BACKGROUND:
Delivering the Africa Health Security and Sovereignty (AHSS) Agenda requires resilient health systems including primary health care (PHC), community trust and predictable domestic financing. Social and behaviour change (SBC) increases service uptake, adherence, and timely care-seeking, yet it is often financed through fragmented, short-term projects and treated as “communication”. Weak costing practice, absent SBC budget lines and unclear public financial management (PFM) codes constrain planning, execution tracking and accountability.

METHODS:
Africa CDC, Member States, and partners co-developed and piloted a systems-based SBC costing and financing approach aligned to AHSS priorities: institutionalized pandemic prevention, preparedness, and response (PPPR), predictable financing and digital transformation. Evidence was generated through in-country costing, validation exercises, multi-country consensus workshops with ministries of health and finance and implementing partners. Outputs included a consolidated costing tool, standardized SBC package, a draft SBC budget-coding taxonomy and an SBC institutionalization scorecard.

RESULTS:
End-to-end costing clarified the full SBC package beyond media buys and materials, made workforce and community platform costs visible, identified financing gaps and execution bottlenecks. Aligned budget codes and sub-codes strengthened budget formulation, tracking and utilization, enabling alignment with annual budgeting cycles and medium-term expenditure frameworks. Countries linked SBC investments to priorities including immunization recovery, cross-border health, NCD prevention, gender equity, youth health, climate resilience and emergency preparedness, supporting demand, trust and uptake for health services and countermeasures.

CONCLUSIONS:
Institutionalizing SBC as a core health-system function is an AHSS sovereignty and financing decision. We propose a continental roadmap to embed SBC within domestic PFM mechanisms, supported by standard tools, digital reporting, and targeted technical assistance. This approach can sustain health gains, strengthen preparedness, and advance people-centred, equitable and secure health systems in Africa, with transferable lessons for wider global adaptation.