Three southern African countries, Madagascar, Mozambique and Zimbabwe, are among only four African nations that have committed domestic funding for reproductive health supplies and services amid declining international aid, pledging a combined share of more than US$292 million announced at a major global financing event.
The commitments, unveiled during the 81st session of the United Nations General Assembly in New York on 23 September, came from Burundi, Madagascar, Mozambique and Zimbabwe.
Together, the four countries pledged more than US$292 million for health infrastructure, reproductive health commodities, family planning services and maternal healthcare.
United Nations Population Fund (UNFPA) Regional Director for East and Southern Africa Lydia Zigomo said the pledges demonstrated growing national ownership of reproductive health programmes at a time when external funding is under strain.
“When a government buys its own contraceptives and upgrades its own maternity wards, it is making a long-term decision about its future,” Zigomo said on Monday.
The funding represents roughly 40 percent of the more than US$715 million mobilised at the event, which was co-hosted by the UNFPA, FP2030 and the Gates Foundation, alongside several partner governments.
The announcement comes as reproductive health programmes across Africa face growing financial pressure from shrinking donor support, prompting calls for governments to increase domestic investment in essential health services.
Madagascar committed US$20 million from its national budget for reproductive health commodities over 2026 and 2027 while Mozambique pledged US$17.6 million for reproductive health products over the same period.
Zimbabwe made the largest commitment, allocating more than US$250 million to upgrade hospitals nationwide. About 30 percent of that investment will be directed towards maternal and child health infrastructure.
The country also pledged US$2.25 million annually for family planning commodities in 2026 and 2027.
Burundi committed US$4 million for family planning commodities in 2026 and more than US$500,000 for emergency obstetric and newborn care mentorship programmes.
The commitments build on a broader trend towards domestic financing of reproductive health.
According to UNFPA, spending by governments participating in the UNFPA Supplies Partnership increased more than sixfold between 2020 and 2025, reaching a record US$68 million last year.
The partnership, UNFPA’s flagship programme supporting access to contraceptives and maternal health medicines, operates across 54 countries and includes a Match Fund mechanism that matches eligible government contributions up to predetermined levels.
While African governments increased their commitments, international donors also announced new support at the New York event.
The United Kingdom pledged £254 million (US$337.8 million) for reproductive health programmes, including £204 million for the UNFPA Supplies Partnership.
Denmark and Norway announced new multi-year funding commitments, while philanthropic organisation GiveWell provided a US$10 million grant to UNFPA.
The European Investment Bank also offered a €200 million guarantee.
Health advocates say the blend of domestic and external financing will be critical to sustaining access to family planning services, contraceptives and maternal healthcare as countries seek to reduce dependence on donor funding and strengthen long-term health system resilience.
JN/APA