To accurately comprehend the current state of health research in Africa, it is vital to evaluate the challenges, acknowledge the advancements, and compare them with global standards. The most formidable obstacle that arises is the insufficient funding, which also extends to a major obstacle to youth involvement in health research. According to the latest UNESCO science report, despite a global rise in spending on science and the number of scientists in the past five years, a trend amplified by the COVID-19 pandemic, no African country is allocating 1% of its Gross Domestic Product towards research and development [5, 6] (See Fig. 1). Inadequate funding for health research in Africa leads to dependency on external donors, skewing research towards global rather than local needs and limiting young researchers’ contributions. This focus may neglect important health areas and leaves young researchers at underfunded institutions with scarce career development opportunities. Such limited investment undermines research quality and impacts, significantly affecting research directions and the support for young African researchers. The global call to decolonize global health research strongly aligns with the imperative to invest in the capacities of African young researchers. This alignment implies a crucial shift: recognizing and rectifying how traditional funding and research paradigms have often marginalized African perspectives, especially those of the youth. Experts have also suggested that the current model of philanthropic aid for health research could perpetuate Africa’s dependence on the Global North and to break this dependency, African stakeholders must develop and implement clear strategies, taking the lead in decisions [4].

Gross Expenditure on Research and Development (GERD) as a percentage of GDP for Africa, sub-Saharan Africa, and Arab States in Africa from 2014 to 2018. Data Source UNESCO Science Report [6]. Note The line connecting the data points for 2014 and 2018 is for visualization purposes only and does not imply linearity or any specific trend between these years

The state of health research in Africa can be further illuminated by examining the number of researchers and their density per million inhabitants. Despite the strides made globally, sub-Saharan Africa’s share of global researchers remains small, moving from 0.6% in 2014 to 0.7% in 2018 [5]. However, this still represents a substantial increase in researcher density per million inhabitants for the region - from 102 in 2014 to 124 in 2018. Several African countries showed promising growth and were among the 38 worldwide that had increased their researcher density per million inhabitants by over 15% between 2015 and 2018 [5]. These statistics point to a promising growth in research capacity within the African continent. Yet, for young African researchers, this data also underscores a pressing concern. Despite an increase in researcher numbers, Africa’s youth remain underrepresented in global health research, leading to a skewed understanding of health challenges. More researchers do not necessarily mean a stronger global voice, particularly when young contributions are overlooked. Additionally, disparities in researcher density across countries create unequal opportunities for young researchers, affecting access to resources, training, and mentorship, and contributing to an uneven playing field within the continent.

Another critical obstacle facing health research in Africa is the high emigration rate of skilled researchers, a problem known as brain drain [7,8,9]. Over 10% of sub-Saharan Africans with graduate degrees emigrate, with numbers significantly higher in the healthcare workforce [9]. This exodus is often driven by factors such as limited local funding and training opportunities, as well as pull factors such as more appealing research environments and working conditions in high-income countries. Retention of professionals with specific technical skills is vital for a thriving health research landscape, making it paramount for African leaders to invest more in its youthful population. Furthermore, the lack of investment in Research & Development (R&D) by African companies, particularly in the health sciences field is another prominent challenge. Globally, pharma companies are leading investors in R&D. However, in Africa, only few companies have R&D units or directors to oversee product creation, knowledge, and technology transfer [10]. Even though Africa is blessed with vast medicinal plants, the research landscape into the health benefits of these plants is still underexplored. This lack of institutional support further hinders the development and growth of health research on the continent. Overall, bolstering the health research ecosystem in Africa requires a comprehensive approach that addresses funding, capacity development, brain drain, and local industry investment [11]. Critiques of capacity development in Africa focus on the disconnect between donor-driven programs and the continent’s specific needs. These efforts, while aimed at empowerment, often fail to consider the complexities of local health systems and cultures, risking dependency rather than fostering sustainable growth.

Africa’s health research is at a critical point, needing to strengthen its global role. Fonn et al. [2] note Africa’s small research output relative to its population, suggesting a need for greater global research participation. Ezeh et al. [1] and the establishment of Consortium for Advanced Research Training in Africa (CARTA) represent steps toward enhancing health research capacity in Africa through a multidisciplinary approach, emphasizing the importance of youth engagement in addressing complex health challenges. Ndejjo et al. [7] bring forth the imperative of positioning Africa’s public health doctoral students as leaders poised to drive societal transformation and development. The youth, being at the helm of innovative solutions and possessing a contemporary understanding of prevailing health issues, are indispensable in the quest to elevate Africa’s health research landscape. Their involvement will not only enriches the research ecosystem but also propels the continent towards homegrown solutions, as underscored by Christoffels [12]. Thus, youth involvement is not a mere accessory but a fundamental requisite to accelerate Africa’s trajectory in global health research and, by extension, its impact on public health outcomes.

Despite these constraints, Africa has demonstrated that it has the talent and ambition to make significant contributions to health research [11]. From pioneering work in managing HIV/AIDS to ground-breaking research in malaria and COVID-19 response, African researchers have made strides in addressing some of the continent’s most pressing health challenges [13,14,15]. Initiatives like the African Academy of Sciences’ Grand Challenges Africa, Global Health Focus University Excellence, the African Research Excellence Fund, and the Alliance for Accelerating Excellence in Science in Africa showcase the potential of targeted investments in engaging young people and fostering local innovation. Despite signs of growth, the current investment in health research is insufficient to meet the Sustainable Development Goals and Africa’s Agenda 2063.

Recognizing the value of investing in health research is fundamental in prioritizing its development. The potential dividends extend beyond the health sector, promising significant economic, social, and strategic returns. Youth involvement can significantly augment the value of health research by injecting fresh perspectives, innovative ideas, and a dynamic energy into the sector as well as more opportunities for development in Africa.

Health research investment can play a significant role in stimulating economic growth and development. This funding nurtures a broad spectrum of high-skilled jobs that range from laboratory scientists to public health experts, thereby reducing unemployment rates and boosting economic productivity. Moreover, investing in health research can spur technological advancement and innovation, particularly in fields like biotechnology, pharmaceuticals, and healthcare delivery systems [16]. The creation of new treatments, health interventions, and advanced medical devices can result in profitable commercial applications, creating new industries and market opportunities. Such investment can also stimulate an ecosystem of spin-off industries, including data management, logistics, regulatory affairs, and intellectual property management. This ripple effect can result in further job creation and economic development.

From a social perspective, health research is pertinent to achieving better health outcomes and reducing health disparities [17]. Most of the knowledge needed to solve Africa’s health research problems reside in the confines of the continent itself. Balancing local and international research collaboration is key to Africa’s health research development. While local research ensures cultural and contextual relevance, international partnerships bring global expertise and resources. This synergy enhances capacity building, ensuring that local insights are integrated into global health discourse without losing their unique value. Investing in the capacity of young people within the health research sector can foster a locally-driven approach to tackling health disparities, leveraging the inherent knowledge and cultural understanding present within the continent. Through their active involvement and development, youth can contribute to innovative solutions and community engagement strategies that are tailored to Africa’s unique health challenges, thereby enhancing the social impact and relevance of health research in improving health outcomes. Strategic investment in health research holds critical importance for Africa, paving the way for African youth to spearhead efforts in investigating diseases that predominantly afflict the continent, instead of depending on expertise or evidence from other regions. This proactive stance enables African youth to address endemic diseases with heightened precision and efficacy, a necessity given the escalating burden of both infectious and non-infectious diseases. Furthermore, looming global health challenges such as climate change and rapid urbanization are anticipated to usher in unprecedented health issues ranging from heat-related illnesses to pollution-induced respiratory diseases.

The COVID-19 pandemic has accentuated the importance of nurturing a sturdy, home-grown research capacity capable of promptly responding to emerging health crises [18,19,20,21]. Without robust health research infrastructure, Africa risks over-reliance on global health initiatives that might not align with its unique needs. Strengthening this infrastructure is key for empowering African youth with tools to understand and address specific health challenges, ensuring they can effectively protect public health in changing conditions. Investing in health research is, therefore, not just a matter of health policy but an imperative for economic development, social equity, and strategic foresight. To harness these benefits, a significant commitment from regional leaders is required.

With a youth population projected to reach almost 1 billion by 2050, Africa boasts the youngest demographic in the world [22]. This emerging powerhouse of youthful energy and innovative potential presents an extraordinary opportunity for the continent to leapfrog development barriers. Among the manifold areas for youth engagement, health research stands as a pivotal field where young Africans can significantly contribute towards reshaping their communities and countries [11]. African youth offer unique insights into health challenges based on their lived experiences, understanding the broader impact on economy, society, and quality of life. Developing a pipeline of young researchers will position Africa not just as a research subject but as a key player in the global health arena.

Despite the clear advantages that youth involvement offers, they face several barriers that often stifle their potential. These challenges range from under-resourced educational institutions and limited opportunities for advanced research training, to inadequate mentorship– often due to over-worked or insufficiently qualified senior staff - and the perpetual struggle for research funding [23,24,25]. Consequently, many young Africans who are interested in health research are left unsupported and underutilized. Under-resourced institutions and the lack of quality education are critical barriers. Many African universities and research institutions lack the capacity to provide high-quality health research training [26]. Limited access to up-to-date resources, inadequate research infrastructure, and the dearth of experienced research mentors further compound these challenges. This situation stifles the intellectual growth of young researchers and hinders their ability to make meaningful contributions to the field of health research.

In addition to education, funding is a fundamental challenge. Despite the vast potential that young African researchers offer, securing funding for their research projects is often difficult [24]. Young researchers typically lack the track record and experience that grant review committees look for. As a result, they often struggle to compete with established researchers for limited funding resources. This lack of financial support not only stifles their current research activities but also threatens to discourage them from pursuing a career in health research altogether. Addressing these challenges requires comprehensive, systemic solutions. Improving the quality of education and research training can create a conducive environment for young researchers to grow and thrive [11]. This might entail investing in research infrastructure, updating curriculum to meet international standards, providing access to digital resources, and fostering partnerships with international institutions for research collaboration and faculty development. Additionally, creating more dedicated funding streams and grants for young researchers, such as the Royal Society of Tropical Medicine and Hygiene Early-Career Small Grants, can enable them to kickstart their research careers. Mentorship programs that connect young researchers with established scientists can further support their professional growth. Encouragingly, several initiatives across Africa are paving the way for youth engagement in health research. Programs such as the African Research Leaders programme, Global Health Emerging Leaders Programme, Global Health Mentorship, and the Developing Excellence in Leadership, Training, and Science Africa programme among others, are fostering the next generation of African health researchers. These efforts, however, need to be scaled up and complemented by national policies that prioritize youth involvement in health research.