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.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal...th information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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The WHO recommends parenteral artesunate over quinine and artemether for treating severe Plasmodium falciparum malaria in adults and children. Intravenous administration is preferred. A new one-step, arginine-based formulation eliminates the need for dilution steps, reducing errors and accelerating ...the initiation of treatment—a critical factor for survival. This formulation was first prequalified by the WHO in 2023. By contrast, the conventional two-step artesunate formulation, which was prequalified in 2010, requires more complex preparation. Clear guidance is essential, as product-specific protocols differ. These training materials aim to support the correct and effective administration of the medication.
Accessed on 27/06/2025.
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This guide provides strategic direction for host countries, event organizers, health authorities, and key stakeholders to effectively plan and conduct Simulation Exercises (SimEx) and After Action Reviews (AARs) for mass gathering events. Packed with practical tools, it empowers users to seamlessly ...integrate these activities into ongoing learning and emergency risk management processes. Aligned with the International Health Regulations (IHR, 2005), the guide serves as a critical resource for strengthening global and national health resilience, ensuring safer and more prepared mass gatherings.
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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The One Health (OH) High-Level Expert Panel (OHHLEP) of the Quadripartite Organizations defined OH as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.”
It recognizes the health of humans, domestic and wild animals, plan...ts, and the wider environment (including ecosystems) are closely linked and interdependent [1]. The Tripartite which comprised the Food and Agriculture Organization (FAO) of the United Nations (UN), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) later became the Quadripartite organizations when the United Nations Environment Programme (UNEP) joined the OH alliance in 2022. There are Global and Regional Quadripartite Secretariats consisting of officials of headquarters and regional offices, respectively.
Over the years, the Tripartite/Quadripartite organizations and other partner agencies have developed several OH assessment and operational tools to support Member States in assessing their core capacities to achieve compliance with the requirements of international standards such as the International Health Regulations 2005 (IHR), WOAH’s Terrestrial and Aquatic Animal Health Codes, World Trade Organization’s Sanitary and Phytosanitary Measures (WTO-SPS), FAO/WHO Codex standards, etc. Technical areas that the existing tools currently support include progress monitoring, coordination and collaboration mechanisms, and capacity building for prevention, detection, preparedness, and response to health threats emerging at human-animal-environment interface. More OH B operational tools are in the pipeline.
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This guidance document has been produced by WHO to assist blood services in the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply, whether from an existing infectious agent that is changing in incidence and spread, or from a ...newly identified infectious agent. It is intended that this document be followed to guide the national blood service through the process of planning how to respond in a timely, controlled and appropriate way to any specific infectious threat that may subsequently emerge. It is acknowledged that it is not only the blood supply that may be affected by such emerging infectious threats; in those countries undertaking transplantation, the supply of cell, tissues and organs may also be threatened. Increasingly, blood services are taking overall national responsibility for transplantation in their capacity as the organization responsible for the collection, processing, storage and supply of cells, tissues and organs. This approach is both sensible and appropriate, as the overall donor selection and screening processes are the same or very similar. This guidance document can therefore also be used to assist those bodies responsible for the provision of cells, tissues and organs to prepare for an emerging infectious threat.
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USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system throu...gh achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
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Mounting an effective international humanitarian response to a chemical, biological, radiological or nuclear (CBRN) event, especially if the response is undertaken on an ad hoc basis, would be extremely difficult and would pose many risks to the responders. The International Committee of the Red Cro...ss (ICRC) has created a competency-based capacity to respond to at least small-scale CBRN events, including a deployable capability to undertake operational activities. This involves informed assessments of CBRN risks, timely and competent decisions on how to respond, and effectively mobilizing appropriate resources to implement these decisions, through the creation of an emergency roster. In addition to the acquisition of technical expertise and material resources, the creation of such capacity requires the application of central processes, ensuring systematic management of CBRN response (including risk-based decision-making), standing operational procedures, and availability of and access to the necessary resources. Implementation of the ICRC's CBRN response framework as described in this article should be considered by any agency or other stakeholder preparing for international humanitarian assistance in CBRN events – especially if such events are related to armed conflict.
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OpenWHO is an interactive, web-based, knowledge-transfer platform offering free online courses to improve the response to health emergencies. In summary, OpenWHO currently offers courses covering the following topics and languages to support the response to COVID-19:
A general introduction to ...emerging respiratory viruses, including novel coronaviruses (available in Arabic, Chinese, English, French, Russian, Spanish, Hindi, Hungarian, Indian Sign Language, Indonesian, Macedonian, Persian, Portuguese, Serbian, Turkish and Vietnamese);
Clinical care SARI (available in English, French, Russian, Spanish, Indonesian, Portuguese and Vietnamese);
Health and safety briefing for respiratory diseases – ePROTECT (available in Chinese, English, French, Russian, Spanish, Indonesian and Portuguese);
IPC for COVID-19 (available in Chinese, English, French, Russian, Spanish, Indonesian, Italian, Japanese, Macedonian, Portuguese, Serbian and Turkish);
COVID-19 operational planning guidelines and partners platform to support country preparedness and response (available in Chinese, English, French, Russian and Portuguese);
SARI treatment facility design (available in Arabic, English and Portuguese);
An introduction to Go.Data (available in English and in additional languages); and
How to put on and remove PPE for COVID-19 (available in English and in additional languages).
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nt. J. Environ. Res. Public Health 2014, 11(12), 13097-13116; https://doi.org/10.3390/ijerph111213097
Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate chang...e risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
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Medical care for people caught up in armed conflict and other insecure environments saves lives and alleviates suffering. It is one of the most immediate and high priority needs of an affected population and is often the first type of response activated and/or requested by authorities and affected c...ommunities. Medical teams working in armed conflict and other insecure environments
frequently face serious threats to their security and safety, challenges to patient access, and at times limited acceptance by affected communities in which they work and parties to the conflict. Such difficulties are likely to increase (6) and
thereby creating a critical need to establish contact and trust with all sides in conflicts and in other insecure environments to ensure operational continuity. This trust can best be achieved when all sides perceive the medical teams to be neutral, impartial, and independent, and specifically not aiding (or being perceived to aid) any one party to achieve a military, political or economic
advantage. For medical teams that are deploying increasingly closer to the frontlines, the implications of and consequences for both staff and patients of teams not being fully prepared, and/or not fully comprehending the context in which they work, can be severe. Medical response can easily be hindered or compromised by intentional or unintentional acts and the behaviour and
conduct of the teams themselves
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance...r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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This facilitator’s manual is designed to support the implementation of the Dengue Clinical Management training course. The guide contains specific instructions for the facilitator and provides:
- a detailed description of the clinical course of dengue illness, which reflects the dynamic and sys...temic nature of dengue that has crucial bearing on the patient’s management;
- a detailed description of the basic pathophysiological changes of severe dengue (i.e. plasma leakage and hypovolaemia/shock) and guidance on the recognition of these changes and appropriate action of management;
- a brief discussion on WHO classification (1997) and its limitations;
- guidance on the differential diagnoses that can be confused with dengue or vice versa; they were described according to the stage of disease;
- a more focused guide on the disease monitoring in accordance with the dynamic changes as the disease progresses;
- emphasis on the importance of monitoring the plasma leakage (haemodynamic status of the patient, clinical signs of plasma leakage and haematocrit);
- a clearer algorithm for fluid management in cases of severe dengue; and
- emphasis on the importance of recognizing or suspecting significant occult bleed. Keep the facilitator’s manual with you each day as you prepare and deliver the information. Use it as a reference when delivering classroom presentations, but avoid reading directly from it during sessions.
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Rapport de mission, 10-14 juillet 2017
Madagascar a conduit la mission d’évaluation externe conjointe de la mise en œuvre des capacités du Règlement Sanitaire International (2005) du 10 au 14 juillet 2017. ...
Pour disposer de capacités fonctionnelles et pérennes, le pays devra ren...forcer encore d’avantage l’ensemble des 19 domaines techniques en mettant en œuvre les recommandations ci-dessous. A cet égard, il est primordial de mettre l’accent sur : i) l’élaboration et l’application de cadres législatifs, propices à l’application du Règlement sanitaire international (2005) et à la gestion des risques de catastrophe ; ii) la coordination multisectorielle dans la mise en œuvre du Règlement sanitaire international (2005) ; iii) le renforcement des capacités du point focal RSI ainsi que sa relation avec tous les secteurs clés dans la prévention, la détection et la riposte ; iv) la rédaction et la mise en œuvre des procédures requises en tenant compte de l’approche englobant l’ensemble des menaces ; et v) l’analyse et la cartographie des risques d’épidémies et de catastrophes, en utilisant une approche multisectorielle qui permettra d’actualiser et d’établir des plans de préparation et de riposte contre les zoonoses, les maladies infectieuses émergentes et ré-émergentes et les facteurs de risque environnementaux en utilisant l’approche « Une seule santé ».
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The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r...ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
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