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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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The Manifesto to Secure a Healthy Planet for All – A Call for Emergency Action | InterAction Council

International Action Council (2019) C2

The Manifesto was launched at a High Level Event in London on the 31st July 2019, where Emergency response mechanisms to address the Climate and Environmental Crisis are being explored. The Manifesto has been developed in response to the increasing international and United Nations evidence and under... more

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The roles, training and knowledge of community health workers about diabetes and hypertension in Khayelitsha, Cape Town

Tsollekile, L.P.; H. Schneider and T. Puoane Curationis (2018) CC

CONCLUSIONS: The roles performed by CHWs are broad, varied and essential for diabetes and hypertension management. However, basic knowledge about diabetes and hypertension remains poor while training is unstandardised and haphazard. These need to be improved if community-based NCD management is to b... more

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How effective are community health workers?

Henry Perry; Rose Zulliger John Hopkins Bloomberg University (2012)

An Overview of Current Evidence with Recommendations for Strengthening Community Health Worker Programs to Accelerate Progress in Achieving the Health-related Millennium Development Goals

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Operational Guidelines for Gender Equality and Social Inclusion Mainstreaming in the Health Sector

Government of Nepal Ministry of Health and Population ( MoHP) (2013)

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National sexual and reproductive health and rights (SRHR) policy

Government of Malawi, Ministry of Health (2009) C1

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Rapid Mental Health and Psychosocial Support Situational Assessment

International Medical Corps (2015) C1

Services, Identified needs and recommendations following the April and May 2015 Earthquakes in Nepal

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Global spending on health: rising to the pandemic’s challenges

World Health Organization WHO (2022) C_WHO

The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ... more

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Nature, biodiversity and health: an overview of interconnections

World Health Organization. Regional Office for Europe (2021) C_WHO

Urbanization, land use, global trade and industrialization have led to profound and negative impacts on nature, biodiversity and ecosystems across the world. The ongoing depletion of natural resources not only afects environmental conditions but also has an enormous impact on the well-being and secu... more

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Summary of Guidance for Public Health Strategies to Address High Levels of Community Transmission of SARS-CoV-2 and Related Deaths, December 2020

Honein MA, Christie A, Rose DA, et al. Centers for Disease Control and Prevention CDC (2020) C_CDC

MMWR Morb Mortal Wkly Rep. ePub: 4 December 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6949e2

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National Health in All Policies Strategic Framework 2017-2021

Ministry of Health, Zambia (2018) CC

The attainment of Zambia’s goal of being a prosperous and middle-income country by 2030 as stipulated in its Vision 2030 is dependent on among others, a healthy and productive population. Therefore, the Government of the Republic of Zambia (GRZ) has prioritized health as a key socio-economic inves... more

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Epilepsy: a public health imperative
recommended

World Health Organization WHO, International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) (2019) C_WHO

This is the first global report on epilepsy summarizing the available evidence on the burden of epilepsy and the public health response required at global, regional and national levels. The reports highlights major gaps in awareness, diagnosis, treatment, and health policies through a series of a... more

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Urban HEART : Urban Health Equity Assessment and Response Tool

World Health Organization WHO (2010) C_WHO

The Urban Health Equity Assessment and Response Tool (Urban HEART) is a user-friendly guide for policy- and decision-makers at national and local levels to: identify and analyse inequities in health between people living in various parts of cities, or belonging to different socioeconomic groups with... more

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Emergency health response plan for drought in Somalia: Early action to protect health and save lives April-December 2022

World Health Organisation (WHO) (2022) C_WHO

Nearly 260 000 people died in parts of Somalia between October 2010 and April 2012, including 133 000 children under five during the famine and food crisis in Somalia making it the worst famine in history. A study commissioned and funded by the Food and Agriculture Organization of the United Natio... more

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Clinical management of rape and intimate partner violence in emergencies: training curriculum for health workers, facilitator guide: web annex B: participant job aids

World Health Organization WHO (2025) C_WHO

The training you receive will give you the tools you need to feel confident about broaching the subject with your patients. Reviewing the materials the job aids, especially job aids 4a and 7a, can help refresh your knowledge in the months and years ahead. Remember, with practice over time, you will ... more

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EU compass for action on mental health and well being

Helen Killaspy, Peter McPherson, Chiara Samele, Rene Keet, JM Caldas de Almeida European Union (2018) CC

Providing community-based mental health services position paper

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Nurses and midwives: a vital resource for health

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

This European compendium was produced to provide operational examples of the new nursing and midwifery roles and new service delivery models currently being employed across the Region. The case studies directly relate to the priority areas in Health 2020 and exemplify the types of activities needed ... more

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WHO Profile on mental health in development (WHO proMIND): Sierra Leone

World Health Organization (WHO), Department of Mental Health and Substance Abuse (2012) C_WHO

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Demographic and Health Survey - Kyrgyz Republic

USAID; UNFPA; STAT.KG (2013) C2

National Statistical Committee of the Kyrgyz Republic Bishkek, Kyrgyz Republic Ministry of Health Bishkek, Kyrgyz Republic MEASURE DHS ICF International Calverton, Maryland, U.S.A.

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Competencies for critical care nurse specialist (Adult)

South African Nursing Council (2020) CC

Epilepsy: a public health imperative recommended

Epilepsy: a public health imperative
recommended