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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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Rwanda Demographic and Health Survey 2010

National Institute of Statistics of Rwanda (NISR) [Rwanda], Ministry of Health (MOH) [Rwanda], and ICF International (2012) C2

The government of Rwanda conducted the 2010 Rwanda Demographic and Health Survey (RDHS) to gather up-to-date information for monitoring progress on healthcare programs and policies in Rwanda, including the Economic Development and Poverty Reduction Strategy (EDPRS), the Millennium Development Goals ... more

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Kenya: Health Policy Project

USAID, PEPFAR, Health Policy Project (2016) C1

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Health Care Waste Management Policy for Ghana

Ministry of Health Ghana (2020) CC

Ghana's attempt to regulate health care waste management started in 2002 with the development of guidelines on health care waste manage-ment by the Environmental Protection Agency (EPA). In 2006, the Ministry of Health developed the health care waste policy and guidelines. This guidance document im... more

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Tracking aid flows for development assistance for health

Vassall A.; Shotton J.; Klein O. et al Global Health Action (2014) CC

he global architecture for providing development assistance for health (DAH) has become increasing complex in the last decade, with many new funding agencies entering the health sector. This study presents a detailed picture of European Union (EU) and EU member state originating DAH between 2006 ... more

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2010-11 Senegal Demographic and Health and Multiple Indicators Survey: Key Findings

L’Agence Nationale de la Statistique and ICF International (2012) C1

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Reducing UPOPs and Mercury Releases from the Health Sector in Africa

Pieper, R. UNDP; GEF; Health Care without Harm (2020) CC

Technical lessons learnt report UNDP GEF Project

External Link

Development, monitoring and evaluation of functional core capacity for implementing the International Health Regulations (2005): Concept note

World Health Organization (2015)

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Namibia Demographic and Health Survey 2013

Ministry of Health and Social Services (MOHSS) (2014) C1

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"Toward Quality Car for Patients" - National Core Standards for Health Establishments in South Africa

National Department of Health Health Department Republic of South Africa (2011) CC

The Department of Health is committed to providing the best quality care to patients and users of health services, in order to meet their expectations and needs, and to improve service delivery. The main purpose of the National Core Standards is to: • Develop a common definition of quality of ... more

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Community dialogues for healthy children: encouraging communities to talk

Malaria Consortium (2014)

Integrated community case management (ICCM) – an approach where community-based health workers are trained to identify, treat and refer children under-five with pneumonia, diarrhoea and malaria – is increasingly being used across sub-Saharan Africa to supplement the gaps in basic healthcare prov... more

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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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Comprehensive Evaluation of the Community Health Program in Rwanda (FINAL REPORT)

Centre for Maternal and Newborn Health (CMNH), from the Liverpool School of Tropical Medicine (LSTM) (2016) C2

The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo... more

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World Health Organization Surgical Safety Checklist

Woodman, N.; and I. Walker World Health Organization WHO (2016) C_WHO

Patient Safety tutorial 325

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Swaziland Demographic and Health Survey 2006-07: Key Findings (siSwati) (English)

Central Statistical Office (CSO) [Swaziland] and Macro International (2008) C2

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Understanding the Climate Change and Health Interface

The One UN Climate Change Learning Partnership (UN CC:Learn) World Health Organization WHO (2013) C_WHO

Resource Guide for Advanced Learning

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Essential Health Services Package for UHC Sierra Leone

Ministry of Health & Sanitation (2022) CC2

It is against this background that the Ministry of Health and Sanitation with its partners have taken the lead to develop Essential Health Services Package (EHSP). The MOHS believes that the development of EHSP; defining the services that should be available at each level of care (community to ... more

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Democratic Republic of the Congo. Demographic and Health Survey 2013-14. Key Findings

Ministère du Plan et Suivi de la Mise en œuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP) and ICF International (2014) C2

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Evaluation of Community-based Health Insurance Pilot Schemes in Ethiopia: Final Report

The Federal Democratic Republic of Ethiopia; Ethioian Health Insurance Agency (2015) C1

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National Implementation Plan/ National Disability Mainstreaming Plan

Bedding, E.J.; M. Banda-Chalwe; T. Mtonga (2013) C1