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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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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

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 the... 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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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

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, t... more

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Health Taxes: A Compelling Policy for the Crises of Today

The Task Force on Fiscal Policy for Health Report 2024 Bloomberg (2024) CC

For this report, the Task Force commissioned additional background papers on health taxes to update the evidence, assess short-term revenue potential, and understand the role of health taxes in the current era of multiple crises. We find that health taxes continue to be underutilized despite th... more

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A healthy return: Investment case for a sustainably financed WHO

World Health Organization (WHO) (2022) CC

There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.

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WHO guidelines on meningitis diagnosis, treatment and care
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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Regional Child Protection Operational Note

International Organization for Migration (IOM) (2025) C2

The Regional Child Protection Operational Note has been developed by IOM and UNICEF’s Regional and Country Offices in North, West and Central Africa as a collaborative inter-agency and cross-regional endeavour within the framework of the sixth phase of the IOM Regional Development and Protection P... more

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Community deployment of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine: a field guide

World Health Organization WHO (2024) C_WHO

The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st... more

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Efficacité de la chimioprévention du paludisme saisonnier à l’échelle de l’Afrique de l’Ouest et de l’Afrique centrale : une étude d’observation

Partenariat ACCESS-SMC (2020) CC

Lancet 2020 ; 396 : 1829-40

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Basic malaria microscopy. Part II: Tutor's Guide

World Health Organization WHO (2020) C_WHO

This second edition of the Basic Malaria Microscopy package is a stand-alone product, providing all that is needed to conduct a complete training course

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Community led-monitoring guide for key malaria programs for civil society organisations

Civil Society For Malaria Elimination CS4ME (2022) CC

Community led-monitoring is based on the principle that «Nothing that is done for us should be done without us”. The combination of this principle with evidence shows that community-led monitoring is an important driver of improved service delivery and health outcomes that needs to be re-empha... more

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Surveillance and control of Anopheles stephensi: country experiences

World Health Organization WHO (2024) C_WHO

Anopheles stephensi is an invasive mosquito species which has been found spreading across Africa. While this species presents a new challenge for malaria control on the continent, its surveillance and management have been ongoing in Asia for many years. This document aims to summarize key lessons fr... more

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Surveillance template protocol for pfhrp2/pfhrp3 gene deletions

World Health Organization WHO (2024) C_WHO

2nd edition. The purpose of this document is to present updated standardized protocols that P. falciparum-endemic countries can use to determine the prevalence of parasites with pfhrp2/3 gene deletions causing negative HRP2 RDT results among symptomatic falciparum patients. The findings should be us... more

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Childhood TB - Training Toolkit

International Union Against Tuberculosis and Lung Disease (2014) CC

The training focuses on building the capacity of health care workers at the primary and secondary level to address and manage TB in children.

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Humanitarian Action for Children 2022 - Syrian refugees

UN Children's Fund UNICEF (2021) C_UNICEF

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Annual Hospital Statistics Report 2013

The Republic of the Union of Myanmar, Ministry of Health, Department of Public Health (2015) C1

This report is intended to provide information regarding reporting status of the public and private hospitals, availability and utilization of hospital services, performance of the hospitals under administration of Ministry of Health, hospital deliveries and leading causes of hospitalization and mor... more

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Baseline Study Report Female Genital Mutilation/Cutting and Child Marriage among the Rendille, Maasai, Pokot, Samburu and Somali Communities in Kenya

United Nations Children’s Fund (UNICEF) (2017) C_UNICEF

In recognition that Female Genital Mutilation (FGM) is not only a harmful practice but a violation of human rights, Kenya has adopted a robust legal framework. The country has ratified several international legal instruments that have become part of the Kenyan law as provided for in Article 2 of the... more

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Strategies for Identifying and Linking HIV-Infected Infants, Children, and Adolescents to HIV Care and Treatment

Centers for Diseases Control and Prevention; USAID (2019) C_CDC

Accessed: 08.10.2019

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EQUINET Information sheet on COVID-19

R Loewenson EQUINET (2020) C1

Produced by Training and Research Support Centre for the Regional Network for Equity in Health in east and southern Africa (EQUINET), March 20, 2020. This brief summarises and provides links to official, scientific and other resources to support an understanding of and individual to regional level... more

WHO guidelines on meningitis diagnosis, treatment and care recommended

WHO guidelines on meningitis diagnosis, treatment and care
recommended