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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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Directives Nationales de Santé des nouveau-nes au Bénin

République du Bénin Ministère de la Santé Direction de la Santé de la Mère et de l’Enfan (2015) C2

Les périodes périnatale et néonatale constituent des moments critiques dans la vie des mères et des nouveau-nés. En effet, pendant ces périodes, des complications obstétricales, foetales et néonatales surviennent entrainant des mort-nés, des décès néonatals et des possibilités d’incap... more

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Tuberculose. Guide pratique à l’usage des médecins, infirmiers, techniciens de laboratoire et auxiliaires de santé
recommended

Mèdecines sans Frontières MSF (2022) C3

This Tuberculosis guide has been developed jointly by Médecins Sans Frontières and Partners In Health. It aims at providing useful information to the clinicians and health staff for the comprehensive management of tuberculosis. Forms of susceptible and resistant tuberculosis, tuberculosis in child... more

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Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis
recommended

World Health Organization WHO (2025) C_WHO

Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that they prefer. In this guideline, WHO recommends an offering long-acting injectable lenacapavir (LEN... more

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Integrating Primary Care And Public Health

Bernd Rechel Eurohealth (2020) CC

There are many calls for improved integration between primary care and public health, but also sizeable obstacles to achieving this, such as differences in the ways the two sectors are organised and financed, as well as differences in education, culture and approach. This article, based on a new... more

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community-based rehabilitation: CBR guidelines - Introductory booklet (russian)

Kamala Achu, Kathy Al Jubah, Svein Brodtkorb, Philippe Chervin, Peter Coleridge, Mike Davies, Sunil Deepak, Kenneth Eklindh, Ann Goerdt, Cindy Greer, Karen Heinicke-Motsch, Derek Hooper, Venus B Ilagan, Natalie Jessup, Chapal Khasnabis, Diane Mulligan, Barbara Murray, Alana Officer, Francesca Ortali, Bob Ransom, Aline Robert, Sue Stubbs, Maya Thomas, Venkatesh Balakrishna et Roselyn Wabuge-Mwangi. WHO (2010) C_WHO

Recommendations to develop guidelines on community-based rehabilitation (CBR) were made during the International Consultation to Review Community-based Rehabilitation which was held in Helsinki, Finland in 2003. WHO; the International Labour Organization; the United Nations Educational, Scientific ... more

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Central African Republic: National Recovery and Peacebuilding Plan 2017-21

World bank group The World Bank (2017) CC

The Central African Republic is at a major turning point in its history. The country is just emerging from a very violent conflict, during which thousands of human lives were lost and one-third of the population was displaced. After a three-year transition, and with the support of the internationa... more

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Hidden cities: unmasking and overcoming health inequities in urban settings

WHO, UN-HABITAT (2010) C_WHO

The World Health Organization (WHO) and United NationsHuman Settlements Programme (UN-HABITAT) joint globalreport, Hidden cities: unmasking and overcoming healthinequities in urban settings, exposes the extent to whichcertain city dwellers suffer disproportionately from a wide range of diseases and ... more

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Malawi’s Community-based Health System Model: Structure, Strategies, and Learning

Devlin, K.; Pandit-Rajani, T.; Egan, F.K. Advancing Partners & Communities (2017) CC

The Community-based Health System Model Series briefs identify and discuss critical health system inputs and processes that have contributed to the implementation and expansion of community-based service delivery in different countries. Countries were selected for their geographic diversity, type o... more

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Every child alive: The urgent need to end newborn deaths

UNICEF (2018)

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.... more

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Urban HEART : Urban Health Equity Assessment and Response Tool

World Health Organization WHO (2010) C_WHO

The Urban Health Equity Assessment and Response Tool (Urban HEART) is a user-friendly guide for policy- and decision-makers at national and local levels to: identify and analyse inequities in health between people living in various parts of cities, or belonging to different socioeconomic groups with... more

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Ethiopia Humanitarian Response Plan 2020 Mid Year Review

Govt. Ethiopia, OCHA (2020) CC

Ethiopia saw a six-fold increase in confirmed COVID-19 cases between June and August, with 5,689 cases by end June compared to 34,058 cases as of 19 August. Ethiopia also registered more than 13,000 recoveries and more than 600 deaths. As of the last week of August, Ethiopia was leading eastern Afri... more

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Addressing Forced Displacement through Development Planning and Co-operation: Guidance for Donor Policy Makers and Practitioners

Mwangi, Annabel; Gamez, Laura et al. Organisation for Economic Co-operation and Development (OECD) (2017) C1

OECD Development Policy Tools
Recognising that donor policies and responses constantly evolve, this guidance recommends that donors operating in situations of forced displacement prioritise three broad areas of work, where they can best contribute to existing capacities at the national, regiona... more

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Situation Analysis and Recommendations: Antibiotic Use and Resistance in Kenya

Kenya Medical Research Institute (2011) C2

In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric bacterial pathogens such as typhoid, ... more

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Lao PDR: Disaster Management Reference Handbook

Center for Excellence in Disaster Management and Humanitarian Assistance (2017) C1

Lao People’s Democratic Republic (Lao PDR), also referred to as Laos, or Lao, is exposed to natural disasters such as flooding, typhoons, cyclones, drought, and earthquakes. The country is vulnerable to recurrent, sudden-onset and slow onset natural disasters with flooding, storms and typhoons hav... more

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Burkina Faso: Malaria Operational Plan FY 2019

U.S. Global Malaria Coordinator (2019) C2

This FY 2019 Malaria Operational Plan presents a detailed implementation plan for Burkina Faso, based on the strategies of PMI and the National Malaria Control Program (NMCP). It was developed in consultation with the NMCP and with the participation of national and international partners involved in... more

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A living WHO guideline on drugs for covid-19
recommended

Rochweg, B.; et al. (2021) CC

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379 Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE... more

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Developing and Strengthening Community Health Worker Programs at Scale, A Reference Guide for Program Managers and Policy Makers

USAID, MCHIP (2013) CC

Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... more

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TACKLING ANTIMICROBIAL RESISTANCE (AMR) TOGETHER Working Paper 5.0: Enhancing the focus on gender and equity

World Health Organization WHO (2018) C_WHO

This document aims to assist countries to take the first step towards better considering gender and equity issues in their efforts to tackle antimicrobial resistance (AMR), to inform the implementation of strategies in national action plans and contribute to improved reach and effectiveness of AMR e... more

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Promoting human rights in mental health WHO QualityRights training to act, unite and empower for mental health (P I L O T V E R S I O N)

World Health Organization WHO (2017) C_WHO

This document has been developed to provide training and guidance on how to integrate a human rights approach in mental health and related areas, based on international human rights instruments, in particular the UN Convention on the Rights of Persons with Disabilities (CRPD).

Tuberculose. Guide pratique à l’usage des médecins, infirmiers, techniciens de laboratoire et auxiliaires de santé recommended

Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis recommended

A living WHO guideline on drugs for covid-19 recommended

Tuberculose. Guide pratique à l’usage des médecins, infirmiers, techniciens de laboratoire et auxiliaires de santé
recommended

Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis
recommended

A living WHO guideline on drugs for covid-19
recommended