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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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Guidelines for drinking-water quality: Small water supplies

World Health Organization WHO (2024) C_WHO

Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati... more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more

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Measures to strengthen primary health-care systems in low- and middle-income countries

Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey World Health Organization (2020) C_WHO

Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar... more

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Birth defects surveillance: a manual for programme managers

World Health Organization (2014)

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Nepal: Vulnerable Community Development Plan

Ministry of Health, Government of Nepal (2016) C1

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Regulatory barriers to providing emergency and transitional shelter after disasters - Country case study: Nepal

IFRC - International Federation of Red Cross Red Cresent Societies (2014) C1

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Smart Disinfection Solutions

Bouman, D., W. Novalia, P. Hiemstra, et al. NWP, Aqua for All,Kit Publisher et al. (2010) C1

Examples of small-scale disinfection products for safe drinking water

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Handbook of Humanitarian Health Care Logistics 2nd edition

McGuire, George (2011) CC

Handbook of HUMANITARIAN HEALTH CARE LOGISTICS Designing the Supply Network and Managing the Flows of Information and Health Care Goods in Humanitarian Assistance during Complex Political Emergencies

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Standard operating procedures for controlling Ebola and Marburg virus epidemics

World Health Organization (2014)

Provisional recommendations May 2014

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Healthcare waste

USAID (2019) C1

Sector Environmental Guidelines, Full technical Update

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Responding to urban disasters: Learning from previous relief and recovery operations

David Sanderson and Paul Knox-Clarke ALNAP (2012)

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SODIS manual Guidance on solar water disinfection
recommended

Luzi, S; Tobler, M; Suter, F; Meierhofer, R EAWAG (2016) C1

SODIS manual - updated version The SODIS manual contains detailed information about technical and promotional aspects of the SODIS method. Former version also available in French, Portuguese, Spanish, Uzbek, Russian

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Household Water Treatment Ceramic Filtration

Centers for Disease Control and Prevention CDC (2008) C_CDC

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Typhoon Preparedness

Ian Mosquisa CRS Philippines Emergency Capacity Building (2012)

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Considerations for implementing and adjusting public health and social measures in the context of COVID-19
recommended

World Health Organization WHO (2021) C_WHO

interim guidance, 14 June 2021 This document is intended for national authorities and decision makers in countries that have introduced large scale public health and social measures. It offers guidance for adjusting public health and social measures, while managing the risk of a resurgence of cases... more