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Toolboxes
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2
This paper was commissioned by N´weti and Wemos as part
of the project “Equitable health financing for a strong health
system in Mozambique”. Its purpose is to contribute to the
debate of the Mozambican Ministry of Health’s draft Health
Sector Financing Strategy (HSFS) 2025 – 2034
Overall, harmonisation and innovation should be the
focus of the future direction of DAH and the creation of
a healthy global community. The world needs all hands
on deck if it were to move towards achieving the SDGs,
addressing global health inequalities and improving the
welfare of the global
...
population, while ensuring that no
one is left behind.
more
To realize Agenda 2030, aid agencies, private philanthropies, and their partners in the Global South need better data to monitor how official development finance (ODF) dollars advance the Sustainable Development Goals (SDGs) and avoid missing the mark. In this report, we summarize the results of a n
...
ovel effort to tag and analyze 2.7 million ODF projects between 2010-2021 using machine learning to understand their contributions to the SDG thematic areas at a goal
and target level. This time frame is instructive: it compares the last six years of the Millennium Development Goals era and the first six years of the new SDG age, from early optimism to later uncertainty about the resilience of the agenda to drive collective commitments amid unanticipated global shocks.
more
In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financialization in the
health domain could be described as the uncontrolled expansion of finance along vari
...
ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
more
Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before the pandemic, evidence showed the significant returns
...
on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
more
The key tools and governance approaches for
international cooperation for sustainable development
(hereafter, international cooperation) were set up in a
markedly different time and age. International
cooperation – with official development assistance
(ODA) as the dominant means of implementa
...
tion –
remains key, despite being generally considered as no
longer adequate for addressing today’s common and
collective challenges.
more
Development Finance at a Turning Point: Effects and Policy Recommendations
Berensmann K., Laudage Teles S., Sommer C., et al.
German Institute of Development and Sustainability (IDOS)
(2023)
CC
Development finance is at a turning point, as the macroeconomic environment has changed profoundly and the financing gap for low- and middle-income countries has widened. The events that led to this new situation are the multiple crises that the global economy is facing, such as the climate crisis,
...
the COVID-19 crisis and the war in Ukraine. As a
result, interest rates have risen sharply over the past year and are not expected to decline anytime soon. High interest rates further restrict low- and middle-income countries’ access to international financial markets by making borrowing more expensive. At the same time, debt
levels in several countries are rising to levels that are almost impossible to repay. Poorer countries find themselves in a trap where financing the Sustainable Development Goals (SDGs) becomes a distant goal for them.
more
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
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
...
space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
more
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.
more
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
...
e
powerful impact they have in reducing preventable
death and disease — a particularly glaring act of
neglect in a world that has experienced a massive
pandemic.
more
The world is facing a sustainable development crisis. The 2024 Financing for Sustainable Development Report: Financing for Development at a Crossroads finds that financing challenges are at the heart of the crisis and imperil the SDGs and climate action. The window to rescue the SDGs and prevent a c
...
limate catastrophe is still open but closing rapidly. Financing gaps for sustainable development are large and growing – the estimates by international organizations and others are coalescing around $4 trillion additional investment needed annually for developing countries. This represents a more than 50% increase over the pre-pandemic estimates. Meanwhile, the finance divide has not been bridged, with developing countries paying around twice as much on average in interest on their total sovereign debt stock as developed countries. Many countries lack access to affordable finance or are in debt distress. Weak enabling environments are preventing progress. Average global growth has declined, while policy and regulatory frameworks still do not set appropriate incentives. Public budgets and spending is not fully aligned with SDGs. Private investors are not incentivised to invest enough in SDGs and climate action. The world is at a crossroads. This is the last chance to correct course if we want to achieve the SDGs by the 2030 deadline. Only an urgent, large-scale and sustainable investment push can help us achieve our global goals. Next year’s Fourth International Conference on Financing for Development in 2025 will be a once in 80-year opportunity to support coherent transformation of financing.
more
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
...
s reestablishment by increasing the intensity and quality of interventions, reorienting initiatives, reducing delays that favor transmission, and ensuring adequate monitoring to adjust interventions.
more
This chapter of the AMP LLIN Mass Campaign Toolkit outlines the strategic communication approaches that are essential before, during and after long-lasting insecticide-treated net (LLIN) distribution campaigns. It emphasises the importance of setting up a national communications sub-committee under
...
the leadership of the National Malaria Control Programme (NMCP) and the Ministry of Health (MoH) to coordinate advocacy, social mobilisation and behaviour change communication (BCC). The aim of these three components is to secure political and financial support, mobilise communities, and promote sustained net use through tailored, multi-channel messaging. Effective coordination and planning are critical for successful malaria prevention efforts.
more
4th edition, Reference Manual
This Malaria Surveillance Assessment Toolkit implementation reference guide is a comprehensive reference document, as well as a step by-step guide. It aligns and adapts available tools into a single set of standardized tools, which can be used to conduct malaria surveillance assessments across all t
...
ransmission settings. Use of these standardized tools allows comparison of results between countries and within the same country over time, enabling countries to track their progress towards surveillance system strengthening.
more
Vector control, alongside case management, remains the most effective approach to controlling and eliminating malaria. Key interventions, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs), have significantly reduced malaria transmission in many African countries. This
...
has enabled some countries to transition from the control phase to the elimination phase.
more
Thematic brief. This brief highlights the link between climate change and VBDs in Asia Pacific. Using malaria to tell the narrative, it lists key actions that policymakers and the public health community can consider in addressing the impact of a changing climate on health. The brief also includes
...
a list of resources that countries can benefit from in planning their response.
more
National Strategic Plan for Malaria Elimination in Bangladesh: 2021-2025
National Malaria Elimination Programme - Directorate General of Health Services
Ministry of Health & Family Welfare - Government of Bangladesh
(2021)
C2
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.
more
The framework recommends expanded coverage of malaria diagnostic and treatment services, intensified vector control to drive down transmission, strengthened malaria surveillance, and increased transborder collaboration, especially in terms of efforts to control the sale and use of artemisinin monoth
...
erapies. Since it is unlikely that national malaria control programs will be able to implement all the activities described in this framework simultaneously, a list of suggested priority activities has been included in the Annex.
more
