The COVID-19 pandemic demonstrated that
the world was not well prepared to respond
to an infectious disease threat of this magnitude. Countries across all socioeconomic and development categories have struggled
to implement effective national responses. Substantial amounts of additional investmen...t are required to support the development of country capacities to prevent, detect and respond to both existing and emerging
infectious disease threats. Prior research efforts have estimated that between US$96 and $204billion is required, globally, to
advance country-level health security capacities, with US$63–131billion needed over a 3-year period. Given the substantial costs
of ongoing COVID-19 response, estimated to
be over US$12.5trillion through 2024, and an estimated 12.1–22.7million excess deaths, globally, due to COVID-19 as of January 2022,
the importance and potential return on investment of such upfront investments in capacity building are more evident than ever before.
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In contrast to bilateral aid, aid disbursed from
multilateral institutions increased significantly at the onset
of the COVID-19 pandemic. Yet, at a time when a coherent
and effective multilateral response is needed most, the
COVID-19 pandemic revealed a shifting landscape of donor
agencies that... struggle with basic functions, such as crossnational coordination. While multilaterals are uniquely
positioned to transcend national priorities and respond
to pandemics, functionally we find official development
assistance (ODA) from these entities may increasingly
mimic the attributes of bilateral aid. We explore three
important, but not comprehensive, attributes of aid leading
up to and during the COVID-19 pandemic: (1) earmarking,
(2) donor concentration and (3) aid modality.
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Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, termed progress and ambitious, aimed at strengthening co...mprehensive health service delivery to achieve SDG 3 and universal health coverage in low-income and middle-income countries (Stenberg et al., 2017). Out of the 47 countries in the WHO African region only eight, on average, met the recommended threshold of spending a minimum of US$ 249 per capita on health during the period from 2012 to 2020. In 2020, this achievement was observed in only five countries while the remaining countries spent less than US$ 249 per capita, with health expenditures ranging from US$ 16.4 to US$ 236.6, highlighting significant disparities across the region.
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In the last three decades, health financialization has surged in
several creative ways, yet this growing phenomenon remains surprisingly
unknown, and neglected, in the global health arena. Financialization in the
health domain could be described as the uncontrolled expansion of finance along vari...ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before the pandemic, evidence showed the significant returns... on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
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The key tools and governance approaches for
international cooperation for sustainable development
(hereafter, international cooperation) were set up in a
markedly different time and age. International
cooperation – with official development assistance
(ODA) as the dominant means of implementa...tion –
remains key, despite being generally considered as no
longer adequate for addressing today’s common and
collective challenges.
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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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In 2019, the Task Force on Fiscal Policy for Health concluded that taxes on tobacco, alcohol, and sugar-sweetened beverages were a highly effective but greatly underused policy tool to reduce consumption, save lives, and raise domestic resources. The Task Force estimated that if all countries increa...sed their excise taxes to raise prices by 50 percent, over 50 million premature deaths could be averted worldwide over the next 50 years while
raising over USD 20 trillion of additional revenue. Since the Task Force first convened, the world has faced a “polycrisis,” including a global pandemic, an economic recession, and the outbreak of wars in Europe and the Middle East. Against this backdrop, the world has also experienced prolonged health and fiscal crises. Health systems, weakened by the COVID-19 pandemic, lack sufficient financing to rebuild and respond to the surging noncommunicable diseases epidemic caused by uncontrolled risk factors such as tobacco, alcohol, and sugar consumption. Opportunities to raise domestic resources are limited and debt burdens have squeezed budgets. The period from 2019 to 2027 risks becoming a “lost decade” for health and social policies, with 110 countries facing little prospect of any
ability to raise government revenues beyond current levels. In this paper, we describe the current health and fiscal crises and review the contribution that health taxes could make in turning around this dire situation. We conclude that taxes on tobacco, alcohol, and
sugar-sweetened beverages are an ideal policy solution—good for the budget and good for health. These taxes are relatively quick to implement, and, unlike other taxes, do not put economic growth at risk—a vital benefit in the current era.
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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 ...note, we briefly review the major reform proposals from 2009 onwards, highlighting the key issues underlying approaches to ODA reforms, and the main “types” of proposals typically put forward.
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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...nd wider outbreak operations. These data can be used to inform risk communication and community engagement activities as well as other response pillars. Some of the issues covered in these questions are complex, for example stigma or views on vaccine safety
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Actualización de 2023. Nota informativa. En 2021, los resultados preliminares de los estudios observacionales del proyecto de Acceso Comunitario al Artesunato Rectal para el Paludismo (CARAMAL, por sus siglas en inglés) no confirmaron el impacto en la mortalidad observado en el ensayo controlado d...e 2009. En consecuencia, la OMS publicó una nota informativa sobre el artesunato rectal en la que se sugerían medidas inmediatas de reducción del riesgo.
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Diese Publikation erklärt anhand von Grafiken die Wichtigkeit von Entwicklungszusammenarbeit im Allgemeinen und für Gesundheit im Speziellen. Denn finanzielle Beiträge im Rahmen der Entwicklungszusammenarbeit haben sich in den letzten Jahrzehnten als unerlässlich, wirksam, günstig und verantwor...tungsvoll erwiesen.
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This publication uses graphics to explain the importance of development cooperation in general and for health in particular. Financial contributions in the context of development cooperation have proven to be indispensable, effective, affordable and responsible in recent decades.
Trop. Med. Infect. Dis. 2022, 7, 152. https://doi.org/10.3390/tropicalmed7080152
Las Directrices de la OMS sobre la malaria reúnen las recomendaciones más actualizadas de la Organización acerca de la malaria (o paludismo) en una plataforma en línea fácil de usar y de navegar.
La primera versión de las Directrices es una recopilación de las recomendaciones existentes de... la OMS sobre la malaria y reemplaza a dos publicaciones anteriores de la OMS: las Directrices para el tratamiento del paludismo, tercera edición (en inglés unicamente), y las Directrices para el control de vectores del paludismo. Se seguirán revisando las recomendaciones sobre la malaria y, cuando proceda, se actualizarán en función de los últimos datos probatorios disponibles. Todas las recomendaciones actualizadas mostrarán siempre la fecha de la revisión más reciente en la plataforma MAGICapp. Con cada actualización, habrá también disponible en el sitio web de la OMS una nueva versión en PDF de las directrices unificadas que se podrá descargar.
Esta versión corresponde a la publicada en inglés el 13 de julio del 2021. La actualización se está traduciendo actualmente.
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Relapsing malaria caused by Plasmodium vivax parasites poses a significant challenge to global malaria elimination efforts. About one third of the population remains at risk of contracting P. vivax malaria, and 85% of P. vivax infections stem from reactivated latent parasites, leading to chronic ana...emia and increased morbidity and mortality. In addition to diagnostic tools that can detect the acute, blood-stage of P. vivax, new tools are needed to detect the dormant infections before they reactivate and contribute to morbidity and onwards transmission
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El propósito de esta guía es brindar orientaciones clínicas actualizadas en TB/VIH con énfasis en aspectos de diagnóstico, incluidas nuevas técnicas, así como de tratamiento vigente, sin perder de vista un enfoque de salud pública. Al recopilar y consolidar en una sola guía las últimas rec...omendaciones de la Organización Mundial de la Salud en el tema, se busca elaborar un documento de referencia y consulta frecuente, que unifique y estandarice el manejo de la coinfección TB/VIH de manera integral en establecimientos de salud con base en el principio de “dos enfermedades, un solo paciente”. También busca sustentar la actualización de normas y guías nacionales sobre la coinfeccion y complementar el trabajo coordinado que debe existir entre los programas de prevencion y control de TB y VIH a todo nivel en el marco las doce actividades de colaboración TB/VIH recomendadas internacionalmente.
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The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating the latest World Health Organization recommendatio...ns on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
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The "Integrated Management of Malaria Training – Health Worker’s Manual" is a practical guide developed by Uganda’s Ministry of Health to train healthcare workers at all levels in the effective diagnosis, treatment, prevention, and management of malaria. It aligns with national malaria treatme...nt guidelines and aims to improve the quality of care and reduce malaria-related illness and death. The manual covers key topics such as clinical assessment of fever, use of rapid diagnostic tests (RDTs), case management of uncomplicated and severe malaria, malaria in pregnancy, co-infections like HIV, as well as community engagement and proper documentation. It includes structured training sessions, case studies, and job aids designed to strengthen the skills of health workers in both public and private sectors, and to ensure standardized, evidence-based malaria care across the country.
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