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.
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Development assistance for health (DAH)
plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically
focused on infectious diseases and maternal and child
health, there is a lack of comprehensive analysis of DAH
trends, strategic shifts and the...ir impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
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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 ...country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie...ty and other partners. The pivotal meeting sought to leverage political commitment, scientific innovation and community engagement to reshape the trajectory of malaria control in high burden African countries, and beyond.
At the end of the meeting and in the weeks that followed, Ministers of Health from the 11 “High Burden High Impact” African countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda and United Republic of Tanzania) signed the Yaoundé Declaration, pledging their “unwavering commitment” to the principle that “no one should die from malaria given the tools and systems available.” Success in reducing malaria morbidity and mortality will hinge on efforts by countries to translate this political commitment into actions and resources that will save lives.
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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...enges. The report provides empirical evidence to support the expansion of nursing education within the region with a focus on private sector engagement, effective labor market regulation, and regional collaboration. A regional focus for investment may be necessary to create enough potential deals, reduce individual country and regulatory risks, encourage good private institutions to move across borders within the region, and seek to create regional standards for regulation.
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The Strategic Malaria Communication Guide for Central America is intended to facilitate the shift from malaria control to elimination by strengthening communication and advocacy initiatives throughout the region. Based on interviews and a review of literature, the guide offers National Malaria Progr...ammes (NMPs) recommendations on messaging, target audiences, communication channels and advocacy strategies. The guide's primary goals are to raise awareness of malaria elimination, encourage long-term commitment from decision-makers and mobilise sustainable resources. The guide outlines two strategic objectives: (1) creating a shared understanding of the long-term requirements for malaria elimination, including funding, surveillance and multi-sectoral engagement, and (2) expanding support among public, private and cross-sectoral stakeholders. With malaria cases having already reduced by 88% since 2000, the guide emphasises the importance of maintaining focus and investment in order to fully eliminate the disease and prevent its re-establishment in Central America.
Accessed on 10/06/2025.
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This Communication Guide for Malaria Control Interventions is aligned with Tanzania’s Malaria Strategic Plan (2015–2020) and provides comprehensive guidance on the implementation of Social and Behaviour Change Communication (SBCC) for the prevention, diagnosis and treatment of malaria. It is int...ended for all stakeholders and implementing partners, with the aim of ensuring harmonised messaging and coordinated communication efforts. The guide outlines strategies, key messages, communication channels and target audiences, with a focus on sustaining and improving malaria-related behaviours at the individual, family and community levels. It incorporates malaria stratification and supports the development of tailored SBCC interventions in different risk areas. Developed with contributions from the Ministry of Health and Social Welfare, the National Malaria Control Programme and various partner organisations, the guide aims to reduce the malaria burden and promote a malaria-free Tanzania. Supplemented by Standard Operating Procedures (SOPs), the guide serves as a practical tool for consistent and effective malaria communication nationwide.
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Pillar 3 of the Global technical strategy for malaria 2016–2030 calls for the transformation of malaria surveillance into a core intervention in all malaria-endemic countries, as well as in countries which have eliminated malaria but remain susceptible to re-establishment of transmission. This ref...erence manual covers subjects that are relevant to both settings.
The target readership of this manual includes staff working in ministries of health, national malaria programmes and health information systems; partners involved in malaria surveillance; and WHO technical officers who advise countries on malaria surveillance.
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The National Strategic Plan for Malaria Elimination 2021–2025 outlines Bangladesh’s roadmap to achieve zero indigenous malaria cases by 2030, with an interim goal to reduce transmission to near-zero levels by 2025. The strategy builds upon earlier successes in malaria control and shifts focus to...ward elimination in both high- and low-endemic areas.
The plan emphasizes five core objectives: ensuring universal access to quality malaria prevention and treatment services, strengthening surveillance and case detection systems, improving vector control through long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), building community engagement, and enhancing program governance and accountability.
High-priority districts, especially in the Chittagong Hill Tracts, are targeted for intensified interventions, including active case detection and tailored outreach to mobile and vulnerable populations. The strategy also calls for robust health systems support, cross-border collaboration, and integration of malaria services into broader primary health care.
This document serves as Bangladesh’s strategic foundation to transition from malaria control to phased elimination, in line with national and global targets.
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These guidelines promote the delivery of people-centred health services for STIs by providing evidence-based recommendations related to decentralization, integration, task sharing and digital health. These recommendations complement existing WHO guidelines for STI testing, treatment and management, ...and other service delivery interventions, such as self-care interventions. All the recommendations will be incorporated into the forthcoming WHO consolidated guidelines on STI prevention and care.
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This policy brief presents a summary of current evidence on vulnerability to TB and proposes interventions for equitable, person-centred, and human rights-based TB prevention and care. It aligns with WHO policies and guidance on TB prevention and screening, management of TB and comorbidities, access... to health care, universal health coverage, determinants of TB, TB-associated impairment and disability, social protection, as well as ethics, equity and human rights.
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This operational guidance provides a structured approach to support countries in sustaining priority services for HIV, viral hepatitis and sexually transmitted infections in the context of reduced external funding. The guidance is intended for national governments, public health programmes, communit...y-led organizations, civil society, technical partners and donors working to safeguard priority services, support phased adaptation, protect health outcomes and preserve hard-won gains.
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Growing emergencies and displacements across the world demand increasingly complex interventions and responses. The World Health Organization (WHO) has developed Malaria control in emergencies: a field manual to provide technical guidance to help partners respond effectively to malaria in emergency ...situations. This field manual supersedes the 2013 WHO handbook.
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Despite being a preventable and curable infectious disease, tuberculosis (TB) has continued to elude global controll efforts. In 2023, 8.2 milion people with TB were diagnosed and notified to the WHO, the hightest number ever reported since WHO began tracking.
This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child health p...rogrammes, and spur collaborative global action. The document summarizes the background information, evidence, and rationale for making KMC available to every preterm or LBW newborn and seeks to galvanize the international maternal, newborn, and child health community and families to come together to support the implementation of KMC for all preterm or LBW infants to improve their and their mothers and families health and well-being.
This position paper is intended to be used by policy-makers (i.e. those responsible for national policy, guideline development and budget allocation), development partners, programme managers, health workforce leadership, practising clinicians, civil society leadership (e.g. parent and professional organizations) and researchers/research organizations involved in KMC implementation research.
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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs), as they have a higher risk of severe illness... and death from COVID-19. COVID-19 has been associated with an
excess in all-cause and cardiovascular disease (CVD) mortality beyond that related to the infection itself and its immediate consequences. Studies in the
United Kingdom (UK) and United States of America (USA) have clearly shown increasing deaths from ischemic heart disease, stroke and hypertensive disease due to COVID-19. Overall, the impact has been greater in individuals with lower socioeconomic status, even in high income nations.
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The UNAIDS 2020 global report is a call to action. It highlights the scale of the HIV epidemic and how it runs along the fault lines of inequalities.
A Systematic Review, Country Case Studies, and Recommendations for Integration into National Health Systems
Alliance Report
Participation of community health workers (CHWs) in the provision of primary health care has been experienced all over the world for several decades, and there is an amount ...of evidence showing that they can add significantly to the efforts of improving the health of the population, particularly in those settings with the highest shortage of motivated and capable health professionals.
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This updated version, endorsed by the World Health Assembly in May 2021 through resolution WHA74.9, reflects lessons learned in the global malaria response over the last 5 years. While the milestones and targets remain the same, the approaches to tackling the disease, in some areas, have evolved to ...keep pace with the changing malaria landscape.
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