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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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Comprehensive Literature Review on Village Based Health Workers in Myanmar: Extending Services to Communities

The Republic of the Union of Myanmar, Ministry of Health and Sports (2017) C1

The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. In order to extend service delivery to all communities, the NHP calls for all health workers (whether c... more

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Preventing and managing COVID-19 across long-term care services (Arab Version)

World Health Organization WHO (2020) C_WHO

Policy brief, 24 July 2020 The COVID-19 pandemic has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as h... more

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Mental Health in Haiti: Beyond Disaster Relief

Olivia Tiberi The Journal of Global Health (2016) C1

Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t... more

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Vaccines and immunization for monkeypox: Interim guidance, 16 November 2022

World Health Organization WHO (2022) C_WHO

The goal of the global outbreak response for monkeypox is to stop human-to-human transmission of monkeypox, with a priority focus on communities at high risk of exposure which may differ according to context, and to effectively use strong public health measures to prevent onward spread of the diseas... more

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Baseline assessment of community based TB services in 8 WHO ENGAGE-TB priority countries

World Health Organization WHO (2018) C_WHO

This document contains a series of desk reviews for the eight ENGAGE-TB priority countries supported by the Global Fund (DRC, Kenya, Indonesia, Mozambique, Myanmar, Nigeria, Pakistan and Tanzania). The document provides a situation assessment and gap analysis about the state of community based TB ac... more

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Planetary Health Ethics: Beyond First Principles

FosterA.; J. Cole A. Farlow and I. Petrikova (2019) CC

Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging movement has not yet agreed upon a code of ethics t... more

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Point-of-use fortification with micronutrient powders (mnp)improving the nutrition of infants and young children aged 6-23 months (Healthcare Providers)

Ministry of Health, Kenya (2020) C1

The micronutrient powders will be distributed at the health facilities where instructions on use will be provided by Health Care Providers. Community Health Volunteers will educate, counsel, and mobilize caregivers at the community level to visit health facilities for nutrition assessment and provis... more

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Nepal: Monitoring the situation of children and women, Multiple Indicator Cluster Survey

Government of Nepal, National Planning Commission, Secretariat Central Bureau of Statistics, UNICEF (2014)

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Perinatal mortality audit: North Macedonia 2019

World Health Organization WHO (2021) C_WHO

The purpose of the review was to assign a cause of death, to ascertain the fac-tors that contributed to the death and to identify any systemic issues that could be addressed to prevent future similar deaths. The perinatal mortality audit process in 2019 provided important insights and evidence-based... more

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Cervical cancer in Zimbabwe: a situation analysis
recommended

Oppah Kuguyo, A. Matimba, Nomsa Tsika, et al. African Field Epidemiology Network (AFENET) (2017) CC

Pan African Medical Journal 2017;27:215. doi: 10.11604/pamj.2017.27.215.12994

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Family Planning, Maternal, Newborn and Child Health Situation in Rural Nepal: A Mid-term Survey for NFHP II

Nepal Family Health Program II, New ERA (2010) C1

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Situation Analysis of Children in Mozambique 2014

UN Children's Fund UNICEF (2015)

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Situational analysis of quality improvement in maternal and neonatal health care, Sierra Leone

United Nations Population Fund UNFPA (2018) CC

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Situation of child and adolescent health in Europe (2018)

World Health Organization WHO; Regional Office for Europe (2018) C_WHO

The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental health, overweight/obesity and adolescent risk-taking behaviour. The report ... more

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Health Sector Response to Gender Based Violence - Standard Operating Procedures for First Contact Point Health Care Providers - Sri Lanka

Ministry of Health, Nutrition & Indigenous Medicine (2019) CC

The United Nations Population Fund (UNFPA) is the lead UN agency working to further gender equality and women’s empowerment in Sri Lanka. We are pleased to be a part of the joint effort with the Ministry of Health to develop the first ‘Standard Operating Procedures on sexual and gender-based vio... more