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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 Evolution of the ODA Accounting Rules

Casadevall-Bellés S., Calleja R. Center for Global Development (2024) CC

Frequent efforts to revise the official development assistance (ODA) accounting rules have raised important questions about the integrity and relevance of what currently “counts” as ODA spending. In this note, we outline a brief history of the evolution of the ODA accounting rules to date, highl... more

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Madagascar: Malaria Country Profile

World Health Organization (WHO) (2015) C_WHO

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WHO guidelines on meningitis diagnosis, treatment and care. Web Annex A. Quantitative 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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Factors associated with the unsuccessful TB treatment outcomes in the northern regions of Namibia: a mixed methods study

Amkongo, M.; Mitonga, H. K.; Alfeus, A.; et al. (2023) CC2

BMC Infectious Diseases volume 23, Article number: 342 (2023). Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB bur... more

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Pocket Manual for the Diagnosis and Treatment of Malaria

Olumese P., Al Zedjali M.S., Al-Mukhaini S. Ministry of Health, Sultanate of Oman - Department of Malaria Eradication (2025) C2

The "Pocket Manual for the Diagnosis and Treatment of Malaria", published by the Ministry of Health of the Sultanate of Oman, provides practical guidance for healthcare professionals on how to identify, manage, and treat malaria cases. It emphasizes parasitological confirmation before treatment, out... more

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Traitement d’urgence du paludisme sévère chez l’enfant par application intranasale d’artésunate

Yobouet I.K. Université Claude Bernard Lyon (2022) C2

La thèse de Yobouet Inès Kouakou, soutenue à l’Université Claude Bernard Lyon 1, porte sur le traitement d’urgence du paludisme sévère chez l’enfant à l’aide d’une administration intranasale d’artésunate. L’objectif principal de ce travail est d’explorer, in vitro, la voie na... more

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Technical Brief Workforce Development
recommended

I-Tech International Training and Education Center for Health (2021) CC2

The World Health Organization (WHO) projects a global shortfall of 18 million health workers by 2030, mostly in low- and lower-middle-income countries. Contributing to the global deficit are chronic under-investment in education and training of health workers; workforce migration; an aging health wo... more

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Health Namibia Budget Brief

UNICEF (2022) C_UNICEF

Strengthening health financing to accelerate progress towards universal health coverage. Total Government Health Expenditure exceeds the commitment by African Union member states to commit at least 15% of their budgets to the health sector. With a sector allocation of 16.6% of total budget in 2022/... more

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Country Disease Outlook - Namibia

World Health Organization WHO, Regional Office of Africa (2023) C_WHO

Infographics and data

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National Tuberculosis And Leprosy Programme: Annual Report 2021

Ministry of Health Zambia (2021) CC

Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success. The NTLP is ... more

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Folgen der US-Kürzungen und der Auflösung von USAID: Eine Analyse und Handlungsempfehlungen für Akteure in der Entwicklungszusammenarbeit - Kurzfassung

Liebau L., Rüppel T., Schottmayer K. medmissio (2025) CC

Diese zweiseitige Kurzfassung bietet eine Problemanalyse der US-Kürzungen im Bereich globale Gesundheit und leitet daraus konkrete Handlungsempfehlungen für medizinische Akteure ab. Im Fokus steht die Analyse der direkten Auswirkungen auf die gesundheitsspezifische Entwicklungszusammenarbeit.

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Consequences of the US budget cuts and the dissolution of USAID: An analysis and recommendations for action for stakeholders in international development cooperation

Liebau L., Rüppel T., Schottmayer K. medmissio (2025) CC

This publication provides a problem analysis of the U.S. cuts in global health and derives concrete recommendations for action for medical actors. The focus is on analyzing the direct effects on health-specific development cooperation.

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Drugs for Intermittent Preventive Treatment of Malaria in Pregnancy: Current Knowledge and Way Forward

Figueroa-Romero, A.; C. Pons-Duran, and R. Gonzalez (2022) CC

Trop. Med. Infect. Dis. 2022, 7, 152. https://doi.org/10.3390/tropicalmed7080152

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Intermittent screening and treatment in pregnancy and the safety of ACTs in the first trimester

World Health Organization WHO (2015) C_WHO

Recommendations

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Seasonal Malaria Chemoprevention SMC Training Manual

Medicines for Malaria Venture MMV (2013) CC

This comprehensive reference document is intended for those responsible for training in SMC (Seasonal Malaria Chemoprevention). It assumes that SMC will be implemented using the Community Health Worker strategy.

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Info pack for Key Malaria messages in Schools: Chase Malaria - Embrace Malaria Prevention and control Interventions

Ministry of Health of Uganda UNICEF; World Health Organization WHO (2018) CC

This document sets out key messages to support malaria prevention and control efforts, for teachers, pupils and the wider community. It is designed to facilitate health education in schools by encouraging teachers to guide pupils through the core messages about malaria and emphasise the most importa... more

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Lil Mosquito, Big Problem Campaign: Phase II

Breakthrough ACTION Guyana; Ministry of Health of Guyana (2025) C1

In 2023, Breakthrough ACTION and Guyana’s Ministry of Health refined the 'Lil Mosquito, Big Problem' malaria campaign using human-centred design. Phase II introduced peer-led videos (Miners' Buzz), community champions, incentives for volunteer testers and a transport network to improve supply deli... more

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Malaria: 10 messages for children to learn and share

Children for Health (2018) C1

This malaria education poster by Children for Health uses clear, child-friendly language to raise awareness of malaria and promote its prevention. Using simple language and engaging visuals, it informs children and caregivers about key facts, symptoms and protective behaviours, such as using insecti... more

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Malaria Posters

The National Institute for Communicable Diseases NICD of South Africa (2025) C1

This set of malaria awareness posters, created by the National Institute for Communicable Diseases (NICD), provides the general public in South Africa with clear visual messages about malaria prevention, symptoms and the importance of early treatment. Designed for community outreach, the posters enc... more

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex A. Quantitative evidence reports recommended

Technical Brief Workforce Development recommended

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex A. Quantitative evidence reports
recommended

Technical Brief Workforce Development
recommended