Building Enduring Health Security Systems: Insights from the 2025 Conference on Public Health in Africa

The fourth Conference on Public Health in Africa (CPHIA), held in Durban, South Africa, October 2025, marked a strategic shift in Africa’s public health agenda from emergency response toward sovereignty, sustainability, and system strengthening. Deliberations emphasized that durable health security depends on stable institutions, data sovereignty, interoperable digital systems, and predictable domestic financing. National Public Health Institutes (NPHIs) were identified as central to preparedness, integrating surveillance, laboratory systems, emergency operations, research translation, and cross-sectoral coordination. The 7-1-7 performance framework—detecting outbreaks within seven days, reporting within one day, and initiating response within seven days—was highlighted as a practical accountability tool for measuring timeliness and exposing system bottlenecks. Data system interoperability emerged as foundational to real-time decision-making, while genomic sequencing was positioned as a sovereign capability that must transition from crisis-driven deployment to routine surveillance integration. Financing discussions underscored that resilience requires protected, predictable domestic investment, supported by governance reforms and innovative fiscal mechanisms. Preparedness was further linked to Primary Health Care and Universal Health Coverage as essential platforms for prevention and trust. For Zambia, CPHIA 2025 clarifies priority actions: institutionalizing 7-1-7 monitoring, advancing a national interoperability agenda, integrating genomic sequencing into routine systems, strengthening regulatory and procurement reforms, and securing sustainable financing for health security.