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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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Government Health Spending Outlook - Projections Through 2029: Diverging Fiscal Pressures, Uneven Constraints

The International Bank for Reconstruction and Development The World Bank (2024) CC

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 gove... 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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Why Is There So Little Contractually Contingent Financing?

Dissanayake R. Center for Global Development (2024) CC

Most foreign aid comes in one of two forms: either we pay a person or an institution today in exchange for delivering some beneficial activity in the future, or we observe something bad happen to them and then give them support to recover from it. This kind of aid is simple to design and deliver, b... more

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Financing the Pandemic Cycle: Prevention, Preparedness, Response, and Recovery and Reconstruction

Fan V. Y., Kim S., Pineda D., et al. Center for Global Development (2024) CC

The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This chapter presents a comprehensive framework for pandemic financing that spans the entire pandemic cycle... more

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Proposals for ODA Reform: A Review of Key Approaches

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

Questions concerning the relevance and reform of official development assistance (ODA), and how ODA and broader development finance could—or should—change to better reflect shifting demands are not new, with academics and policymakers suggesting a range of options for reform. In this background ... more

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Financing for Sustainable Development Report 2024

Inter-agency Task Force on Financing for Development United Nations (UN) (2024) CC

The world is facing a sustainable development crisis. The 2024 Financing for Sustainable Development Report: Financing for Development at a Crossroads finds that financing challenges are at the heart of the crisis and imperil the SDGs and climate action. The window to rescue the SDGs and prevent a c... more

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Plan of Action for Malaria Elimination 2021-2025

Pan American Health Organization (PAHO) (2022) C_WHO

The Plan of Action for Malaria Elimination 2021-2025 has been developed in consultation with countries and regional partners as a framework of reference to guide the efforts of countries and the contributions of donors and partners towards elimination of the disease in the Americas. The Plan subscri... more

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Denial of Humanitarian Access to Children: A Guidance Note for the Children and Armed Conflict Agenda

UNICEF; UN Office of the SRSG for Children and Armed Conflict Reliefweb OCHA (2025) C_UNICEF

ith a view to support the monitoring and reporting on the denial of humanitarian access against children, the Office of the Special Representative of the Secretary-General for Children and Armed Conflict and UNICEF publish today* a guidance note offering new tools to practitioners to better address ... 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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Resilient development planning in Myanmar: an overview (Burmese version)

The Republic of the Union of Myanmar, Ministry of National Planning and Economic Development, Planning Department (2013) C1

Planning and Implementation Training. Myanmar
This training module on resilient development planning in Myanmar consists of a 2.5 hours session, at the end of which, the participants will:
a) Have a common understanding on development and disaster linkages.
b) Be able to identify the ... more

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Synthesized Guidance For COVID-19 Message Development

John Hopkins Bloomberg School (2020) CC

As information about COVID-19 is rapidly evolving, it can be challenging to navigate and synthesize all of the information. The purpose of this document is to provide a synthesized, indexed reference of accurate, standardized COVID-19 information from trustworthy sources. Information is presented in... more

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Financing Health for All in the context of scarcity

Corinne Grainger Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH (GIZ) (2023) CC

CATALYST DIALOGUE ON HEALTH FINANCING Insights from a debate on how to increase funding for health and spend existing funds more effectively. Catalyst Dialogue participants: Christoph Benn, Director for Global Health Diplomacy, Joep Lange Institute • Jayati Ghosh, Professor of Economics, Univer... more

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Microscopie pour la détection, l’identification et la quantification des parasites du paludisme sur frottis sanguins ou gouttes épaisses colorés dans les environnements de recherche
recommended

Organisation Mondiale de la Santé OMS (2020) CC

procédures : guide méthodologique

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National Treatment Guidelines for Antimicrobial Use in Infectious Diseases India
recommended

National Centre for Disease Control; Ministry of Health & Family Welfare India (2016) C1

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Protocolo Clínico e Diretrizes Terapêuticas Doença de Chagas

Ministério da Saúde, Brazil (2018) CC

Outubro/2018 Nº 397

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Sexual and Reproductive Health of Women and Adolescent Girls Living With HIV

EngenderHealt;; UNFPA (2008)

guidance for health managers, health workers, and activists

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Standard treatment guidelines laboratory medicine (India)

Ministry of Health & Family Welfare, India (2020) C1

Accessed Febr. 6, 2020

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Situational Brief: Palestinian Refugees in the occupied Palestine Territories during Covid-19

Kaloti R., R. Kafri, H. Meghari (2020) CC

As of 12June 2020, there are 667confirmed COVID-19 casesin the OPT (565 of which are recovered cases), and 48% of which (320 cases) are in East Jerusalem and its suburbs. Additionally, there have been 5 reported COVID-19 deaths (1 in the West Bank, 1 in Gaza and 3 in East Jerusalem)

Microscopie pour la détection, l’identification et la quantification des parasites du paludisme sur frottis sanguins ou gouttes épaisses colorés dans les environnements de recherche recommended

National Treatment Guidelines for Antimicrobial Use in Infectious Diseases India recommended

Microscopie pour la détection, l’identification et la quantification des parasites du paludisme sur frottis sanguins ou gouttes épaisses colorés dans les environnements de recherche
recommended

National Treatment Guidelines for Antimicrobial Use in Infectious Diseases India
recommended