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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
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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
The most packed schedule of cyclical replenishments in global health multilateral institutions has the potential to also clash with competing interests fuelled by a packed election calendar. But health imperatives are not a winner gets all scenario. The article provides a perspective on what needs t
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o be done so as to reach out to all interests without compromising on the mission of tackling global health threats. It focuses on the 8th Grant Cycle of the Global Fund and offers suggestions on the way forward.
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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
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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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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
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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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Conditioned domestic financing policy, referring to the domestic financing of health projects, programs, and national responses conditioned by global health funding agencies and recipient country governments, is one mechanism to promote sustainability and country ownership. We aim to understand how
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the concept is defined and operationalized by agencies and how such policies relate to overall health spending patterns.
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
In 2019, the Task Force on Fiscal Policy for Health concluded that taxes on tobacco, alcohol, and sugar-sweetened beverages were a highly effective but greatly underused policy tool to reduce consumption, save lives, and raise domestic resources. The Task Force estimated that if all countries increa
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sed their excise taxes to raise prices by 50 percent, over 50 million premature deaths could be averted worldwide over the next 50 years while
raising over USD 20 trillion of additional revenue. Since the Task Force first convened, the world has faced a “polycrisis,” including a global pandemic, an economic recession, and the outbreak of wars in Europe and the Middle East. Against this backdrop, the world has also experienced prolonged health and fiscal crises. Health systems, weakened by the COVID-19 pandemic, lack sufficient financing to rebuild and respond to the surging noncommunicable diseases epidemic caused by uncontrolled risk factors such as tobacco, alcohol, and sugar consumption. Opportunities to raise domestic resources are limited and debt burdens have squeezed budgets. The period from 2019 to 2027 risks becoming a “lost decade” for health and social policies, with 110 countries facing little prospect of any
ability to raise government revenues beyond current levels. In this paper, we describe the current health and fiscal crises and review the contribution that health taxes could make in turning around this dire situation. We conclude that taxes on tobacco, alcohol, and
sugar-sweetened beverages are an ideal policy solution—good for the budget and good for health. These taxes are relatively quick to implement, and, unlike other taxes, do not put economic growth at risk—a vital benefit in the current era.
more
Questions concerning the relevance and reform of official development assistance (ODA), and how ODA and broader development finance could—or should—change to better reflect shifting demands are not new, with academics and policymakers suggesting a range of options for reform. In this background
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note, we briefly review the major reform proposals from 2009 onwards, highlighting the key issues underlying approaches to ODA reforms, and the main “types” of proposals typically put forward.
more
The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover
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nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
more
WHO guidelines on meningitis diagnosis, treatment and care. Web Annex C. Evidence-to-Decision frameworks
recommended
The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover
...
nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
more
This document sets out key messages to support malaria prevention and control efforts, for teachers, pupils and the wider community. It is designed to facilitate health education in schools by encouraging teachers to guide pupils through the core messages about malaria and emphasise the most importa
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nt points. Pupils are expected to actively engage by taking notes and applying what they learn. Ultimately, the goal is to equip children with the practical knowledge to influence behavioural change at both the individual and community levels.
more
Fragile Beginnings. The Fragile Beginnings series examines the growing body of research on the unique vulnerabilities of children: in utero and at birth, during infancy and childhood and throughout adolescence. Its purpose is to enable evidence-based advocacy and action on children’s environmental
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health
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
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a list of resources that countries can benefit from in planning their response.
more
A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it a
...
lso showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
more
A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it a
...
lso showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.
more
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
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to health care, universal health coverage, determinants of TB, TB-associated impairment and disability, social protection, as well as ethics, equity and human rights.
more
Diabetes is an increasingly prevalent yet under-recognised health crisis in Africa, driven by demographic and socioeconomic transitions. In 2021, 24 million adults in the region were living with diabetes, and this figure is expected to increase by 129% by 2045.
The National Strategic Plan on Malaria Prevention and Elimination Period 2021 – 2025 seeks to build on the previous national successes of the National Institute of Malariology, Parasitology, and Entomology (NIMPE) while addressing current challenges to reduce the overall burden of malaria in the S
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outhern and Central provinces and to initiate elimination activities in remaining focal areas of transmission throughout the country. The overall targets proposed to be reached by 2025 are:
Reduce malaria morbidity rate to below 0.015/1,000 population
Reduce malaria mortality rate to below 0.002/100,000 population
Eliminate malaria in 55 provinces
Ensure no malaria outbreaks
To address the urgent threat of drug resistance, Viet Nam has committed to accelerate efforts to eliminate locally-acquired P. falciparum by 2023.
more
The Gaza Strip is experiencing one of the most severe food security crises globally, with the entire population of approximately 2.1 million people now facing crisis-level food insecurity or worse (IPC Phase 3+). As of May 2025, more than one in five Gazans—about
470,000 people—are at risk of s
...
tarvation (IPC Phase 5: Catastrophe), while over half are classified in Emergency (IPC Phase 4). This marks a significant deterioration compared to just one month earlier and reflects the impact of a comprehensive blockade that has
restricted all humanitarian and commercial supplies since early March. Vital goods have been depleted, food prices have skyrocketed by over 3,000 percent in some areas, and coping mechanisms have all but collapsed, forcing many to scavenge for food or go without entirely. Acute malnutrition has reached serious levels and is projected to worsen, particularly in North Gaza, Gaza, and Rafah, where critical levels are expected between May and September 2025.
more