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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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Social and Behavior Change Communication SBCC for Malaria in Pregnancy: Strategy Development Guidance

Health Communication Capacity Collaborative HC3; USAID (2017) CC

This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), which is funded by USAID and based at the Johns Hopkins Center for Communication Programs, offers structured guidance for improving social and behavioural change communication (SBCC) strategies relat... more

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Framework for Environmental and Social Management

Food and Agriculture Organization of the United Nations FAO (2023) CC

The Food and Agriculture Organization of the United Nations (FAO) launched a new Framework for Environmental and Social Management (FESM) to ensure that both people and the environment are protected from any potential impacts of FAO programmes and projects. “This Framework ensures that our proj... more

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Global spending on health: rising to the pandemic’s challenges

World Health Organization WHO (2022) C_WHO

The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ... more

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Molecular and Clinical Aspects of Chronic Manifestations in Chagas Disease: A State-of-the-Art Review

Medina-Rincón, G.; Gallo-Bernal, S.; Jiménez, P.; et al. (2021) CC

Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493 .Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech... more

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Realizing Agenda 2030: Will donor dollars and country priorities align with global goals?

Sethi, T.; S. Custer; J. Turner et al. AidData at William & Mary (2017) CC

This report seeks to uncover the extent to which global goals crowd in international financing, inform domestic policy priorities, and navigate progress toward development outcomes in low- and middle-income countries (LICs and MICs). Our report: Provides a historical perspective on how ODA financin... more

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A guide to implementing the One Health Joint Plan of Action at national level
recommended

World Health Organization WHO; Food and Agriculture Organization of the United Nations FAO; UN UN Environment Programme UNEP; World Organisation for Animal Health WOAH (2023) C_WHO

The guide to implementing the One Health Joint Plan of Action (OH JPA) at national level provides practical guidance on how countries can adopt and adapt the OH JPA to strengthen and support national One Health action. Building on the OH JPA theory of change, this guide describes three pathways a... more

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National Strategy for Rural Water Supply, Sanitation and Hygiene (WASH), WASH in Schools and WASH in Health Facilities 2016 - 2030

Government of the Republic of the Union of Myanmar (2016) C1

The purpose of this Strategy is to set out the way to meet the needs of the rural populations for improved domestic water supply services, access to and use of improved sanitation with elimination of open defecation, and improved hygiene behaviour by the Year 2030. It also addresses water, sanitatio... more

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Disability and Related Factors among Road Traffic Accident Victims in Benin: Study from Five Public and Faith-Based Hospitals in Urban and Suburban Areas

Yolaine Glèlè-Ahanhanzo, Alphonse Kpozèhouen, Noël Moussiliou Paraïso, Patrick Makoutodé, Chabi O. Alphonse Biaou, Eric Remacle, Edgard-Marius Ouendo, Alain Levêque Scientific Research Publishing (2018) C2

Open Journal of Epidemiology, 2018, 8, 226-241 Abstract Introduction: Road traffic accidents (RTAs) are a major public health issue in developing countries, where roads tend to be built haphazardly and accidents take a heavy toll on victims—including leaving them disabled. This study seeks ... more

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Mental Health in Haiti: Beyond Disaster Relief

Olivia Tiberi The Journal of Global Health (2016) C1

Haiti, one of the poorest countries in the world, was devastated by an earthquake in 2010. The disaster uncovered the realities of a non-existent mental health care system with only ten psychiatrists nationwide. Attempts were made to assess the increased prevalence of mental illness, likely due to t... more

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The multidimensional comprehension of Chagas disease

Sanmatino, M.; Forsyth, C.; Avaria, A. et al. (2022) C2

Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e200460, 2022 Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness... more

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Every child alive: The urgent need to end newborn deaths

UNICEF (2018)

Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.... more

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Watch List 2019

International Crisis Group ICG (2021) C1

Crisis Group’s Watch List identifies ten countries or regions at risk of deadly conflict or escalation thereof in 2021. In these places, early action, driven or supported by the EU and its member states, could enhance prospects for peace and stability. Crisis Group’s early-warning Watch List id... more

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Birth registration for every child by 2030 - Are we on track?

UNICEF (2020) C1

Society first acknowledges a child’s existence and identity through birth registration. The right to be recognized as a person before the law is a critical step in ensuring lifelong protection and is a prerequisite for exercising all other rights. A birth certificate is proof of that legal ide... more

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Agenda for the Americas on Health, Environment, and Climate Change 2021–2030

Pan American Health Organization (2021) C_WHO

This publication presents the Agenda for the Americas on Health, Environment, and Climate Change 2021–2030 (the Agenda). The Agenda is a call to action to the health sector to lead the charge to address environmental determinants of health in the Americas. The Pan American Health Organization (PAH...O) will work with Member States to achieve its goal and objective to ensure healthy lives and promote well-being for all at all ages using a sustainable and equitable approach that places a priority on reducing health inequity. The Agenda has been developed under the umbrella of the WHO Global Strategy on Health, Environment, and Climate Change, and builds upon the commitments set forth in the Sustainable Health Agenda for the Americas 2018–2030 and the PAHO Strategic Plan 2020–2025. The Agenda was developed in consultation with the Technical Advisory Group and through a consensus-driven decision-making process with Member States during the 2019–2020 period. Looking toward the achievement of Sustainable Development Goal 3, the Agenda focuses on: improving the performance of environmental public health programs and institutions; fostering environmentally resilient and sustainable health systems; and promoting environmentally healthy and resilient cities and communities. Its implementation will be context-specific, based on the needs and realities of the countries. It will benefit countries and territories by promoting good governance practices, strengthening the leadership and coordination roles of the health sector, fostering cross-sectoral action, focusing on primary prevention, and enhancing evidence and communication. It will facilitate access to human, technical, and financial resources necessary to address environmental determinants of health and ensure that the Region is fully engaged in global health, environment, and climate change processes and agreements. The objective of the Agenda is to strengthen the capacity of health actors in the health and non-health sectors to address and adapt to environmental determinants of health (EDHs), prioritizing populations living in conditions of vulnerability, in order to meet Outcome 18 of the PAHO Strategic Plan 2020–2025 directly and several other outcomes of the Plan indirectly. To address and adapt to the challenges of EDHs in the Region, an integrated and evidence-informed approach within the health sector and across sectors will be needed, one enabled, and supported by good governance practices, adequate management mechanisms, high-level political will, and adequate human, technical, technological, and financial resources. more

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Clinical management and infection prevention and control for monkeypox
recommended

World Health Organization WHO (2022) C_WHO

Interim rapid response guidance, 10 June 2022. It includes considerations for certain populations such as patients with mild disease with considerations for community care, patients with moderate to severe disease, sexually active persons, pregnant or breastfeeding women, children and young persons... more

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Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors
recommended

World Health Organisation (WHO) (2023) C_WHO

The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys... more

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WHO operational handbook on tuberculosis: module 4: treatment: tuberculosis care and support
recommended

World Health Organization WHO (2022) C_WHO

The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, ... more

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Forced displacement from and within Ukraine

European Union; International Organization for Migration; Organisation for Economic Co-operation and Development (2022) C2

Joint EUAA, IOM and OECD report provides new insights on displacement from and within Ukraine The European Union Agency for Asylum (EUAA), the International Organization for Migration (IOM) and the Organisation for Economic Co-operation and Development (OECD) have published a Joint Report on profil... more

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Community Management of Acute Malnutrition CMAM Guidelines

Republic of South Sudan (2017) C1

Maternal and child malnutrition is a significant public health problem in South Sudan. Among children aged 6-59 months, 31% are stunted, 28% are underweight, and nearly 23% are acutely malnourished of which 13% are estimated to suffer from moderate acute malnutrition and 10% from severe acute malnut... more

A guide to implementing the One Health Joint Plan of Action at national level recommended

Clinical management and infection prevention and control for monkeypox recommended

Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors recommended

WHO operational handbook on tuberculosis: module 4: treatment: tuberculosis care and support recommended

A guide to implementing the One Health Joint Plan of Action at national level
recommended

Clinical management and infection prevention and control for monkeypox
recommended

Access to NCD medicines: emergent issues during the COVID-19 pandemic and key structural factors
recommended

WHO operational handbook on tuberculosis: module 4: treatment: tuberculosis care and support
recommended