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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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Kenya national action plan on antimicrobial resistance: review of progress in the human health sector

World Health Organization WHO (2022) C_WHO

This policy brief aims to provide a review of the current progress on implementing the Kenya national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing ac... more

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Rohingya Refugee Crisis in Cox’s Bazar District, Bangladesh: Health Sector Bulletin No. 15, Reporting period: April to June 2021

World Health Organization (WHO) (2021) C_WHO

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Modelling COVID-19 vaccination status and adherence to public health and social measures, Eastern Mediterranean Region and Algeria

World Health Organisation (WHO) (2023) C_WHO

The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of recommended preventive measures (wearing a mask in public, keeping a distance from other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vac... more

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Transforming health systems: the vital role of water, sanitation and hygiene

WaterAid (2018) C1

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Mental health and poor recovery in female nursing workers: a contribution to the study of gender inequities

Lúcia Rotenberg,1 Aline Silva-Costa,1 and Rosane Härter Griep Pan American Health Organization PAHO (2017) C_WHO

Rev Panam Salud Publica. 2014;35(3):179–85

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Human Resources for Health Strategic Plan 2012-2016 (Sierra Leone)

Ministry of Health and Sanitation, Sierra Leone (2012) C1

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The Case for the Digital Transformation of Circulatory Health

World Heart Federation (2020) CC

This paper explores the angles and opportunities of digital health, with a look at digital innovation and its potential to support patients with circulatory diseases. In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging ... more

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Research for universal health coverage: World health report 2013

World Health Organization (2013) C_WHO

Universal health coverage ensures everyone has access to the health services they need without suffering financial hardship as a result. In December 2012, a UN resolution was passed encouraging governments to move towards providing universal access to affordable and quality health care services. As ... more

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Health in all policies: training manual

World Health Organization (2015) C_WHO

The purpose of this manual is to provide a resource for training to increase understanding of Health in All Policies (HiAP) by health and other professionals. It is anticipated that the material in this manual will form the basis of two- or three-day workshops, which will: • Bu... more

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Inheriting a sustainable world? Atlas on children’s health and environment.

World Health Organization (WHO) (2018) C_WHO

In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents a window of particular vulnerability, where enviro... more

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Global spending on health: Weathering the storm

World Health Organization WHO (2020) C_WHO

The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach... more

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Global expenditure on health: Public spending on the rise?

World Health Organisation (WHO) (2021) C_WHO

The 2021 Report examines country health spending patterns and trends over the past 20 years, before the COVID-19 pandemic, with greater focus on public spending on health. The report also presents spending on primary health care, preliminary health expenditure in 2020 for a small set of countries (i... more

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Key considerations: mental health and psychosocial support, North Kivu, DRC

Social Science in Humanitarian Action: A Communication for Development Platform (2018) C1

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Financing Global Health 2013: Transition in an Age of Austerity

Institute for Health Metrics and Evaluation (2014) CC

Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of development assistance for health. This year’s updated estimates show that despite lackluster economic growth and fi... more

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Public Spending on Health: A Closer Look at Global Trends

World Health Organisation (WHO) (2018) C_WHO

The 2018 global health financing report presents health spending data for all WHO Member States between 2000 and 2016 based on the SHA 2011 methodology. It shows a transformation trajectory for the global spending on health, with increasing domestic public funding and declining external financing. T... more

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Assessing Health Vulnerabilities and Adaptation to Climate Change

Berry, P.; P. M. Enright, J. Shumake-Guillemot et al. (2018) CC

Int. J. Environ. Res. Public Health 2018, 15(12), 2626; https://doi.org/10.3390/ijerph15122626 Climate change is increasing risks to human health and to the health systems that seek to protect the safety and well-being of populations. Health authorities require information about current associatio... more

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Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations

A. Tausch; Oliveira e Souza, R.; Martinez Viciana, C.; et al. Pan American Health Organization (2021) CC

The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young people, those with pre-existing mental health conditions, health workers, and p... more

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The Planetary Health Diet in Theory and Practice

Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) (2019) CC

On the global scale, the impacts of the current food system on the environment are severe. The agro-industrial revolution has made it possible to increase food production at a price.

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Inheriting a sustainable world: Atlas on children’s health and the environment

Marie-Noel Bruné Drisse and Fiona Goldizen World Health Organisation (WHO) (2017) C_WHO

This new publication presents the continuing and emerging challenges to children’s environmental health.