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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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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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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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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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Technical note on accelerating P. falciparum elimination in the Americas

Pan American Health Organization (PAHO) (2023) C_WHO

All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the e... more

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Tackling malaria in countries hardest hit by the disease: ministerial conference report, Yaoundé, Cameroon, 6 March 2024

World Health Organisation (WHO) (2024) C_WHO

The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie... more

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WHO guidelines for malaria - arabic version

World Health Organisation (WHO) (2024) C_WHO

The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-friendly and easy-to-navigate online platform. The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-frie... 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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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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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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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

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Drugs for Intermittent Preventive Treatment of Malaria in Pregnancy: Current Knowledge and Way Forward

Figueroa-Romero, A.; C. Pons-Duran, and R. Gonzalez (2022) CC

Trop. Med. Infect. Dis. 2022, 7, 152. https://doi.org/10.3390/tropicalmed7080152

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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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Innovative delivery systems for paediatric medicines

World Health Organization WHO; Unitaid (2020) C_WHO

Technology landscape

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Fighting Cholera - Operational Handbook: Response to outbreaks and risk prevention in endemic areas

Solidarités International (2018) CC

Cholera is a diarrhoeal disease that is usually contracted when drinking water contaminated with Vibrio cholerae bacteria. The fight against this disease requires a multidisciplinary approach that combines a water, hygiene and sanitation (WaSH) response with a monitoring system, improved water suppl... more

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Infant and young child feeding counselling: an integrated course: course handouts
recommended

World Health Organization WHO; UNICEF (2021) C_WHO

These Course handouts have been designed for use by directors and trainers to aid in registering participants and evaluating trainers, and include job aids, answer sheets, forms, checklists and other tools for course participants to use during the training sessions. Items not supplied in the Course ... more

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Buruli ulcer : management of Mycobacterium ulcerans disease : a manual for health care providers
recommended

J. Buntine; Crofts, K. World Health Organization WHO (2001) CC

This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... more

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Sierra Leone - Multiple Indicator Cluster Survey 2017: Survey Findings Report

UNICEF; Global MICS Programme; Government of Sierra Loene, WHO; et al. (2018) C1

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Cholera: Clinical features, diagnosis, treatment, and prevention

LaRocque, R.; S.B. Calderwood and A.Bloom UpToDate (2020) C1

The document provides a detailed overview of cholera, including its clinical features, diagnosis, treatment, and prevention. It explains the causes of cholera, its symptoms such as severe diarrhea and dehydration, and the importance of rehydration therapy (oral or intravenous) to reduce mortality. T... more

Infant and young child feeding counselling: an integrated course: course handouts recommended

Buruli ulcer : management of Mycobacterium ulcerans disease : a manual for health care providers recommended

Infant and young child feeding counselling: an integrated course: course handouts
recommended

Buruli ulcer : management of Mycobacterium ulcerans disease : a manual for health care providers
recommended