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From Panic and Neglect to Investing in Health Security

The World Bank (2017) CC

Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the ... more

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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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Antimicrobial Resistance Curriculum Assessment Tool for Medical Education

World Health Organisation (WHO) (2024) C_WHO

The Global Action Plan on Antimicrobial Resistance (AMR) calls for making AMR a core component of professional education and training. In 2018, the World Health Organization (WHO) published Competency framework for health workers’ education and training on AMR to ensure that academic institutions ... more

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Implementation of the Learning for Performance Approach in Rwanda: Final Report

Combary, P., Sinzahera, J., Mukakarara, V., et al. (2009) C2

The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job tra... more

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Health workforce development and retention in Guinea: a policy analysis post-Ebola

van de Pas R., Kolie D., Delamou A., Van Damme W. BMC - Biomed Central (2019) CC

The state of the Guinean health workforce is one of the country’s bottlenecks in advancing health outcomes. The impact of the 2014–2015 Ebola virus disease outbreak and resulting international attention has provided a policy window to invest in the workforce and reform the health system. This re... more

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National guidance and district-level practices in the supervision of community health workers in South Africa: a qualitative study

Assegaai, T. and H. Schneider Human Resources for Health (2019) C1

Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance... more

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Situation Analysis of Children with Disabilities in Myanmar

UNICEF Myanmar (2016)

The study analyses the current situation of children with disabilities in relation to realizing their rights and accessing basic services, as well as their life experiences in their communities. It also focuses on identifying the barriers created by society that prevent children with disabilities fr... more

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UNICEF’s HIV Programming in the Context of COVID-19: Building back better for children, adolescents and women

Unicef (2021) CC2

The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and ... more

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Taking Stock: Sexual and Reproductive Health and Rights in Climate Commitments - an East and Southern Africa Review

UNFPA (2024) CC

Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres... more

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Strengthening mental health responses to COVID-19 in the Americas: A health policy analysis and recommendations

A. Tausch; Oliveira e Souza, R.; Martinez Viciana, C.; et al. Pan American Health Organization (2021) CC

The COVID-19 pandemic is having a major impact on the mental health of populations in the Americas. Studies show high rates of depression and anxiety, among other psychological symptoms, particularly among women, young people, those with pre-existing mental health conditions, health workers, and p... more

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The state of food security and nutrition in the world 2023

World Health Organisation (WHO) (2023) C_WHO

This report is the annual global monitoring report documenting progress towards Sustainable Development Goal (SDG) 2 targets 2.1 and 2.2. This year’s report explores the links between urbanization and changing food systems and how these changes are impacting the availability, affordability and des... more

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Innovative and impactful strategies to accelerate the HIV response among sex workers in Myanmar

UNAIDS (2017) C1

Policy Brief, Updated in March 2017
Key messages
• Meaningful involvement of sex workers in the HIV response through peer-based education and outreach and consultation in policy making and programme planning is vital to reduce their vulnerability to HIV and other sexually transmitted inf... more

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Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach

Standleya C. J., Carlinb E. P., Sorrella E. M. et al. Elsevier (2019) CC

To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp... more

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Equity of resource flows for reproductive, maternal, newborn, and child health: are those most in need being left behind?

Martinez-Alvarez, M.; F. Federspiel; N. Singh et al. British Medical Journal (BMJ) (2020) CC

Since 2002 the distribution of external funding to reproductive, maternal, newborn, and child health (RMNCH) has become more equitable and better targeted at the poorest countries and those experiencing the highest mortality. The aid envelope is not large enough or well enough concentrated to close ... more

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An analysis of the services provided by community health workers within an urban district in South Africa: a key contribution towards universal access to care

Thomas, L.S., E. Buch and Y. Pillay Human Resources for Health (2021) C1

Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage? As the proactive arm of the health services, community health workers teams provide ho... more

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Key considerations for the use of law to prevent noncommunicable diseases in the WHO European Region

World Health OrganizationEurope World Health OrganizationEurope (2017) C_WHO

Report of an intensive legal training and capacity-building workshop on law and noncommunicable diseases (Moscow, 30 May–3 June 2016) The report summarizes important issues, themes and topics discussed during the meeting in Moscow, ranging from the design and implementation of legislation, reconc... more

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2 million African community health workers - Harnessing the demographic dividend, ending AIDS and ensuring sustainable health for all in Africa

UNAIDS (2017) CC

This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ... more

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Community health workers at the dawn of a new era: 6. Recruitment, training, and continuing education

Meike J. Schleif, Iain Aitken , et al. Health Research Policy and Systems (2021) CC

This is the sixth of our 11-paper supplement entitled “Community Health Workers at the Dawn of New Era”. Expectations of community health workers (CHWs) have expanded in recent years to encompass a wider array of services to numerous subpopulations, engage communities to collaborate with and to... more

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Review of Community-Based Management of Acute Malnutrition Implementation in Burkina Faso

Deconinck H., S. Diene, P. Bahwere Food and Nutrition Technical Assistance II Project (FANTA-2) (2010) C2

The United States Agency for International Development (USAID) Bureau for Democracy, Conflict, and Humanitarian Assistance Office of U.S. Foreign Disaster Assistance (DCHA/OFDA) requested Food and Nutrition Technical Assistance II Project (FANTA-2) assistance to review Community-Based Management of ... more

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OCHA Policy Brief on Gendered Drivers, Risks and Impacts of Food Insecurity in the Sahel and the Horn of Africa

UN Office for the Coordination of Humanitarian Affairs (2023) CC

It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t...he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency. Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls. An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is: A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes). An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa. The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions. Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward. more