In 1992, Queen Elizabeth II described her annus horribilis as a year when institutions she assumed were stable revealed their fragility. For global health, 2025 played a similar role. The disruption did not come from an unexpected crisis or a novel pathogen. It came from a sequence of deliberate political decisions that exposed how much of the global health system rests on discretion rather than durable assurance. From an African perspective, the experience stripped away comforting assumptions.
