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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 nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal ... more

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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

The Council was established in late 2020 by Dr Tedros Adhanom Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t... 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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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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A healthy return: Investment case for a sustainably financed WHO

World Health Organization (WHO) (2022) CC

There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.

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Political economy analysis for health financing: A ‘how to’ guide

World Health Organization (WHO) (2024) CC

This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within health financing, and... more

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Manual for Stratifying Malaria Risk and the Elimination of Foci

Pan American Health Organization PAHO (2022) C_WHO

All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it... more

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National Strategic Plan: Malaria Elimination 2023-27

National Centre for Vector Borne Disease Control (NCVBDC) Ministry of Health and Family Welfare (MoHFW) - India (2023) C2

The National Strategic Plan for Malaria Elimination in India (2023-2027) focuses on achieving malaria elimination by 2030, in alignment with the Global Technical Strategy. The document outlines the strategies, targets, and goals for malaria elimination, aiming for zero indigenous malaria cases by 20... more

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Plan of Action for Malaria Elimination 2021-2025

Pan American Health Organization PAHO (2022) C_WHO

The Plan subscribes to the goals and pillars of the WHO Global Technical Strategy against Malaria 2016-2030 (GTS), while presenting key elements to address the specific challenges of the Region.

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WHO guidelines on meningitis diagnosis, treatment and care. Web Annex C. Evidence-to-Decision frameworks
recommended

World Health Organization WHO (2025) C_WHO

The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover... more

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WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended

World Health Organization WHO (2025) CC

The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of... more

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Country Office Annual Report 2022 Namibia-Update on the context and situation of children

UNICEF (2022) C_UNICEF

In 2022, Namibia had an estimated population of 2.6 million people, where 51 per cent per cent are females and 52.5 per cent of households in urban areas, with fast-growing urban informal settlements which lack access to basic services. Namibia has a young population; 42 per cent are children (0-17 ... more

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Disability-inclusive Employment Promotion: Lessons learned from five GIZ projects

Deutsche Gesellschaft für Internationale Zusammenarbeit GIZ (2019) CC2

In the initial chapters, you will find different approaches that describe how to support job creation for entrepreneurs or employees who live with disabilities. The interventions are often initiated by the readiness to find and pick the right opportunities, such as an engaged entrepreneur or an open... more

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ECSA report. Eastern, Central and Southern African Region - Education and Labor Markets for Nurses

World Bank Group; International Council of Nurses (2021) CC2

Challenges and Opportunities. This report presents a comprehensive assessment of the education and labor markets for nurses in the ECSA region. It documents the main challenges to train and deploy nurses and discusses opportunities for government and private sector employers to overcome these chall... more

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Evaluatin of the Namibian Community Health Workers Programme

UNICEF; USAID; Maternal and Child Survival Program (2017) C_UNICEF

In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary health care, provision of health services did not go beyond the health facilities, irrespective of the fast dist... more

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Namibia Country Operational Plan 2022 Strategic Direction Summary April 21 2022

U.S. President's Emergency Plan for AIDS Relief (2022) CC2

Namibia is estimated to be at 94-97-93 as defined by the UNAIDS 95-95-95 treatment cascade, one of the first high burden countries to approach epidemic control. COP22 is about sustaining the impact of years of investment and partnership with the Namibian government and other stakeholders by employin... more

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Violence Against Children and Youth in Namibia

Ministry of Gender Equality, Poverty Eradication and Social Namibia (2020) CC2

Namibia has, for many years, had a strong legislative and policy framework for the protection of children. These policies and laws have been developed through the combined expertise of those working in the field of child protection who have ensured Namibia has a robust legal framework that is in li... more

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Consequences of the US budget cuts and the dissolution of USAID: An analysis and recommendations for action for stakeholders in international development cooperation

Liebau L., Rüppel T., Schottmayer K. medmissio (2025) CC

This publication provides a problem analysis of the U.S. cuts in global health and derives concrete recommendations for action for medical actors. The focus is on analyzing the direct effects on health-specific development cooperation.

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex C. Evidence-to-Decision frameworks recommended

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries recommended

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex C. Evidence-to-Decision frameworks
recommended

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended