India-Africa health cooperation has a well-established institutional history that predates India Africa Forum Summit (IAFS) IV. At IAFS III in 2015, India announced a dedicated India-Africa Health Fund of USD 10 million as part of a USD 600 million grant assistance package and it was the first time that health had its own named fund within the IAFS framework.1 The institutional followthrough was more substantial than is commonly acknowledged.

Health security threats are intensifying across the Global South at a time when digital transformation is advancing unevenly across health systems. Global assessments continue to highlight persistent preparedness gaps and fragmented surveillance capacities (Independent Panel for Pandemic Preparedness and Response, 2021; World Health Organization [WHO], 2023a).