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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
...
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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2nd edition. This second edition builds on the experience of more than 10 years of SMC deployment, and reflects changes introduced in the WHO guidelines for malaria, 3 June 2022. The goal of this publication is to share these best practices to improve SMC implementation, coverage, and monitoring and
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evaluation. Examples of materials and tools as well as links to resources are included to support managers and health workers in their efforts to conduct successful SMC activities and prevent malaria among vulnerable children.
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Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that they prefer.
In this guideline, WHO recommends an offering long-acting injectable lenacapavir (LEN
...
) as an additional HIV prevention choice, as part of combination HIV prevention approaches. LEN, administered twice a year as PrEP, has been shown to be highly effective at reducing the risk of HIV acquisition. In this guideline, WHO also recommends using HIV rapid diagnostic tests (RDTs) for individuals initiating or continuing long-acting injectable PrEP, such as LEN and long acting injectable cabotegravir (CAB-LA). Flexible HIV testing approaches are essential for ensuring that testing does not become a barrier to accessing or continuing PrEP, including long-acting injectable options.
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Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis. Web Annex B
Noncommunicable diseases (NCDs) (e.g., cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases) and mental health conditions (e.g., Alzheimer’s disease and related dementias, depression, anxiety, autism spectrum disorders) are the world’s leading cause of preventable illness
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, disability, and death. This report examines the dangers posed by current and rising rates of noncommunicable diseases and mental health conditions (NMHs) in South America, beyond their health risks, by demonstrating their considerable negative impact on economic growth. An analytical model was developed that projects the macroeconomic effects of NMHs over the period 2020–2050 in ten South American countries: Argentina, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. The results showed that the macroeconomic impact of NMHs in South America indicates significant economic shortfalls resulting from NMHs. Overall, the total GDP loss due to NMHs in South America amounts to USD 7.3 trillion (2022 international USD) over the period 2020–2050
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The Guidelines for the Use of the APCA African Palliative Outcome Scale (POS) has been developed by the APCA, in collaboration with
stakeholders, to help appropriately trained health practitioners and researchers across the region to utilise the APCA African POS in their work place (Powell et
...
al, 2007; Warria et al, 2007). Not only do the guidelines provide a clear rationale for measuring palliative care outcomes, but they also outline practical information on how to use the tool to collect data and analyse its results. So why is there a need for these guidelines?
Palliative care as a concept and discipline is not well understood across Africa, and its development is still embryonic in many countries. While there are many obstacles that hinder palliative care development on the continent, a key challenge is the lack of accurate information about the palliative care being provided and its outcomes. The APCA African POS is a useful tool to help us measure these outcomes and, given that
measuring palliative care outcomes remains a relatively new concept, it is important to guide people on how to use the tool. Of course, these guidelines are not intended to address everything related to the measurement of palliative care outcomes; they contain only essential information for providers. More detailed information on the use of outcome tools, and in particular within the research setting, can be gained from contacting relevantly trained professionals.
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This report synthesizes the state of knowledge on the interlinkages between environmental degradation climate change conflict and mobility in the East and Horn of Africa, focusing on Burundi, Djibouti, Ethiopia, Kenya, Somalia, South Sudan, Tanzania, and Uganda.
This Climate terminology bank provides key definitions and facts related to climate and resilience for Uganda’s refugee response. Its goal is to build a common understanding among stakeholders and support the integration of climate-smart practices in humanitarian efforts.
PHSM are vital in reducing the risk and scale of infectious disease transmission and lowering hospitalization and deaths. Examples include contact tracing, quarantine and isolation, mask use, ventilation, school or workplace measures, mobility restrictions and travel requirements.
While these mea
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sures are essential, decision-making on PHSM becomes particularly complex during rapidly evolving health emergencies, with incomplete information and under significant public and political pressure, especially when the pathogen is novel or poorly understood. In such contexts, guidance needs to be agile and responsive, developed and adapted based on emerging evidence and shifting epidemiological patterns. Decision-makers are frequently confronted with difficult trade-offs, having to balance measures that are:
─ effective but socially disruptive;
─ cost-effective but logistically burdensome;
─ beneficial for public health but economically disruptive; or
─ practical but inequitable or unethical
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Strengthening global health security to protect the world against future epidemics and pandemics requires well-tested and decentralized capacities for the local detection and rapid containment of outbreaks of infectious disease. For such capacities to translate into effective response actions, ind
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ividuals and teams must be well connected and coordinated, despite differences in the size, geography, technical focus or constituency of their parent institution.
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Building true health security in a global age. Findings and recommendations of the Global Council. In landmark findings based on two years of research and convenings around the world, the new report shows that high levels of inequality are linked to outbreaks becoming pandemics and that inequality i
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s undermining national and global responses, making pandemics more disruptive, deadly, and longer in duration. The report also shows that pandemics increase inequality, fuelling a cycle that research shows is visible not just for COVID-19, but also for AIDS, Ebola, Influenza, Mpox and beyond.
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Operational requirements for implementing WHO recommendations in digital systems. 2nd edition.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed to facilitate the accurate reflection of WHO’s clinical, public health
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and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems.
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A toolkit for health facilities. This toolkit highlights successful differentiated-care approaches implemented in a number of settings and countries in sub-Saharan Africa. The toolkit will be further updated as more experience is gained with these and similar
approaches
A Training Curriculum
a comprehensive guide
for the HCPs who work in counselling and psychological care of children and adoles-
cents. The Handbook includes information on HIV clinical care; growth and development;
mental health; child protection; counselling and communication; disclosure; loss, grief,
and bereavemen
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t; adherence; sexual and reproductive health; transition of care; support
systems; and monitoring and evaluation of psychosocial services. The material provided
in the Handbook aims to equip HCPs with important information that will help them to
maximise resiliency, minimise risk factors, and promote positive personal growth among
the children and adolescents they care for who are living with or affected by HIV.
more
This facilitator manual is aimed at trainers of a three-day
‘Integrating VAC prevention and response into HIV settings’
course. It is for use by all facilitators who are delivering the
training.
The family-centered approach to reaching every child living with HIV. This report examines the structural barriers impeding equitable access to HIV testing, treatment initiation and long-term adherence – essential elements for sustaining health and well-being for children, adolescents and young wo
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men. Rooted in socio-cultural norms, gender disparities and systemic inequalities, these barriers obstruct progress by perpetuating stigma, limiting healthcare access and destabilizing treatment continuity, stalling efforts toward the 10-10-106 and 95-95-957 targets.
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This document aims to provide Ministry of Health guidance on the implementation of PEP and PrEP to prevent HIV transmission and improve overall health outcomes. This comprehensive approach reflects the commitment of all involved in combating HIV and enhancing public health.
Populations affected by emergencies are continually at risk of outbreaks of epidemic-prone diseases and other public health hazards. This operational guidance aims to guide decision-making on when and how to implement and strengthen Early Warning Alert and Response (EWAR) in preparation for and resp
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onse to emergencies. Each module aims to provide updated operational guidance for EWAR practices, which may be more easily understood and applied during emergencies. Through its application, this operational guidance aims to contribute to:
- earlier detection of acute public health events
- earlier and more effective response
- reduced impact of emergencies on health
- increased trust of the population in the (public) health system
- fulfilling our collective commitments to the International Health Regulations (IHR,
2005).
This guidance was developed jointly by 69 experts from more than 20 organizations from global level to country level.
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