This study examines how public health spending affects the performance of the manufacturing sector in Africa, while highlighting the ability of environmental quality to moderate this effect. The analysis is based on panel data for 39 African countries over the period 2000–2024, and is performed using a Fixed Effects regression with Driscoll–Kraay standard errors and a two-step System Generalized Method of Moments (System-GMM) approach, which takes account of endogeneity, heteroskedasticity and serial correlation.  The results suggest that the direct effect of public health expenditure is not significantly associated with manufacturing performance, suggesting that the potential positive effect of improved health may take time to manifest itself as improvement-in-productivity. The relationship between public health spending and environmental quality, however, is positive and statistically significant, suggesting that the productivity impact of public expenditure on health is magnified in cleaner environments. Trade openness is also determined to positively affect the performance in manufacturing but GDP growth does not show any substantial contribution which depicts structural imbalances in African economies.  The study concludes that environmental quality is an essential facilitating condition enhancing the relationship between investment in public health and industrial productivity. It suggests that African governments should mainstream environmental sustainability in the health and industrial policies to achieve synergistic growth, support green industrialization and have a sustainable economic transformation.

Keywords: Public Health Expenditure, Manufacturing Sector Performance, Environmental Quality; CO₂ Emissions, Trade Openness, System-GMM, Africa, Industrial Productivity.