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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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PEPFAR: Exploring Co-Financing as a Tool for Domestic Resource Mobilization

Kates J. Kaiser Family Foundation (KFF) (2024) CC

There is growing pressure on PEPFAR, the U.S. global HIV program, to increase its planning for sustainability, including through domestic resource mobilization and, ultimately, transitioning financing at least in part to recipient countries. While this is connected to a broader push in global healt... more

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Financing the Pandemic Cycle: Prevention, Preparedness, Response, and Recovery and Reconstruction

Fan V. Y., Kim S., Pineda D., et al. Center for Global Development (2024) CC

The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This chapter presents a comprehensive framework for pandemic financing that spans the entire pandemic cycle... more

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Tackling malaria in countries hardest hit by the disease: ministerial conference report, Yaoundé, Cameroon, 6 March 2024

World Health Organisation (WHO) (2024) C_WHO

The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie... more

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Nutrition in the First 1,000 Days: State of the World’s Mothers 2012

Safe the children (2012)

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“No Control, No Choice”

Human Rights Watch (2017) C1

Lack of Access to Reproductive Healthcare in Sudan’s Rebel-Held Southern Kordofan

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World Bank Group Approach and Action Plan for Climate Change and Health

World Bank Group (2017) C1

Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and health, nutrition and population (HNP). In the last 5 years, the number of voices calling for... more

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Age-friendly Primary Health Care (PHC) Centres Toolkit

World Health Organization WHO (2008) C_WHO

The toolkit's purpose is to: improve the primary health care response for older persons. sensitize and educate primary health care workers about the specific needs of their older clients. provide primary care health workers with a set of tools/instruments to assess older people's hea... more

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Hammer-blow: How the conflict in Ukraine will have a catastrophic impact on displaced communities in crises

Norwegian Refugee Council (2022) CC

Global food insecurity has markedly increased over the last two-years due to conflict, economic and political instability, displacement, environmental degradation and disasters, and major disruptions to global food systems because of the Covid-19 pandemic. In 2021, levels of hunger surpassed all pre... more

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Coronavirus disease 2019 (covid-19): a guide for UK GPs

M. S. Razai; K. Doerholt; S. Ladhani; et al. BMJ (2020) C2

BMJ 2020;368:m800 doi: 10.1136/bmj.m800 (Published 5 March 2020)

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Longlist of knowledge gaps in Planetary health

Royal Netherlands Academy of Arts and Sciences (2023) C2

The longlist of knowledge gaps is based on existing research agendas published in 2015 or later and expert input from reviewers of the first draft of the longlist. It only includes knowledge gaps focussing on a better understanding of the relationship between global environmental change and human h... more

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Apostolic Exhortation Evangelii Gaudium

Pope Francis Vatican Press (2013) CC

Apostolic Exhortation Evangelii Gaudium of the Holy Father Francis to the Bishops, Clergy, Consecrated Persons and the lay faithul on the proclamation of the gospel in the today`s world

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Standard Operating Procedures - Bacteriology

Indian Council of Medical Research (2015) C1

Antimicrobial Resistance Surveillance and Research Network | This manual describes well accepted methods to carry out drug susceptibility testing on important gram positive and gram negative clinically relevant bacteria. Methods of specimen collection, transport, culture, anti-microbial drug suscept... more

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Climate–Poverty Connections: Opportunities for synergistic solutions at the intersection of planetary and human well-being

Project Drawdown (2022) CC

Project Drawdown (2022) provides evidence of how climate solutions can also be win-win opportunities for meeting development and human well-being needs while boosting prosperity for rural communities in sub-Saharan Africa and South Asia. The report summarizes the co-benefits of five groups of a subs... more

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Extemporaneous Formulation

Abida Haq binti Syed M. Haq et al. Ministry of Health Malaysia (2015) CC

Compounding of pharmaceutical formulations remain as the core skill of pharmacists and this manual is produced to include well referenced recipes that are easy to prepare, use readily available ingredients, have the longest expiry date possible and when necessary, pr... more

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Implementing the SAFE Strategy for Trachoma Control

Center for Disease Control and Prevention CDC (2006) CC

Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes. This is photomicrograph ... more

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My Child: 2 to 5 years (Arabic Version)

Health Service Excecutive HSE Ireland (2021) CC

My Child: 2 to 5 years is a free book from the HSE with advice to help you and your child from age 2 to 5. This edition has text in English with Arabic translation.

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Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease
recommended

Pan American Health Organization PAHO PAHO, WHO (2021) C_WHO

This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be u... more

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Democratic Republic of the Congo Country Strategic Plan (2021–2024)

World Food Program WFP (2021) CC

Food and nutrition security in the Democratic Republic of the Congo is subject to the relentless impact of conflict, epidemics and climate events that have persisted in the country for decades, further compounded by the global COVID-19 pandemic. Lack of infrastructure and investment in agriculture, ... more

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MSF List of Medicines

Medicins Sans Frontieres (2014) C3

Accessed July 2014.

Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease recommended

Chronic Care for Neglected Infectious Diseases: Leprosy/ Hansen’s Disease, Lymphatic Filariasis, Trachoma, and Chagas Disease
recommended