The cost of not knowing: evidence gaps and Africa´s Universal Health Coverage financing journey

Abstract

African governments routinely make consequential health financing decisions with insufficient analytical support. Drawing on direct experience as Deputy Governor of the Central Bank of Liberia, twice Minister of Finance and Development Planning, and Senior Health Financing Advisor at Africa CDC, this commentary argues that Africa's persistent Universal Health Coverage (UHC) financing failures are as much an evidence problem as a resource problem. The evidence that finance ministries and central banks need, granular, domestically grounded, politically legible, is largely absent. The uncharted relationship between ECOWAS monetary convergence criteria and health fiscal space illustrates one such critical gap. The African Journal of Health Economics, Systems and Policy (AJHESP) is positioned to build the analytical infrastructure this continent urgently needs.