Health has overtaken unemployment as the policy issue Africans most want their governments to tackle, marking a significant shift in public priorities across the continent for the first time in at least a decade, a major new survey has found.
The finding comes from the latest Afrobarometer (AB) Pan-Africa Profile released on World Health Day, Tuesday, April 7, 2026, and based on 45,600 face-to-face interviews across 38 African countries conducted between January 2024 and September 2025.
On average across the 38 surveyed countries, 38% of respondents cited health among their top three priorities for government action, placing it ahead of unemployment at 33%, as well as education, the rising cost of living, infrastructure, and water supply, all cited by 23% of respondents.
The report, titled “Pressure Points: Africa’s Health Systems Amid Global Aid Contraction,” arrives as donor-funded health programmes face deep cuts, with the collapse of United States Agency for International Development (USAID) funding introducing severe uncertainty across the continent’s health infrastructure.
Seven in 10 Africans, representing 70% of respondents, said their governments should ensure that all citizens have access to adequate health care, even if doing so requires raising taxes.
Despite that clear public mandate, the survey reveals a continent where health coverage and access remain deeply inadequate. Only 20% of respondents across 36 surveyed countries reported having any form of medical aid coverage. Ghana ranked second highest among all countries surveyed, with 72% of Ghanaian respondents reporting coverage, behind Gabon at 83% and ahead of Morocco at 71% and Tunisia at 70%. In sharp contrast, fewer than one in 20 respondents in Lesotho, Sierra Leone, Malawi, Uganda, and São Tomé and Príncipe said they had any medical cover at all.
The lived experience of ordinary Africans paints a difficult picture. More than half, 53% of respondents, said they worried a great deal that they or a family member would fall ill and be unable to obtain or afford care. Almost two-thirds, 65%, said they or a family member went without needed health care during the previous year, including 26% for whom this happened many times or always.
Among those who had contact with a public clinic or hospital in the past year, half said it was difficult or very difficult to obtain the care they needed, and almost two-thirds indicated that high costs prevented them from getting the care or medicines they required. Majorities also reported long wait times, shortages of medicines and supplies, facilities in poor condition, and absent medical staff.
Afrobarometer is a pan-African, nonpartisan survey research network headquartered in Accra, Ghana. Its Round 10 surveys covered 38 countries, with nationally representative samples yielding margins of error of plus or minus two to three percentage points at the 95% confidence level.
