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

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

This two-page summary 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.

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Malaria Capacity Building Initiative

Schellenberg D., Ortega L. World Health Organization (WHO) (2018) C_WHO

The presentation titled "Malaria Capacity Building Initiative" outlines efforts led by the WHO and partner organizations to strengthen the skills and systems needed to fight malaria globally. It highlights the need for a coordinated, long-term strategy to build human resource capacity in malaria-end... more

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Best Management Practice for Mosquito Control Program for UN Duty Station

UN Medical Services Division (2016) C1

This document outlines the best practices for mosquito control and surveillance in United Nations duty stations affected by mosquito-borne diseases. It sets out an integrated vector management (IVM) approach combining environmental, biological, mechanical, chemical and personal protection strategies... more

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Overview of WHO recommendations on HIV and sexually transmitted infection testing, prevention, treatment, care and service delivery

World Health Organization WHO (2025) C_WHO

This document highlights the latest WHO recommendations designed to optimize health outcomes, streamline delivery and address persistent barriers to prevention and care. It especially focuses on people often left behind in service delivery, including adolescents and young people, key populations and... more

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The environmental footprint of health care: a global assessment

Lenzen, M.; A. Malik, M.Li, et al. (2020) CC

Lancet Planet Health 2020; 4: e271–79

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Hungary: The impact of Food Insecurity on Gender-Based Violence in the Ukraine Refugee Response

CARE International; VOICE (2022) C2

The number of people facing acute food insecurity1 is growing at an alarming rate in the European Union (EU) Member States of Central Eastern Europe. COVID-19 and the resulting disruption to global markets, trade, and food supply chains have negatively affected food security since 2020; now, this ha... more

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Global report on neglected tropical diseases 2024: executive summary

World Health Organization WHO (2024) C_WHO

Three full years have passed since the launch of the road map for neglected tropical diseases 2021–2030. Data on progress begin to provide insights into the prospects of attaining the 2030 targets.

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Working With the Environment to Protect People: UNEP’s COVID-19 Response

UN environment programme (2020) CC

The United Nations Environment Programme (UNEP) is stepping up its work on mapping zoonotic threat and protecting the environment to reduce the risk of future pandemics, such as the COVID-19 crisis currently sweeping the globe.

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Gender Analysis Toolkit for Key Population HIV Prevention, Care, and Treatment Programs

FHI 360 (2017) C1

This toolkit provides practical guidance to governments, funders, civil society organizations and other implementing partners on conducting a gender analysis and using findings to inform HIV prevention, care and treatment programs with key populations. It outlines considerations and steps for conduc... more

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Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries

Patel P.; Roberts B.; Gury S. et al. PLOS Medecine (2009) CC

Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official developm... more

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Child and adolescent health in humanitarian settings: operational guide: a holistic approach for programme managers

World Health Organization WHO; Eastern Mediterranean Region (2022) C_WHO

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Progress report on HIV, viral hepatitis and sexually transmitted infections, 2019

World Health Organization (2019) C_WHO

Accountability for the global health sector strategies, 2016–2021 WHO/CDS/HIV/19.7

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Regional action plan for viral hepatitis in South-East Asia: 2016-2021

World Health Organization (WHO), Regional Office for South-East-Asia (2016) C_WHO

With the goal of ending viral hepatitis as a public health threat by 2030, the Regional Action Plan will provide an actionable framework for implementing evidence-based interventions at scale. It will be informed through strategic monitoring of the response, that must be equitable and sustainable an... more

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Situation assessment of rehabilitation in Ukraine

World Health Organization WHO, Regional Office of Europe (2021) C_WHO

It outlines key achievements, needs and opportunities for intervention in the field of rehabilitation in Ukraine. The content of this document is a snapshot in time – not an in-depth analysis of the entire rehabilitation sector. The analysis focuses on rehabilitation policy and governance, service... more

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Hand hygiene in health care in the context of Filovirus disease outbreak response. Rapid advice guideline
recommended

World Health Organization WHO (2014) C_WHO

This document provides a summary of the recommendations for hand hygiene best practices to be performed by health workers providing care and/or support to patients with filovirus infection (Ebola and Marburg viruses).

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Health insurance for India’s poor: A Publication in the German Health Practice Collection

Bundesministerium für wirtschaftliche Zusammenarbeit und Entwicklung (BMZ) Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH (2011) C1

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Consolidated strategic information guidelines for HIV in the health sector. Executive Sumary

World Health Organization (2020) C_WHO

Driving Impact through Programme Monitoring and Management These guidelines – an update to the World Health Organization’s 2015 publication Consolidated strategic information guidelines – present a set of essential aggregate indicators and guidance on choosing, collecting and systematically ... more

Hand hygiene in health care in the context of Filovirus disease outbreak response. Rapid advice guideline recommended

Hand hygiene in health care in the context of Filovirus disease outbreak response. Rapid advice guideline
recommended