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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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Financing the Pandemic Cycle: Prevention, Preparedness, Response, and Recovery and Reconstruction

Fan V. Y., Kim S., Pineda D., et al. Center for Global Development (2024) CC

The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This chapter presents a comprehensive framework for pandemic financing that spans the entire pandemic cycle... more

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Political economy analysis for health financing: A ‘how to’ guide

World Health Organization (WHO) (2024) CC

This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within health financing, and... more

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WHO guidelines on meningitis diagnosis, treatment and care. Web Annex B. Qualitative and economic evidence reports
recommended

World Health Organization WHO (2025) C_WHO

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... more

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Comprehensive mental health action plan 2013–2020
recommended

World Health Organization WHO (2021) C_WHO

This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for Member States, the WHO Secretariat and international, regional and national partners to promote mental health and well-being for all, to prevent mental health conditions for thos... more

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Mauritius National Action Plan on Antimicrobial Resistance 2017-2021

Ministry of Health and Quality of Life Mauritius (2017) C2

Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-line antibiotics, other antibiotics must be used, which are both mo... more

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Working with Individuals, Families and Communities to Improve Maternal and Newborn Health. Module 3

World Health Organization WHO; PAHO Pan American Health Organization, Enfant du Monde (2017) C_WHO

A toolkit for Implementation. Module 3: Participatory community assessment in maternal and newborn health

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Emergency appeal - Ukraine & refugee receiving and hosting countries
recommended

World Health Organization WHO, Regional Office of Europe (2022) C_WHO

WHO issued an updated appeal (May 2022) detailing its resource needs for Ukraine and refugee-receiving and hosting countries for March-August for Ukraine and March-December 2022 for other countries. The needs are an estimated US$ 147.5 million: US$ 80 million for health response in Ukraine and ano... 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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Global mapping report on multisectoral actions to strengthen the prevention and control of noncommunicable diseases and mental health conditions: experiences from around the world

World Health Organisation (WHO) (2023) C_WHO

There is growing understanding and high-level endorsement of the importance of strong collaborative multisectoral approaches to address a broad range of social, economic and governance issues for the prevention and control of noncommunicable disease (NCDs) and mental health conditions. In 2019, Worl... more

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Increasing tuberculosis burden in Latin America: an alarming trend for global control efforts

O. T. Ranzani; Pescarini, J. M.; Martinez, L.; et. al. BMJ Global Health (2021) CC

The Region of the Americas comprises 46 countries and territories and Brazil and Peru are among the WHO high- TB burden countries. T o illustrate the recent increase in TB incidence in the region, we selected 12 countries from Latin America (Argentina, Brazil, Chile, Colombia, Ecuador, El Salvador... more

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Antibiotic resistance: using a cultural contexts of health approach to address a global health challenge

Ledingham, K. World Health Organization Europe (2020) C_WHO

This policy brief has been developed in response to the contemporary challenge of antibiotic resistance (‎ABR)‎. ABR poses a formidable threat to global health and sustainable development. It is now increasingly recognized that the systematic neglect of cultural factors is one of the biggest obs... more

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Global vector control response 2017–2030

World Health Organization (WHO) (2017) C_WHO

The Global vector control response 2017–2030 (GVCR) provides a new strategy to strengthen vector control worldwide through increased capacity, improved surveillance, better coordination and integrated action across sectors and diseases.
In May 2017, the World Health Assembly adopted resolutio... more

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Model Disability Survey

World Health Organization WHO; World Bank (2017) C_WHO

The Model Disability Survey (MDS) is a general population survey that provides detailed and nuanced information about how people with and without disabilities conduct their lives and the difficulties they encounter, regardless of any underlying health condition or impairment.

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WHO recommendations on antiplatelet agents for the prevention of pre-eclampsia

World Health Organization WHO (2021) C_WHO

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Ситуация в регионах. Анализ результатов неофициальных консультаций с людьми, живущими с неинфекционными заболеваниями и психическими расстройствами

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit... more

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Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the national and health care facility level
recommended

World Health Organization WHO (2020) C_WHO

This manual presents a compelling case for action on carbapenem-resistant organisms (CROs) and describes the linkages between the prevention and control of CROs and the Global Action Plan on Antimicrobial Resistance (AMR). It describes how the eight recommendations contained within the World Health ... more

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Essential Guide to Humanitarian Good Practice, 5th ed.
recommended

All in Diary (AID) (2016) C2

A practical tool for field based humanitarian workers. It provides up-to-date, clear and succint guidance on topics accross the humanitarian sector including references to current, relevant resources and practical tools.

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UNICEF Yemen Humanitarian Situation Report reporting period 1-30 November 2020

UN Children's Fund (2020) C_UNICEF

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Working with Individuals, Families and Communities to Improve Maternal and Newborn Health. Module 4

World Health Organization WHO; PAHO Pan American Health Organization, Enfant du Monde (2017) C_WHO

A Toolkit for Implementation. Module 4: Training guide for facilitators of the participatory community assessment in maternal and newborn health

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex B. Qualitative and economic evidence reports recommended

Comprehensive mental health action plan 2013–2020 recommended

Emergency appeal - Ukraine & refugee receiving and hosting countries recommended

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

Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the national and health care facility level recommended

Essential Guide to Humanitarian Good Practice, 5th ed. recommended