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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 nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal ... more

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The cost of austerity: The toll of IMF conditionalities on access to health in Zambia

Make Way, Wemos (2024) CC

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 dollars (USD) 12.7 billion, representing 108% of the ... more

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WHO guidelines on meningitis diagnosis, treatment and care. Web Annex B. Qualitative and economic 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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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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The African Union´s challenges - Central Africa Republic

International Crisis Group International Crisis Group (2019)

4. Central African Republic Clashes throughout 2018 in the capital Bangui and a number of major towns illustrate the deadly threat posed by armed groups – a mix of pro-government militias, ex-rebels, bandits and local “self-defence” units – that control much of the countr... more

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Rwanda Evaluation of TB surveillance system using Standard and Benchmark Checklist

Klinkenberg, E. & Ochola, R. KNCV TUBERCULOSIS FOUNDATION (2013) C2

The National Tuberculosis Programme (NTP) of Rwanda (known as TB & ORD Division/IHDPC/RBC) is preparing to write their next National Strategic Plan and for this reason Rwanda was selected as a country to received technical assistance (TA) to conduct an assessment of their surveillance system using t... more

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Guide to Prudent Use of Antimicrobial Agents in Dairy Production

International Dairy Federation (2013) C2

Antimicrobial agents play an indispensable role in animal health and welfare management. At the same time, the need for prudent use is obvious to ensure good food safety outcomes and to manage the potential risk of antimicrobial resistance. The emergence of multi-resistant bacteria is posing challen... more

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Lista de verificación de alistamiento para la respuesta al COVID-19 en servicios de Emergencias Médicas Prehospitalirias - Instructivo

Organización Mundial de la Salud OMS (2020) C1

Los servicios de emergencias médicas prehospitalarias (SEM) facilitan atención inicial de soporte vital básico y/o avanzado y traslado de heridos o enfermos desde el lugar donde ocurre la emergencia hasta el centro sanitario donde le van a prestar cuidados definitivos. Los SEM también pueden pre... more

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The Case For Frontiline Health Workers in Addressing Non-Communicable Diseases Globally

IntraHealth International (2016) CC

Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... more

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The Strategic Importance of National Investment in Nursing Professionals in the Region of the Americas

Pan American Health Organisation PAHO (2022) C_WHO

Nurses are key players in health promotion and disease prevention and the backbone of health care systems worldwide. Nurses work on the front lines of disease prevention, health promotion, and health management and are often the unsung heroes in health care facilities and emergency response. Despite... more

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WFP Regional Drought Response Plan for the Horn of Africa (January – December 2023)

World Food Programme WFP (2023) CC

After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening. Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima... more

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Recovering from the Ebola Crisis: A summary report

UN Development Programme (2015)

In response to a call by the United Nations Secretary-General and the Governments of Guinea, Liberia and Sierra Leone, an international team conducted an Ebola Recovery Assessment.The aim was to contribute towards laying the foundation for short-, medium- and long-term recovery while the medical eme... more

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Recovering from the Ebola Crisis

Magdy Martínez-Solimán; Abdoulaye Mar Dieye; Izumi Nakamitsu et al. United Nations, The World Bank, European Union and African Development Bank (2015)

Full Report. In response to a call by the United Nations Secretary-General and the Governments of Guinea, Liberia and Sierra Leone, an international team conducted an Ebola Recovery Assessment. The aim was to contribute towards laying the foundation for short-, medium- and long-term recovery while ... more

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Yemen: 2019 Humanitarian Needs Overview

UN Office for the Coordination of Humanitarian Affairs, UN Country Team in Yemen (2019) C1

The humanitarian crisis in Yemen remains the worst in the world. Nearly four years of conflict and severe economic decline are driving the country to the brink of famine and exacerbating needs in all sectors. An estimated 80 per cent of the population – 24 million people – require some form of h... more

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Country cooperation strategy for WHO and Syrian Arab Republic: 2022-2025

World Health Organization WHO (2024) C_WHO

WHO’s Country Cooperation Strategy (CCS) defines the Organization’s medium-term vision for working in and with a particular country. The CCS, developed in the context of global and national health priorities, examines the overall health situation in a country, including the state of the health s... more

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The Sphere Handbook. Humanitarian Charter and Minimum Standards in Humanitarian Response. New Edition
recommended

Sphere (2018) C1

Humanitarian Charter and Minimum Standards in Humanitarian Response. The 2018 Sphere Handbook builds on the latest developments and learning in the humanitarian sector. Among the improvements of the new edition, readers will find a stronger focus on the role of local authorities and communities as ... more

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Assessing the Impact of Nepal’s 2015 Earthquake on Older People and Persons with Disabilities and How Gender and Ethnicity Factor into That Impact

HelpAge International, CBM International and NDRC Nepal (2016)

STUDY REPORT | This study of the impact of the Nepal earthquake of 25 April, 2015, aims to understand the impact factors leading to the exclusion of older people and persons with disabilities from humanitarian action, barriers to their inclusion, and the extent to which their skills and knowledge we... more

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Ways out of the global health crisis

Seitz, K. Misereor, Brot für die Welt, Global Policy Forum GPF (2021) C1

Healthy people, healthy animals and a healthy environment worldwide with the One Health approach. The COVID-19 pandemic has drastically demonstrated just how close the link is between humans, animals, and the environment, and has highlighted and aggravated existing challenges. The destruction of na... more

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex B. Qualitative and economic evidence reports recommended

The Sphere Handbook. Humanitarian Charter and Minimum Standards in Humanitarian Response. New Edition recommended

WHO guidelines on meningitis diagnosis, treatment and care. Web Annex B. Qualitative and economic evidence reports
recommended

The Sphere Handbook. Humanitarian Charter and Minimum Standards in Humanitarian Response. New Edition
recommended