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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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African Union AMR Landmark Report: Voicing African Priorities on the Active Pandemic

Africa Center for Disease Control and Prevention (2024) CC

Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2... more

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When the Drugs Don’t Work – Antibiotic Resistance as a Global Development Problem

The Dag Hammarskjöld Foundation and ReAct (2019) C2

This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and its impacts across different Sustainable Development ... more

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Continuing essential sexual, reproductive, maternal, neonatal, child and adolescent health services during the COVID-19 pandemic

World Health Organization (WHO), Regional Office for South-East Asia; UNICEF; UNFPA (2020) CC

Practical considerations It provides more detailed and practical guidance for continuing services for each life stage across the life-course continuum. As such, both documents should be read and used together. The countries in South-East Asia and the Pacific regions would like to adapt the guidance... more

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WHO Country Support on Climate Change and Health - Visual Guide

World Health Organization WHO (2021) C_WHO

This visual guide provides an overview of the various means of support WHO offers to member states to advance climate-resilient health. The guide offers answers to key questions to understand WHO's support to countries on climate change and health, including: What are the impacts of climate change o... more

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Mental health and psychosocial support aspects of the COVID-19 response
recommended

World Health Organization WHO, Regional Office for Western Pacific (2020) C_WHO

Across the Western Pacific Region COVID-19 is placing enormous strain on health and economic systems apart from direct threats to personal health safety and livelihood the pandemic also has significant implications on mental health and psychosocial well being adversity is an established risk factor ... more

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HPV Vaccine Communication: Special considerations for a unique vaccine

World Health Organization WHO (2013) C_WHO

A lack of knowledge about the threat of vaccine-preventable diseases, risks and benefits of vaccines, mistrust of government and health workers, poor service delivery and alternative health or religious beliefs play a role in lower uptake of some vaccines. These challenges underscore the importance ... more

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Working Together to Fight Antimicrobial Resistance

Pan American Health Organisation PAHO; FAO and OIE (2022) C_WHO

Antimicrobial resistance (AMR) represents a major global threat across human, animal, plant food and environmental sectors, threatening the effective treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi, resulting in prolonged illness and increased mor... more

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Resource package for strengthening countries’ health systems response to violence against women

World Health Organisation (WHO) (2021) C_WHO

o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including: • clinical and policy guidelines; • implementation handbooks and manuals; • training curriculum; • evidence-based polic... more

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Maintaining essential health services: operational guidance for the COVID-19 context
recommended

World Health Organization WHO (2020) C_WHO

1 June 2020 Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidan... more

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The generic all-hazards risk assessment and planning tool for mass gathering events

World Health Organisation (WHO) (2023) C_WHO

The Generic All-Hazards Risk Assessment and Planning Tool for Mass Gathering Events (“All-Hazards MG RA Tool”) aims to support Member States and mass gathering events organizers. The tool is based on the principles of the World Health Organization’s Strategic Toolkit for Assessing Risk (STA... more

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World Health Organization (WHO) interventions in Niger through USAID funding from 2020 to 2023

World Health Organization WHO (2023) CC

The World Health Organization (WHO) has been present in Niger since 1960, and acts as the Government's principal advisor on public health and lead of the health cluster. WHO covers all eight regions of the country with 113 staff members in Niamey and in 7 sub-offices (Agadez, Diffa, Zinder, Maradi,... more

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Interim Guidance on Public Health and Social Measures for COVID-19 Preparedness and Response Operations in Low Capacity and Humanitarian Settings

Inter-Agency Standing Committee IASC (2020) C1

This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, co... more

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IASC Mental Health and Psychosocial Support Minimum Service Package

Inter-Agency Standing Commitee (2022) C2

The MHPSS MSP is an easy-to-follow intersectoral package, which spells out the activities and actions that all humanitarian actors should put in place in all emergencies for an effective MHPSS response. It speaks to different actors at the global, regional, national, and local levels to plan, coordi... more

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WHO Sierra Leone Country Cooperation Strategy 2022–2025

World Health Organisation (WHO) (2023) C_WHO

The Country Cooperation Strategy is the World Health Organization’s corporate framework developed in response to a country’s needs and priorities. The 2022–2025 CCS is the fourth for WHO in Sierra Leone. It is a medium-term strategic document that defines a broad framework for WHO’s work, at... more

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Prevalence, Etiology, and Outcome of Sepsis among Critically Ill Patients in Malawi

Prin, M.; Onofrey, L.; Purcell, L; et al. (2020) CC2

Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ... more

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Cancer in sub-Saharan Africa
recommended

Ngwa, W.; et al. Lancet Oncology Commission (2022) C2

Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8 In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality. Without rapid interventions, data estimates show a major increase in cancer mo... more

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Estimating the Size of Populations through a Household Survey (ESPHS) - RWANDA 2011

Rwanda Biomedical CenterInstitute of HIV (2012) C2

This report presents the findings of the Estimating the Size of Populations through a Household Survey (ESPHS) study that took place in 2011. The study utilized a single household survey to estimate the size of several key populations, including sex workers, men who have sex with men (MSM), injectin... more

Mental health and psychosocial support aspects of the COVID-19 response recommended

Maintaining essential health services: operational guidance for the COVID-19 context recommended

Cancer in sub-Saharan Africa recommended

Mental health and psychosocial support aspects of the COVID-19 response
recommended

Maintaining essential health services: operational guidance for the COVID-19 context
recommended

Cancer in sub-Saharan Africa
recommended