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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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11 years of tracking aid to reproductive, maternal, newborn, and child health: estimates and analysis for 2003–13 from the Countdown to 2015

Grollman, C.; L. Arregoces, M. Martínez-Álvarez et al. Lancet Glob Health (2017) C1

Background:Tracking aid fl ows helps to hold donors accountable and to compare the allocation of resources in relation to health need. With the use of data reported by donors in 2015, we provided estimates of offi cial development assistance and grants from the Bill & Melinda Gates Foundation (coll... more

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REFUGEEUM - Website in Serbian

Dr. Mösko M., Prof. Dr. Y. Nestoriuc (2016) CC

Ova strana nudi informacije i podršku ljudima koji su izegli iz svojih zemalja i čija je dobrobit ugrožena. Telesne i duševne nelagodnosti mogu da uplaše. Pre svega, ako čovek sam ne zna šta one znače, odakle dolaze i šta se može protiv njih preduzeti. Tada može biti od pomoći pročitat... more

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DNDi Plano Estratégico 2021–2028 Resumo Executivo

DNDi - Drugs for neglected diseases initiative (2023) C2

A Iniciativa Medicamentos para Doenças Negligenciadas (DNDi) é uma organização internacional sem fins lucrativos que disponibiliza medicamentos seguros, eficazes e acessíveis para doenças negligenciadas, desde o laboratório até sua chegada às mãos das populações mais vulneráveis do mund... more

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Working Paper 46 - Aid, China, and Growth: Evidence from a New Global Development Finance Dataset

Dreher, A.; A. Fuchs; B. Parks et al. AidData at William & Mary (2017) CC

This paper introduces a new dataset of official financing—including foreign aid and other forms of concessional and non-concessional state financing—from China to 138 countries between 2000 and 2014. We use these data to investigate whether and to what extent Chinese aid affects economic growth ... more

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Abuja Declaration on HIV/AIDS, Tuberculosis, and Other Infectious Diseases

African Union (AU) African Union (AU) (2001) CC

The Abuja declaration identifies that the prevention and control of HIV/AIDS, tuberculosis and related infectious diseases must come with additional financial resources. Therefore, African governments agreed on setting the target of allocating at least 15 per cent of each country’s annual budget ... more

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Tracking Development Assistance for Health: A Comparative Study of the 29 Development Assistance Committee Countries, 2011–2019

Nomura S. et al. (2021) CC

Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD) ... more

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Aid Transparency Index 2022

Publish What You Fund Publish What You Fund (2022) CC

The 2022 Aid Transparency Index reveals that more aid organisations than ever before are publishing good quality information and score “very good” or “good” in the global ranking. However, the whole data set could be under threat as the Aid Transparency Index, the only tool driving tangible ... more

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How much donor financing for health is channelled to global versus country-specific aid functions?

Schäferhoff M.; Fewer S.; Kraus J. et al. The Lancet (2015) CC

The slow global response to the Ebola crisis in west Africa suggests that important gaps exist in donor financing for key global functions, such as support for health research and development for diseases of poverty and strengthening of outbreak preparedness. In this Health Policy, we use the Intern... more

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Shifting official development assistance during COVID-19: earmarking, donor concentration and loans

Woskie L., Wenham C. BMJ Global Health (2024) CC

In contrast to bilateral aid, aid disbursed from multilateral institutions increased significantly at the onset of the COVID-19 pandemic. Yet, at a time when a coherent and effective multilateral response is needed most, the COVID-19 pandemic revealed a shifting landscape of donor agencies that... more

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COVID-19: Orientação operacional para a manutenção de serviços essenciais de saúde

OPAS (2020) C_WHO

Os sistemas de saúde estão enfrentando um rápido aumento na demanda gerada pelo surto da COVID-19. Quando os sistemas de saúde ficam sobrecarregados, há um aumento drástico na mortalidade direta causada por um surto e também na mortalidade indireta por doenças imunopreveníveis e por aquelas... more

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Development assistance for health: past trends, associations, and the future of international financial flows for health

Dieleman, J.L.; M. T. Schneider; A. Haakenstad et al. Lancet (2016) C1

Background: Disbursements of development assistance for health (DAH) have risen substantially during the past several decades. More recently, the international community's attention has turned to other international challenges, introducing uncertainty about the future of disbursements for DAH. Meth... more

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CEPI - Funding and Expenditure

Coalition for Epidemic Preparedness Innovations (CEPI) Coalition for Epidemic Preparedness Innovations (CEPI) (2018) CC

As of December 2018, CEPI has secured more than USD $747million towards its USD $1billion funding target, with financial support provided by the Bill & Melinda Gates Foundation, the Wellcome Trust, the European Commission, and the governments of Australia, Belgium, Canada, Germany, Japan, Norway, an... more

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Development assistance for human resources for health, 1990–2020

Micah, A.E.; J. Solorio; H. Stutzman et al. Human Resources for Health (2022) C1

Background: Investing in the health workforce is key to achieving the health-related Sustainable Development Goals. However, achieving these Goals requires addressing a projected global shortage of 18 million health workers (mostly in low- and middle-income countries). Within that context, in 2016, ... more

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Mobilizing the Resources Required for Universal Health Coverage: Outline of a Global Compact towards Closing the Financing Gap by 2020

Joachim Rüppel medmissio and Action against AIDS Germany (2016) CC

Securing a minimum of financial resources permitting to bring the full range of critical health services to all people constitutes a fundamental human right and an indispensable condition for human dignity. The model outlined here demonstrates that it is within our reach to close the financing gap e... more

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Development assistance for health: trends and prospects

Murray, C. JL; B. Anderson; R. Burstein et al. Lancet (2011) C1

The global economic crisis that began to unfold in 2008 has raised serious concerns about the ability of developing countries to meet targets for improvements in population health outcomes, and about the ability of developed countries to meet their commitments to fund health programmes in developing... more

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Donor funding for family planning: levels and trends between 2003 and 2013

Grollman, C.; F. L. Cavallaro; D. Duclos et al. Health Policy and Planning (2018) C1

The International Conference on Population and Development in 1994 set targets for donor funding to support family planning programmes, and recent initiatives such as FP2020 have renewed focus on the need for adequate funding to rights-based family planning. Disbursements supporting family planning ... more

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Donor Funding for Newborn Survival: An Analysis of Donor-Reported Data, 2002–2010

Pitt1, C.; J. E. Lawn; M. Ranganathan et al. PLoS Med (2012) CC

Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a... more

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Development assistance for health and the Middle East and North Africa

Zhao, Y.; A. E. Micah; S. Gloyd et al. Globalization and Health (2020) C1

Background: Donor countries in the Middle East and North Africa (MENA) including Saudi Arabia, Kuwait and United Arab Emirates (UAE) have been among the largest donors in the world. However, little is known about their contributions for health. In this study, we addressed this gap by estimating the ... more

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Financing Global Health 2015: Development assistance steady on the path to new Global Goals

Institute for Health Metrics and Evaluation (2016) CC

Financing Global Health 2015 is the seventh edition of IHME’s annual series on global health financing. This report captures trends in development assistance for health (DAH) and government health expenditure as source (GHE-S) in low- and middle-income countries. Annually updated GHE-S and DAH est... more