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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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High-Performance Health Financing for Universal Health Coverage

The World Bank The World Bank (2019) CC

The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20... more

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Tracking Universal Health Coverage in the WHO African Region, 2022

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

n 2015, Member States of the United Nations adopted the 2030 Agenda for Sustainable Development and its accompanying Sustainable Development Goals (SDGs), with the third goal of the agenda focusing on health – good health and well-being. This has the attainment of universal health coverage (UHC) a... more

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Strengthening Rwanda’s health workforce: Strategies to improve retention in the health sector

World Health Organization WHO (2025) C_WHO

Rwanda’s national health sector is focused on the equitable delivery of high-quality health services. The Government of Rwanda (GoR) recognizes that developing human resources in the health sector is a critical factor to the well-being of the population. Development of the health workforce has bee... more

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Tracking aid for global health goals: a systematic comparison of four approaches applied to reproductive, maternal, newborn, and child health

Pitt C.; Grollman C.; Martinez-Alvarez M. et al The Lancet (2018) CC

Four initiatives have estimated the value of aid for reproductive, maternal, newborn, and child health (RMNCH): Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and the Organisation for Economic Co-operation and Development (OECD) policy marker. We... more

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Positive Mental Health, fighting Stigma and promoting resiliency for children and adolescents

Matthew Hodes and Susan Gau IACAPAP (2016) C2

The International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) aims to promote the mental health and development of children and adolescents worldwide. It seeks to achieve this by contributing to the training and professional development of the child and adole... more

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Noncommunicable diseases and mental health in small island developing states

World Health Organisation (WHO) (2023) C_WHO

Small island developing states (SIDS) are a set of islands and coastal states that share similar sustainable development challenges, as a result of their size, geography and vulnerability to climate change. Thirty-nine WHO member states in four regions – the African Region, the Region of the Ameri... more

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Strengthening the collection, analysis and use of health workforce data and information: a handbook

World Health Organisation (WHO) (2023) C_WHO

Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d... more

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Handbook for public health capacity-building at ground crossings and cross-border collaboration

World Health Organization WHO (2020) C1

This handbook follows a comprehensive approach to health system strengthening at borders in order to support IHR national focal points and other national agencies in developing and implementing evidence-based action plans for IHR capacity development at ground crossings. The approach includes the mo... more

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Covid-19 Notes on Migrants - An ICMHD Health Policy Contribution

ICMHD (2020) CC

Migration continues to be an essential ingredient of socioeconomic development everywhere. Whether it is a case of people moving from the countryside to cities to find work, or people crossing seas and borders to meet host country demands for new labour, migrants are an integral part of the modern ... more

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Financing Global Health 2017: Funding Universal Health Coverage and the Unfinished HIV/AIDS Agenda

Institute for Health Metrics and Evaluation (IHME) Institute for Health Metrics and Evaluation (IHME) (2018) C2

In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development assistance for health (DAH) has grown at an annualized rate of 1.0%. While global development ass... more

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Quality Criteria for Health National Adaptation Plans

World Health Organization WHO (2021) C_WHO

The Quality Criteria for Health National Adaptation Plans (HNAPs) presents examples of good practice in HNAP development to assist countries in developing a comprehensive, feasible and implementable plan. The criteria are also intended to guide countries in setting the foundation for a long-term ite... more

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Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended

Ministry of Health, Rwanda (2018) C2

Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the... more

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Financing Maternal and Child Health—What Are the Limitations in Estimating Donor Flows and Resource Needs?

Schäferhoff, M.; Schrade, C.; Yamey G. PLOS Med (2010) CC

Marco Schäferhoff and colleagues critique funding estimates for the maternal and child health Millennium Development Goals, and make recommendations for improving the tracking of financing flows and estimating the costs of scaling up interventions for mothers and children.

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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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Addressing Inequalities in Global Health: UNU IIGH Strategic Plan 2024–2028

United Nations University UNU (2024) C1

The 2019-2023 Strategy for UNU-IIGH, developed in 2018, built on UNU-IIGH’s strategic advantage and position vis-à-vis the UN and global health ecosystem. The Strategy set a goal to advance evidencebased policy on key issues related to sustainable development and health and shifted the Instit... more

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Germany: health system review. Health Systems in Transition

Busse R, Blümel M World Health Organization (WHO) (2014)

The Health Systems in Transition (HiT) series consists of country-based reviews that provide a detailed description of a health system and of reform and policy initiatives in progress or under development in a specific country.

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Promoting Health - Guide to national implementationof the Shanghai Declaration

World Health Organization WHO (2018) C_WHO

Guide to national implementation of the Shanghai Declaration describes policy orientations and approaches that can unlock the transformative potential of health promotion for sustainable development. This guide was developed to support country level implementation of the commitments and recommendati... more

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Women’s Mental Health: Promoting a Gendered Approach to Policy and Service Provision

The Women´s Health Council The Women´s Health Council (2007) CC

The mission of the Women’s Health Council is to inform and influence the development of health policy to ensure the maximum health and social gain for women in Ireland. Its membership is representative of a wide range of expertise and interest in women’s health. The Women’s Health Council ... more

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Health statistics in the Western Pacific Region 2023: monitoring health for the SDGs

World Health Organisation (WHO) (2024) CC

Health Statistics in the Western Pacific Region 2023: Monitoring health for the SDGs is the third biennial report providing an overview of the progress of the World Health Organization (‎WHO)‎ Western Pacific Region towards the health-related Sustainable Development Goal (‎SDG)‎ targets. Thi... more

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024) recommended

Rwanda Fourth Health Sector Strategic Plan (July 2018-June 2024)
recommended