We, the participants of the first African Conference on Health Harm Reduction, met on November 16th to 18th to deliberate on health risks, which include all the hazards and risks to health that are beyond the control of individuals and thus fall under the responsibility of public authorities. The conference focused on Health Risk Reduction as a strategy to improve health systems on the continent in terms of accessibility, quality, and affordability.

With over 800 senior-level participants from Africa, the Middle East, Europe, Asia and the Americas – including government officials, health practitioners, scientists, researchers, media representatives and civil society – the Conference was a pre-eminent gathering of minds committed to improve quality health care delivery for all in Africa.

Aware that in this post-pandemic context – when humanity has reached the 8-billion-mark – accessible, quality, and affordable healthcare is key to reach the United Nations Sustainable Development Goals (SDGs) in general and goal number 3 – Good Health and Well-Being in particular.

Cognizant of the need to assess and evaluate health systems in relation to innovations, digital inclusion, financing, policy reforms, social considerations and others, as well as the need to build a healthcare community that embraces multi-sectoral consultative inclusion in order to bring about healthier societies where the dignity and health of all African citizens is preserved, the three-day program created a multidimensional and interactive platform that connected a large number of expert stakeholders in enriching exchanges.

Concerned by the lack of adequate resources, often poorinfrastructure, low health-literacy rates in the global south, on the one hand, and the stigma, barriers, and low level of cooperation from richer countries as witnessed during Covid-19 pandemic, on the other hand.

Responded by sharing and debating interventions that can form a basis for a new framework based on multisectoral collaboration for carrying out scientific research for the development of evidence-based policy and regulatory guidelines that could prevent or reduce health risks and ensure health security and protection for all citizens with equitable access to quality healthcare in Africa.

Deliberated on strengthening health systems in Africa with an emphasis on governments responsibilities as well as financial sustainability models, the use of new information and communication technologies to accelerate digitization, the emerging medical cannabis therapy, and the social determinants of health, including silent-killer diseases, mental health, and addictions.

Believe the Health Harm Reduction approach focused on the patient-citizen’s human right to healthcare has the potential to be an effective public health strategy that can reduce harm whilst lowering the health burden, especially those associated with Non-Communicable Diseases (NCDs) and help reach the ambitious global target to reduce NCDs by 25% by the year 2025.

Acknowledge progress made by governments that are starting to embark on the difficult but necessary road towards setting up universal health coverage in national systems that mandate the reduction of harm as a priority wherever possible and strive to reduce territorial and socio-economic inequities in the quest to include all citizens based on the values of humanism and solidarity.

Mindful of the pressing need for African countries to work together collaboratively to define a collective, integrated, resilient African health system and share best practice to provide health security and quality healthcare for all on the continent, the conference made the following recommendations:

1 . To Promote the strengthening of health systems on the African continent using a Health Risk Reduction approach.

2 . To elevate the daily living conditions of all citizens by improving the environment in which people are born, grow, live and age through health system transformations and ethical Harm Reduction strategies, and risk reducing innovations for known health risks.

3 . To develop Healthcare policies in Africa that are focused on providing universal health coverage to the patient-citizen and respect equitable access to quality healthcare as a basic human right.

4 . To Promote social protection mechanisms and ensure access to quality-assured and affordable essential health services including pharmaceutical medicines, traditional and natural medicines.

5 . To present and learn from Covid-19 response strategies as examples in implementing an efficient, collaborative and resilient healthcare system in Africa.

6 . To Accelerate the implementation of the primary health care vision and strategy to expand telemedicine and the use of digital health to serve remote and vulnerable populations.

7 . To improve access to quality mental and psychiatric care, in line with the development of knowledge and treatments as well as the specific needs of patients in relation to their age, socio-economic situation, environment and vulnerabilities.

8 . To Recognize addictions, both substance and nonsubstance- related, as diseases that qualify for medical attention.

9 . To Promote education for healthier living, including physical activity, healthy diet and risk reducing lifestyle choices. 10 . To Increase health financing through innovative and sustainable funding mechanisms, including publicprivate partnerships, increase allocation of domestic resources and welcome global solidarity.

11 . To Promote Medical cannabis as a new controlled treatment for specific symptoms and diseases and set up Ethical Guiding principles to regulate medical cannabis in order to implement it as a Harm Reduction measure.

12 . To recognize that the field of digital health presents an opportunity for developing and strengthening African health systems by lowering barriers such as cost, accessibility, or lack of quality of care, while expanding the range of services provided, particularly in areas where infrastructure and medical personnel are scarce or nonexistent.

13 . To develop an African Health Harm Reduction Charter based on a multi-stakeholder vision of Health Harm Reduction as a key approach to sovereign health system transformations in an African environment that favors solidarity and cooperation in providing health security for all African citizens.

14 . To hold an annual conference to ensure continued and accelerated efforts towards improved universal health coverage for all on the African continent