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2
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 o
...
n 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
Development assistance for health (DAH)
plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically
focused on infectious diseases and maternal
...
and child
health, there is a lack of comprehensive analysis of DAH
trends, strategic shifts and their impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
more
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 do
...
llars (USD) 12.7 billion, representing 108% of the 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.
more
The Council was established in late 2020 by Dr Tedros Adhanom
Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group
...
of 10 distinguished economists and area experts, the Council has focused on reimagining how to put Health for All at the heart of government decision-making and private sector collaboration at regional, national and international levels.
more
This article provides an in-depth analysis of the Global Fund's strategic initiatives in resource mobilization and recovery amid global economic fluctuations and geopolitical challenges. It highlights the Fund's successful conversion of pledges and innovative financing models that ensure sustainable
...
funding for combating HIV, tuberculosis, and malaria. The discussion extends to the Fund's rigorous recovery processes and advocacy efforts to bolster its visibility on international platforms. Additionally, it explores the impact of economic constraints on health funding and the potential of emerging markets and technologies. Performance metrics and health impact assessments underscore the Global Fund's critical role in advancing global health objectives. This analysis offers stakeholders valuable insights into the complexities of global health financing and the Global Fund's adaptive strategies in response.
more
This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in he
...
alth financing. The report points out the need to improve public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
more
This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (
...
SDGs). The findings reveal wide disparities in governments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also
require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs.
more
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 go
...
vernments, is one mechanism to promote sustainability and country ownership. We aim to understand how the concept is defined and operationalized by agencies and how such policies relate to overall health spending patterns.
more
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 pol
...
itical economy issues within
health financing, and overall system, reform design and implementation processes. This Guide is complementary to WHO’s Health Financing Progress Matrix assessment, as well as Health Financing Strategy development guidance. In this way, it promotes an embedded political
economy analysis approach that can be used in conjunction with other health financing assessments and guidance. The political economy framework can also be extended and easily adapted to broader health policy reforms.
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Promoting and protecting the mental health and psychosocial wellbeing of children, adolescents, and their caregivers remains undamental to achieving the Sustainable Development Goals (SDGs), with a direct contribution to SDG 3 (Good
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Health and Well- eing). In 2024, UNICEF accelerated the scale-up of integrated, multisectoral MHPSS programming. These efforts contributed to the strengthening of national and subnational child and adolescent mental health systems by supporting programming across the continuum of care, investing in workforce development, advancing data systems and evidence generation, and promoting institutional leadership and coordination mechanisms. UNICEF’s growing reach, particularly through health, education, and child protection systems, reflects a strategic commitment to embedding MHPSS in sustainable development frameworks and in responses that bridge humanitarian action and development programming.
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Towards the Peoples Health Assembly Book - 1
What are the common health problems of refugees and migrants arriving in the European Region?
The most frequent health problems of newly arrived refugees and migrants include accidental injuries, hypothermia, burns, gastrointestinal illnesses, cardiovascular events, pregnancy- and delivery-related complications, diabetes and hypertension. Fe
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male refugees and migrants frequently face specific challenges, particularly in maternal, newborn and child health, sexual and reproductive health, and violence. The exposure of refugees and migrants to the risks associated with population movements – psychosocial disorders, reproductive health problems, higher newborn mortality, drug abuse, nutrition disorders, alcoholism and exposure to violence – increase their vulnerability to noncommunicable diseases (NCDs)
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Towards the Peoples Health Assembly Book -1
This report aims to raise awareness about the role that the reform of public health laws can play in advancing the right to health and in creating the conditions for people to live healthy lives. By
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encouraging a better understanding of how public health law can be used to improve the health of the population, the report aims to encourage and assist governments to reform their public health laws in order to advance the right to health.
The report highlights important issues that may arise during the process of public health law reform. It provides guidance about issues and requirements to be addressed during the process of developing public health laws. It also includes case studies and examples of legislation from a variety of countries to illustrate effective law reform practices and some features of effective public health legislation. more
The report highlights important issues that may arise during the process of public health law reform. It provides guidance about issues and requirements to be addressed during the process of developing public health laws. It also includes case studies and examples of legislation from a variety of countries to illustrate effective law reform practices and some features of effective public health legislation. more
Blueprint for a Public Health and Safety Approach to Drug Policy
Tracy Pugh, Julie Netherland, Ruth Finkelstein
The New York Academy of Medicine, Drug Policy Alliance
(2013)
C2
"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re
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lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
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