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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 Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th... 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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Manual for Stratifying Malaria Risk and the Elimination of Foci

Pan American Health Organization PAHO (2022) C_WHO

All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it... more

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National Strategic Plan: Malaria Elimination 2023-27

National Centre for Vector Borne Disease Control (NCVBDC) Ministry of Health and Family Welfare (MoHFW) - India (2023) C2

The National Strategic Plan for Malaria Elimination in India (2023-2027) focuses on achieving malaria elimination by 2030, in alignment with the Global Technical Strategy. The document outlines the strategies, targets, and goals for malaria elimination, aiming for zero indigenous malaria cases by 20... more

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Plan stratégique du Partenariat RBM pour la période 2021-2025

RBM Partnership to End Malaria (2020) C2

Le plan stratégique de la RBM Partnership to End Malaria pour 2021-2025 présente les priorités stratégiques du partenariat mondial visant à éliminer le paludisme. Le document se concentre sur trois objectifs stratégiques principaux : optimiser les programmes régionaux et nationaux, maximiser... more

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Stratégie nationale de changement social et de comportement

Ministère de la Santé Publique, Hygiène et Prévention - République Démocratique du Congo (RDC) (2023) C2

Le "Plan Stratégique National de Communication pour le Changement Social et de Comportement en Lutte contre le Paludisme" de la République Démocratique du Congo (RDC) vise à renforcer les actions de prévention et de traitement du paludisme à travers un changement social et comportemental. Ce p... more

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Safety of artemisinin and non-artemisinin antimalarials in the first trimester of pregnancy

World Health Organisation (WHO) (2024) C_WHO

Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of the burden in these areas is due to infection with P... 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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ECSA report. Eastern, Central and Southern African Region - Education and Labor Markets for Nurses

World Bank Group; International Council of Nurses (2021) CC2

Challenges and Opportunities. This report presents a comprehensive assessment of the education and labor markets for nurses in the ECSA region. It documents the main challenges to train and deploy nurses and discusses opportunities for government and private sector employers to overcome these chall... more

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Theory of Change

Nutrition and Food Security Alliance of Namibia; UNFPA; UNICEF; et al. (2020) CC2

Early Identification and Early Intervention Services for Young Children with Developmental Delays and Disabilities in Namibia Republic of Namibia Namibia Regional Consultations Report

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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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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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Questions bank for healthcare workers during infectious disease outbreaks

Wilkinson, A. Social Science in Humanitarian Action Platform (2025) C1

This question bank is a menu of qualitative questions related to healthcare workers’ knowledge, perceptions and practices during infectious disease outbreaks. The question bank will generate qualitative data on healthcare workers’ subjective understandings of risks, case management, protection a... more

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Banque de questionspour le personnel de santé lors épidemiés de maladies infectieuse

Wilkinson, A. Social Science in Humanitarian Action Platform (2025) C1

Cette banque de questions est un menu de questions qualitatives relatives aux connaissances, aux perceptions et aux pratiques du personnel de santé lors d'épidémies de maladies infectieuses. La banque de questions générera des données qualitatives sur la compréhension subjective qu'ont les pr... more

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Chimioprévention du paludisme saisonnier par administration de sulfadoxine-pyriméthamine et d’amodiaquine aux enfants : guide de terrain

Organisation Mondiale de la Santé OMS (2023) CC

2ieme edtion. Cette deuxième édition s'appuie sur l'expérience de plus de 10 ans de déploiement de la CPS et reflète les changements introduits dans les lignes directrices de l'OMS pour le paludisme, le 3 juin 2022. L'objectif de cette publication est de partager ces bonnes pratiques afin d'am�... more

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Seasonal malaria chemoprevention with sulfadoxine–pyrimethamine plus amodiaquine in children: a field guide

World Health Organization WHO (2023) C_WHO

2nd edition. This second edition builds on the experience of more than 10 years of SMC deployment, and reflects changes introduced in the WHO guidelines for malaria, 3 June 2022. The goal of this publication is to share these best practices to improve SMC implementation, coverage, and monitoring and... more

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Déploiement du traitement préventif intermittent du paludisme pendant la grossesse à base de sulfadoxine-pyriméthamine dans les communautés: guide du terrain

Organisation Mondiale de la Santé OMS (2024) C_WHO

Le guide décrit les étapes essentielles et donne des orientations aux pays pour l’adoption et le déploiement du c-TPIg de manière à l’intégrer dans le système de santé existant. Il s’appuie sur les meilleures pratiques et les enseignements tirés des expériences pilotes dans 8 pays af... more