems and regional early warning platforms.

We urge the establishment of a biannual continental accountability mechanism that tracks member state commitments, financing, preparedness benchmarks, and progress towards domestic ownership of collaborative surveillance systems, with formal, resourced, and meaningful participation of civil society.

• To National Governments (Ministries in charge of Health, Trade and Finance, Planning, and Local Government) and Parliaments and other relevant 

We call for joint leadership and accountability in health security, with surveillance fully integrated into national and subnational planning – including  budgeting, implementation, and accountability structures –  and not reliant on ad hoc or donor-driven funding.

We urge costed, integrated national preparedness plans covering community surveillance, laboratories, digital systems, workforce, logistics, and manufacturing capacity, factoring in climate and cross-border risks and setting clear pathways toward reduced donor dependence by 2040.

• To Civil Society, Community Organizations, Media, and Academia

We commit to strengthening collaborative surveillance at all levels through advocacy, accountability, and cross-sector coalitions linking health, finance, climate, gender, youth, disability, and justice.

We call on the media to elevate surveillance as a public interest issue, tied to protecting lives, livelihoods, and trust, and on academia to advance African-led research, evidence, and training in community-centred surveillance systems.

• To Multilateral Agencies, Bilateral Development Partners, Philanthropic Partners, and Private Sector Actors

We call for predictable, flexible, long-term financing for surveillance and preparedness aligned with national priorities and the strengthening of African health systems, and reject fragmented funding models – urging a fair, well-financed transition from aid dependence to domestic ownership

We call on the private sector to support public surveillance and preparedness systems through innovation, technology, logistics, and manufacturing, while ensuring African leadership in agenda setting, data governance, and resource allocation.

OUR COMMITMENTS 

As signatories, we commit to advancing advocacy and accountability around the priorities set out in this Declaration: supporting and enabling community-centred surveillance and early detection, advancing locally financed and nationally owned surveillance and preparedness systems, and recommitting to effective collaborative disease surveillance that centers communities as experts and first responders. We also commit to tracking progress, amplifying community perspectives, and reconvening within one year to review implementation.