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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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The cost of austerity: The toll of IMF conditionalities on access to health in Zambia

Make Way, Wemos (2024) CC

Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the ... 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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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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Stratégie nationale de changement social et de comportement

Ministère de la Santé Publique, Hygiène et Prévention - République Démocratique du Congo (RDC) (2023) C2

Le "Plan Stratégique National de Communication pour le Changement Social et de Comportement en Lutte contre le Paludisme" de la République Démocratique du Congo (RDC) vise à renforcer les actions de prévention et de traitement du paludisme à travers un changement social et comportemental. Ce p... more

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DNDi Strategic Plan 2021-2028 | DNDi - English version

DNDi - Drugs for neglected diseases initiative (2023) C2

Accessed on 04.04.2023 The Drugs for Neglected Diseases initiative (DNDi) is an international non-profit organization that discovers, develops, and delivers safe, effective, and affordable treatments for the most neglected patients

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International Maternal & Child Health Care - A practical manual for hospitals worldwide

Maternal & Childhealth Advocacy International (MCAI) , Advanced Life Support Group (ALSG) Radcliffe (2015) C2

The purpose of adding the books to the website of MCAI for download, is to make this life-saving, up-to-date information available to all who need it. Fill in a short registration field and you can download the pdf-files. If you work in a hospital in a low income country - providing free care - y... more

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Addendum au Plan de réponse humanitaire 2020 Burundi

OCHA, Cycle de programmation humanitaire (2020) CC

CYCLE DE PROGRAMMATION HUMANITAIRE 2020-2022 Ce document est consolidé par OCHA pour le compte de l’Équipe humanitaire pays et des partenaires humanitaires. Il présente les priorités et les paramètres de la réponse stratégique de l’Équipe humanitaire pays, basés sur une compréhension ... more

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The Missing Billion. Access to Health Services for 1 Billion People with Disabilities

Kuper, H.; and P. Heydt (2019) CC

One billion people around the world live with disabilities. This report makes the case that they are being “left behind” in the global community’s work on health. This lack of access not only violates the rights of people with disabilities under international law, but UHC and SDG 3 cannot be a... more

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Innovative delivery systems for paediatric medicines

World Health Organization WHO; Unitaid (2020) C_WHO

Technology landscape

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Développement d’une stratégie de financement du secteur de l’eau en Afrique centrale

Global Water Partnership Central Africa (2010) C1

Etude nationale sur le financement du secteur de l’eau

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Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa

Molly J Ryan, Tamara Giles-Vernick, Janice E Graham British Medical Journal (2019) CC

BMJ Glob Health 2019;4:e001272. doi:10.1136/bmjgh-2018-001272 Trust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical co... more

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Digital Foundations - Digital Transformation and our Fight against Hunger

World Food Programme (2021) CC

Today, WFP has the capabilities and know-how to tap into mobile technology and artificial intelligence to monitor food security; use satellite technology to locate and track communities in need; and offer digital finance via blockchain technology to put consumer choices in the hands of our beneficia... more

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Inequitable access to COVID-19 tools: A snapshot across 503 facilities in Africa, Asia, and Eastern Europe and Central Asia

The Global Fund (2021) CC

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Situational Brief: Palestinian Refugees in the occupied Palestine Territories during Covid-19

Kaloti R., R. Kafri, H. Meghari (2020) CC

As of 12June 2020, there are 667confirmed COVID-19 casesin the OPT (565 of which are recovered cases), and 48% of which (320 cases) are in East Jerusalem and its suburbs. Additionally, there have been 5 reported COVID-19 deaths (1 in the West Bank, 1 in Gaza and 3 in East Jerusalem)

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COMMENT AMELIORER LA SANTE ET LE DEVELOPPEMENT DE VOTRE ENFANT: Prévention de la Déficience et du Handicap

Christoffel-Blindenmission (CBM) (2012)

Primary Health Toolkit - part 1 (French)

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HOW TO IMPROVE THE HEALTH & DEVELOPMENT OF YOUR CHILD: Preventing Impairment & Disability

Christoffel-Blindenmission (CBM) (2012)

CBM Primary Health Care Toolkit - Part 1 - Flipcharts (English)

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Ukraine: Mental Health in Transition

World Bank (2017) C1

Assessment and Guidance for Strengthening Integration of Mental Health into Primary Health Care and Community-Based Service Platforms in Ukraine

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Etablissements de santé résilients face au changement climatique et écologiquement viables : orientations de l’OMS

Organisation Mondiale de la Santé OMS (2021) CC

RÉSUMÉ D’ORIENTATION L’objectif des présentes orientations est de renforcer la capacité des établissements de santé à protéger et à améliorer la santé des communautés desservies face à un climat instable et changeant ; et de donner aux établissements de santé les moyens d’assur...er leur durabilité environnementale, grâce à une meilleure utilisation des ressources et à une diminution du rejet de déchets dans l’environnement. En étant résilients au changement climatique et écologiquement viables, les établissements de santé peuvent offrir des soins de qualité et des services plus accessibles, et en contribuant à réduire les coûts des établissements, ils garantissent également la prestation de soins plus abordables. Ils représentent par conséquent un élément important de la couverture sanitaire universelle (CSU). Le présent document a pour objectif de : guider les professionnels travaillant dans des structures de soins de santé de manière à ce qu’ils comprennent les risques sanitaires supplémentaires liés au changement climatique et qu’ils s’y préparent efficacement ; renforcer la capacité à exercer une surveillance efficace des maladies liées au climat ; et à suivre, anticiper, gérer les risques sanitaires associés au changement climatique et à s’y adapter ; inciter les responsables des établissements de santé à collaborer avec les secteurs déterminants pour la santé (notamment l’eau et l’assainissement, l’énergie, les transports, l’alimentation, l’urbanisme, l’environnement) afin de se préparer aux risques sanitaires supplémentaires posés par le changement climatique grâce à l’adoption d’une approche de résilience, et à promouvoir des pratiques écologiquement durables dans la prestation des services ; fournir des outils pour aider les responsables des établissements de santé à évaluer leur résilience face aux menaces liées au changement climatique et leur durabilité environnementale, sur la base de l’utilisation appropriée des ressources (en particulier l’eau et l’énergie et les achats durables), et du rejet de matières dangereuses (biologiques, chimiques, radiologiques) dans leur environnement ; promouvoir des mesures visant à garantir que les établissements de santé soient constamment et de plus en plus solides et continuent d’être efficaces et réactifs pour améliorer la santé et contribuer à réduire les inégalités et la vulnérabilité dans leur contexte local. more