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From continental strategy to country implementation

A document-based scorecard for assessing health security and sovereignty readiness in Africa

Bibliographic Data

ID24217202
AuthorsAugustus Osborne (0000-0002-0226-841X, Institute for Development), Camilla Bangura (0000-0003-4571-8246, Njala University), Abdirasak Sharif Ali (0000-0001-5546-5778, SIMAD University), Umaru Sesay (0000-0002-6040-8660, Africa Centres for Disease Control and Prevention), Troy D Moon (0000-0002-1637-829X, Ministry of Health)
Year2026
Volume19
Issue1
Pages2735716-2735716
Publication date2026-12-31
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobal Health Action (JOURNAL)
Journal identifiersISSN: 1654-9716 • E-ISSN: 1654-9880
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/16549716.2026.2735716
PMID42802994
OpenAlexW7214613824
LanguageEN
References cited46

BACKGROUND: The Africa Health Security and Sovereignty (AHSS) Agenda of the Africa Centres for Disease Control and Prevention (Africa CDC) provides a continental framework for strengthening health security and sovereignty. As implementation begins, no document-based readiness assessment instrument exists to monitor progress against AHSS pillars and goals, limiting efforts to identify bottlenecks and target assistance. OBJECTIVE(S): To develop and apply a document-based scorecard for assessing policy readiness for AHSS implementation across selected African countries. METHODS: We conducted a qualitative policy analysis using systematic document review, deductive framework development, structured coding, and scorecard synthesis. The corpus comprised 48 documents: the AHSS Agenda, the African Union Roadmap to 2030, WHO AFRO guidance, and national policies from 12 named African countries in 5 regional economic community zones. A 10-dimension scorecard based on AHSS pillars and WHO building blocks was applied on a 3-level scale. A second author recoded the corpus independently; materials are openly deposited. RESULTS: Readiness was most consistently reflected in governance and strategic planning and least in financing specificity, digital health architecture, and laboratory and pharmaceutical systems. AHSS-relevant provisions appeared in 3 of 12 financing strategies, 3 of 10 pharmaceutical policies, and 2 of 12 plans, indicating strategic intent but weak operational readiness across the 10 dimensions. CONCLUSIONS: The AHSS/WHO document-based scorecard is a feasible and replicable instrument for monitoring readiness. It identifies governance and implementation gaps and helps Africa CDC, WHO AFRO, governments, and partners target technical assistance. Periodic application would strengthen implementation monitoring, cross-setting comparison, and accountability.

Africa · Africa CDC · Digital health · Health care financing · health governance · Health security · health sovereignty · implementation monitoring · WHO building blocks · Global Security and Public Health · Healthcare Systems and Practices · Public Health Policies and Education

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