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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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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

Development assistance for health (DAH) plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically focused on infectious diseases and maternal and child health, there is a lack of comprehensive analysis of DAH trends, strategic shifts and the... more

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Government Health Spending Outlook - Projections Through 2029: Diverging Fiscal Pressures, Uneven Constraints

The International Bank for Reconstruction and Development The World Bank (2024) CC

This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (SDGs). The findings reveal wide disparities in gove... more

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Conditioned Domestic “Co-financing” Policies in Global Health

Sparkes S., Yungrattanachai M., Fan V., et al. Center for Global Development (2024) CC

Conditioned domestic financing policy, referring to the domestic financing of health projects, programs, and national responses conditioned by global health funding agencies and recipient country governments, is one mechanism to promote sustainability and country ownership. We aim to understand how ... more

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Health Taxes: A Compelling Policy for the Crises of Today

The Task Force on Fiscal Policy for Health Report 2024 Bloomberg (2024) CC

For this report, the Task Force commissioned additional background papers on health taxes to update the evidence, assess short-term revenue potential, and understand the role of health taxes in the current era of multiple crises. We find that health taxes continue to be underutilized despite th... more

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Behavioural considerations for acceptance and uptake of COVID-19 vaccines

World Health Organization WHO (2020) C_WHO

WHO technical advisory group on behavioural insights and sciences for health, meeting report, 15 October 2020

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Checklist to support schools re-opening and preparation for COVID-19 resurgences or similar public health crises
recommended

World Health Organization WHO (2020) C_WHO

The checklist is aligned with, and builds upon, existing COVID-19-related WHO guidelines and is structured around protective measures related to: 1) hand hygiene and respiratory etiquette; 2) physical distancing; 3) use of masks in schools; 4) environmental cleaning and ventilation; and 5) respectin... more

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Human Development Report 2020. The Next Frontier: Human Development and the Anthropocene

UN Development Programme UNDP (2020) CC

Overview. The COVID-19 pandemic is the latest crisis facing the world, but unless humans release their grip on nature, it won’t be the last, according to a new report by the United Nations Development Programme (UNDP), which includes a new experimental index on human progress that takes into acco... more

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Ebola and Lessons for Development

Huff, A.R. IDS (2015)

IDS Practice Paper in Brief 16

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Global action plan on HIV drug resistance 2017–2021

World Health Organization (WHO) (2017) C_WHO

The goal of this Global Action Plan is to articulate synergistic actions that will be required to prevent HIVDR from undermining efforts to achieve global targets on health and HIV, and to provide the most effective treatment to all people living with HIV including adults, key populations, pregnant ... more

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Ground Realities: Voices of Humanitarian Aid Workers from the Frontlines

Roel G. Cabulang; Mariam Mushtaq (2014) CC

Conceived as part of the CWS-A/P project on regional security and risk management, this book presents a collection of testimonies from aid workers in some of the most insecure and volatile environments in the world. The participants recount a broad array of security incidents, such as kidnappings,... more

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Standard operating procedures for supply chain management of health products for neglected tropical diseases amenable to preventive chemotherapy
recommended

World Health Organization WHO (2022) C_WHO

Tis first edition describes the standard operating procedures for health products for NTDs amenable to preventive chemotherapy and the medicines donated to treat them. These include albendazole for lymphatic filariasis and soil-transmitted helminthiases; azithromycin for trachoma and yaws; diethylca... more

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Malaria Entomology And Vector Control - Tutor Guide

World Health Organization (2013)

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The Self Advocacy Tool Kit - For Mental Health Services Users

Christina Angela Ntulo CBM & Basic Needs UK in Uganda (BNUU) (2015) C2

First Edition~ This self advocacy toolkit for persons with mental, neurological and substance abuse disorders, developed by Basic Needs and CBM, is the end product of an action research intervention that tracked and documented processes for Self Advocacy in low resourced communities of Uganda. Th... more

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Water, Sanitation and Hygiene Standards for Schools in Low-cost Settings
recommended

World Health Organization WHO (2009) C2

These guidelines deal specifically with water, sanitation and hygiene, and are designed to be used in schools in low-cost settings in low- and medium-resource countries to: • assess prevailing situations and plan for required improvements; • develop and reach essential safety standards as a f... more

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Handbook for Disaster Recovery Practioners

Asian Disaster Preparedness Center, Tsunami Global Lessons Learned Project (2015)

The ‘Toolkit’ is targeted at practitioners responsible for implementing recovery programmes, their objective to provide a ‘how to’ guide on development, implementing and managing complex post-disaster recovery programmes. Disaster Recovery Toolkit

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Clinical Practice Guidelines for Quality Palliative Care

National Consensus Project for Quality of Palliative Care (2018) CC

4th edition

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Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy

World Health Organization (WHO) (2017) C_WHO

The objectives of these guidelines are to provide recommendations outlining a public health approach to managing people presenting with advanced HIV disease, and to provide guidance on the timing of initiation of antiretroviral therapy (ART) for all people living with HIV.
WHO recommends that a... more

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Cost Benefit Analysis of NMT Infrastructure Projects

UNEP (2021) C1

Non-Motorized Transport (NMT) has immense benefits for individual users, as well as society at large, through improvements to physical health, air quality, the environment, climate change, personal finance, accessibility, mobility and the empowerment of vulnerable groups.

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Integrar la salud en la planificación urbana y territorial : manual de consulta

World Health Organisation (WHO) (2023) C_WHO

Este libro de consulta tiene como objetivo detallar por qué la salud debe ser parte de los procesos de planificación urbana y territorial y cómo hacer que esto suceda. Reúne dos elementos vitales que necesitamos para construir ciudades habitables y un planeta habitable: 1) Procesos para guiar el... more

Checklist to support schools re-opening and preparation for COVID-19 resurgences or similar public health crises recommended

Standard operating procedures for supply chain management of health products for neglected tropical diseases amenable to preventive chemotherapy recommended

Water, Sanitation and Hygiene Standards for Schools in Low-cost Settings recommended

Checklist to support schools re-opening and preparation for COVID-19 resurgences or similar public health crises
recommended

Standard operating procedures for supply chain management of health products for neglected tropical diseases amenable to preventive chemotherapy
recommended

Water, Sanitation and Hygiene Standards for Schools in Low-cost Settings
recommended