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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 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 for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

The Council was established in late 2020 by Dr Tedros Adhanom Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t... more

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Conditioned Domestic “Co-financing” Policies in Global Health

Sparkes S., Yungrattanachai M., Fan V., et al. Center for Global Development (2024) CC

Conditioned domestic financing policy, referring to the domestic financing of health projects, programs, and national responses conditioned by global health funding agencies and recipient country governments, is one mechanism to promote sustainability and country ownership. We aim to understand how ... 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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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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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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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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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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WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended

World Health Organization WHO (2025) CC

The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of... 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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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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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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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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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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Manual de transporte, almacenamiento y manejo de pruebas de diagnóstico rápido de la malaria en instalaciones de almacenamiento centrales y periféricas

Organización Panamericana de la Salud (2011) C_WHO

Este manual ofrece directrices prácticas para el manejo adecuado de las pruebas de diagnóstico rápido (PDR) de la malaria, destinadas al personal que trabaja en almacenes centrales, regionales y periféricos del sistema de salud. Su propósito principal es garantizar la integridad y eficacia de e... more

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Manual de transporte, almacenamiento y manejo de pruebas de diagnóstico rápido de la malaria en establecimientos de asistencia sanitaria periféricos

Organización Panamericana de la Salud OPS (2011) C_WHO

Este manual está dirigido al personal de salud que trabaja en establecimientos periféricos y que utiliza pruebas de diagnóstico rápido (PDR) para la malaria. Proporciona instrucciones prácticas para garantizar el buen funcionamiento de estas pruebas en condiciones muchas veces difíciles, espec... more

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Expandindo a quimioprevenção sazonal da malária a novas áreas geográficas

Malaria Consortium (2025) C1

Moçambique foi o primeiro país fora da região do Sahel a expandir com sucesso a quimioprevenção sazonal da malária (QSM). Neste documento de aprendizagem, descrevemos as lições decorrentes da aplicação em larga escala da QSM em Moçambique.

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Basic malaria microscopy. Part II: Tutor's Guide

World Health Organization WHO (2020) C_WHO

This second edition of the Basic Malaria Microscopy package is a stand-alone product, providing all that is needed to conduct a complete training course

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries recommended

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended