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Investment Case - Eighth Replenishment 2025 - Executive Summary

The Global Fund (2025) CC

To deliver on the Global Fund Strategy milestones for 2028 and ensure we keep the SDG 3 target within reach, we need to raise US$18 billion to fund the Global Fund’s next three-year grant cycle.

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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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Malaria and Climate

The Global Fund (2024) CC

Reprogramming examples for GC7. This document supports the introduction of climate change-related interventions into programs to reduce transmission of malaria and protect vulnerable populations.

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Finding the Balance: Public health and social measures in Ghana

Partnership for Evidence-Based Response to COVID-19 (PERC) (2021) CC

October 2021

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Finding the Balance: Public health and social measures in Kenya

Partnership for Evidence-Based Response to COVID-19 (PERC) (2021) CC

October 2021

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Finding the Balance: Public health and social measures in Liberia

Partnership for Evidence-Based Response to COVID-19 (PERC) (2021) CC

October 2021

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Zika virus disease – focus on the global response: Emergency appeal operations update n° 2 (MDR42003)

International Federation of Red Cross and Red Crescent Societies (2016) CC

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Marburg virus disease (MVD)

Internation Federation of Red Cross (2022) CC2

Hey Facts about the disease

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UNHCR Yemen | 2022 Strategy and Action Plan

UN High Commissioner for Refugees UNHCR (2022) C1

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Human Rights monitoring in residential institutions for mentally disabled and psychiatric hospitals

Human Rights Monitoring Institute, Global Initiative on Psychiatry, Lithuanian Welfare Society for Persons with Mental Disability „Viltis“, Vilnius Center for Psychosocial Rehabilitation (2005) C1

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Development and pilot evaluation of a home-based palliative care training and support package for young children in southern Africa

S. N. Naicker; A. Stein; L. Richter; et al. BMC Palliative Care (2016) CC

Naicker et al. BMC Palliative Care (2016) 15:41 DOI 10.1186/s12904-016-0114-7

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Global Action Plan on HIV Drug Resistance: Response to comments & modifications

World Health Organization (2016) C_WHO

12-13 December 2016 Global Action Plan on HIV Drug Resistance - Webinars 12-13 December 2016

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Paediatric Oncology Nursing Care in low- and middle-income countries: a need for baseline standards

Day S., Challinor J., Hollis R., et al. (2015) CC

This article looks at the Baseline Standards developed by the International Society for Paediatric Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The Baseline Standards lay the foundation for effective care and address barriers such as inadequate staffin... more

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Myanmar Humanitarian situation report No.2 2020

UNICEF (2020) C1

In response to COVID-19, UNICEF continues to support the Ministry of Health and Sports’ Health Literacy Promotion Unit to translate and disseminate messages including in ethnic languages for the border areas on good hygiene and handwashing. Social media boosting and message dissemination reach app... more

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Finding the Balance: Public health and social measures in Uganda

Partnership for Evidence-Based Response to COVID-19 (PERC) (2021) CC

October 2021

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The Balanced Counseling Strategy Plus: A Toolkit for Family Planning Service Providers Working in High STI/HIV Prevalence Settings. Counseling Cards, 3rd ed.

Population Council (2015) C1

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Management of type 2 diabetes in adults

Department of Health: Republic of South Africa (2014) CC2

Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-risk individu... more

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World Humanitarian Data and Trends 2018

OCHA Health Affairs (2018) C2

World Humanitarian Data and Trends presents global- and country-level data-and-trend analysis about humanitarian crises and assistance. Its purpose is to consolidate this information and present it in an accessible way, providing policymakers, researchers and humanitarian practitioners with an evid... more

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Priority Countries Consolidated Ebola Virus Disease Preparedness Checklist and Dashbord

World Health Organization (2015)

The dashboard is based on assessments made by the International Preparedness Strengthening missions to 14 priority countries against each of the activities outlined in the WHO EVD Checklist at the time of each mission. Updates indicating progress against each of the indicators will be added on an o... more

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Cameroon: Monitoring The Human Rights of Persons with Disabilities

DISABILITY RIGHTS PR OMOTION INTERNATIONAL (2009) C1