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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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Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies
recommended

Amaya M Gillespie, Rafael Obregon, Rania El Asawi, et al. (2016) CC

doi: 10.9745/GHSP-D-16-00226; Glob Health Sci Pract December 23, 2016 vol. 4 no. 4 p. 626-646

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National Traditional Medicine Policy

[Republic of Libera, Ministry for Health] (2017) C1

no cover page / publication year available
The process to develop this "National Traditional Medicine Policy" included a detailed situational analysis of traditional medicine in Liberia and a desk review of relevant documents and the regional policy framework on the alignment of WAHO countries ... more

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How can the health systems of Guinea, Sierra Leone and Liberia be improved?

DIFÄM (German Institute for Medical Mission); SLADEA (Sierra Leone Adult Education Association), et al. (2016) C1

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Social Mobilization Lessons Learned: The Ebola Response in Liberia

USAID; Health Communication Capacity Collaborative (2017) C1

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Ebola virus disease preparedness strengthening team Ghana country visit 10–15 Novmeber 2014

World Health Organization (2014)

The preparedness strengthening team deployed to Ghana focused on specific objectives in order to assist the country in becoming as operationally prepared as possible to detect, investigate and report potential EVD cases effectively and safely and to mount an effective response to prevent a larger o... more

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A triple dividend: The health, social and economic gains from financing the HIV response in Africa

Cook, R.; S. Jain; S. Aleyan; et al. Economist Impact (2023) CC

This report presents findings from research conducted by Economist Impact to assess the health, demographic, social and economic impacts associated with different scenarios for financing the HIV epidemic across 13 selected countries in Sub-Saharan Africa. The sponsorship of UNAIDS towards this repor... more

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Global mapping report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions: experiences from around the world

World Health Organisation (WHO) (2023) C_WHO

There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl... more

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Liberia: National Policy and Strategic Plan on Health Promotion 2016-2021

Ministry of Health, Liberia; World Health Organization (WHO) (2016) C_WHO

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Environmental and Social Management Framework (Final Report) for the COVID-19 Emergency Preparedness and Response Project

Ministry pf Health and Sanitation Sierra Leone (2021) CC

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Findings and Recommendations from the Noncommunicable Diseases and Injuries (NCDI) Commission of Ethiopia

Federal Democratic Republic of Ethiopia -Ministry of Health (2018) C1

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Beating the DRUM in Lower-Income Countries: Domestic Resource Use and Mobilization for SDG3

The Governments of Burkina Faso and Norway, the Bill & Melinda Gates Foundation, and the World Bank Group Global Financing Facility (GFF) (2018) CC

This paper has been prepared to inform discussion at the conference “Beating the DRUM - Domestic Resource Use and Mobilization for accelerating progress towards SDG3,”. Many countries face critical shortfalls in domestic resource use and mobilization (DRUM) for health, threatening to push health... more

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HEALTH SYSTEMS FINANCING The path to universal coverage

World Health Organization (2010) C_WHO

Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute both to a better quality of life and also to global peace a... more

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Liberia National Health Policy 2007

Ministry of Health & Social Welfare, Liberia (2007) C1

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Liberia: National Leprosy and Tuberculosis Strategic Plan 2014-2018
recommended

Ministry of Health, Liberia; National Leprosy and Tuberculosis Control Program (NLTCP) (2014) C_WHO

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The National Tuberculosis Health Sector Strategic Plan 2015-2020
recommended

Bonsu FA, Hanson-Nortey NN, Afutu FK et al. Ghana, Ministry of Health (2014) C1

The mandate of the National Tuberculosis Control Programme is to provide leadership and stewardship to accelerate intense and coordinated efforts to reduce the adult TB burden of 290 per 100,000 population recently established in the 2013 National TB Prevalence Survey. Other key challenges are low T... more

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Refugee and Migrant Health System Review: Challenges and Opportunities for Long-term Health system Strengthening in Uganda

Government of Uganda; World Health Organization WHO (2024) C_WHO

Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re... more

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Regulation and Management of International Emergency Medical Teams

Ville de Goyet, Claude de; Perez Calderon, Luis Jorge; Saimiento, Juan Pablo et al. International Federation of Red Cross and Red Crescent Societies (IFRC), World Health Organization (WHO) (2017) C_WHO

The purpose of this report is to provide an overview of the issues in regulating and managing international emergency in a selection of large and small-scale sudden onset disasters (SODs). In doing so, it aims to contribute to several key international commitments as well as its objective in disaste... more

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Namibia: HIV and AIDS Mainstreaming Guideline for Sector Responses

Ministry of Health and Social Services (MOHSS) (2017) C2

Accessed November 2, 2017

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Ebola: Beyond the health emergency

Plan (2015)

Summary of research into the consequences of the Ebola outbreak for children and communities in Liberia and Sierra Leone This study describes the range of impacts that Ebola has had on children and families in Liberia and Sierra Leone, looking beyond the immediate health effects

Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies recommended

Liberia: National Leprosy and Tuberculosis Strategic Plan 2014-2018 recommended

The National Tuberculosis Health Sector Strategic Plan 2015-2020 recommended

Social Mobilization and Community Engagement Central to the Ebola Response in West Africa: Lessons for Future Public Health Emergencies
recommended

Liberia: National Leprosy and Tuberculosis Strategic Plan 2014-2018
recommended

The National Tuberculosis Health Sector Strategic Plan 2015-2020
recommended