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Towards Mapping the Fiscal Space: Health Sector Financing Strategy in Mozambique

N’weti, Wemos (2024) CC

This paper was commissioned by N´weti and Wemos as part of the project “Equitable health financing for a strong health system in Mozambique”. Its purpose is to contribute to the debate of the Mozambican Ministry of Health’s draft Health Sector Financing Strategy (HSFS) 2025 – 2034

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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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Rwanda Malaria Strategic Plan 2020–2024

Ministry of Health, Rwanda; Rwanda Biomedical Centre (RBC) Ministry of Health, Republic of Rwanda (2020) C2

The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development. The plan includes strengthening prevention through lo... more

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Epidemiological Alert: Outbreaks of resistant microorganisms associated with medical tourism

Pan American Health Organization PAHO, World Health Organization WHO (2019) C_WHO

Given an increase in outbreaks caused by resistant microorganisms associated with medical tourism, the Pan American Health Organization / World Health Organization (PAHO/WHO) encourages Member States to strengthen their capacity to detect and manage infections caused by resis... more

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11th Annual Meeting and First Virtual Meeting of the Intergovernmental Commission of the Amazonian Countries Initiative for the Surveillance and Control of Chagas Disease (AMCHA)

Pan American Health Organisation PAHO (2022) C_WHO

Due to the particular Amazonian situation of vectorial transmission based mostly on the wild cycle of Trypanosoma cruzi with diversity of triatomine vectors involved in effective transmission, and the variety of eco-epidemiological situations that facilitate such transmission, the countries of the A... more

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COVID-19 and HIV: Moment, Epidemics, Opportunities

UNAIDS (2020) C_WHO

The COVID-19 pandemic has exposed the inadequacy of investments in public health, the persistence of profound economic and social inequalities and the fragility of many key global systems and approaches.

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From emergency response to long-term COVID-19 disease management - Ending the COVID-19 emergency and transitioning from emergency phase to longer-term disease management: Guidance on calibrating the r

World Health Organization WHO (2023) C_WHO

The key actions, activities, and approaches in this document are organized within each of the 5Cs (see Table 1 in the PDF) and those of the Strategic preparedness and response plan (SPRP) pillars as follows: National action plan key activities, prioritized for the current context and the current ... more

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Averting risks to the food chain

FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS FAO (2019) C2

As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of the planet. We rely on land and sea for the produc... more

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Practical Epidemiology

Vaughan, P.; C. Victora and M. Chowdury. (2021) C1

Using Epidemiology to Support Primary Health Care. Updated version of the WHO handbook published in the early 1990's entitled: Manual of Epidemiology for District Health Management or those with an interest in applied epidemiology in primary health care and district health systems

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In the wake of the pandemic. Preparing for Long COVID-19

Rajan, S.; et al. World Health Organization WHO, Regional Office of Europe (2021) C_WHO

Policy Brief. Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the ... more

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Botswana TB/HIV Policy Guidelines

Ministry of Health, Gaborone, Botswana (2011) C2

This strategic framework marries formerly separate mandates for HIV and TB management in to one, comprehensive collaboration. It provides a structure for how to: strengthen the health care system to respond effectively to both epidemics, reduce the burden of HIV/AIDS in TB patients, and establish a ... more

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Technical meeting to support Ebola affected countries on the recovery and resilience plans with a focus on GAVI, the Global Fund and other partners' funding - Report, 9-11 June 2015

World Health Organization (2015)

The objectives of the meeting were to agree on coordinated and aligned support to the 3 countries’ national health recovery plans (Guinea, Liberia, Sierra Leone); to identify cross-cutting areas and opportunities for integration; to identify ways to improve implementation modalities; and to identi... more

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Global commitments, local action

UNAIDS (2021) C_WHO

3 June 2021. After 40 years of AIDS, charting a course to end the pandemic. The report shows that countries with progressive laws and policies and strong and inclusive health systems have had the best outcomes against HIV. In those countries, people living with and affected by HIV are more likely t... more

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Health workers’ education and training on antimicrobial resistance: curricula guide
recommended

World Health Organization WHO (2019) C_WHO

This curricula guide builds on several existing products of WHO and partners, aimed at supporting countries in their effort to address the first objective of the GAP-AMR (to improve awareness and understanding of AMR). It is targeted specifically at health educators and policy planners, and applies ... more

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Powerful Myths Hidden Secrets

United Nations Population Fund (UNFPA) (2017) C1

This assessment is the first of its kind to be conducted in the south-eastern region of Myanmar. It is an important contribution to ensuring the full inclusion of women and children in Myanmar’s political, social, and cultural systems, with a specific focus on the issue of gender-based violence (G... more

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COVID 19 Strategic preparedness and response plan - Monitoring and evaluation framework

World Health Organization WHO (2021) C_WHO

The COVID-19 Strategic Preparedness and Response Plan (SPRP) 2021 Monitoring and Evaluation Framework tracks global progress against the COVID-19 SPRP 2021 for the ten pillars of the public health response. The operational intelligence complements the epidemiologic information used to drive a global... more

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Keeping the 100-year-old promise: making insulin access universal

WHO (2021) C_WHO

High prices, hard-to-access human insulin, few insulin producers, and weak health systems are just some of the barriers that people with diabetes face a century after insulin was discovered, WHO notes in a new report

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An integrated, Sustainable Framework to Elimination of Communicable Diseases in the Americas. Concept Note

Pan American Health Organisation (PAHO) (2019) C_WHO

The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou... more

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The World Health Report 2008: Primary Health Care - Now more than ever

World Health Organization (2008) C_WHO

Primary care - Putting people first: This chapter describes how primary care brings promotion and prevention, cure and care together in a safe, effective and socially productive way at the interface between the population and the health system.

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Public Health in Ukraine

akkon Hochschule für Humanwissenschaften; Institute for research in international assistance (2022) C2

Despite its rich culture, great economic potential, high level of education and last but not least its sheer size – it is the largest state whose borders lie entirely within Europe and is 1.7 times the size of the Federal Republic of Germany – Ukraine seems far away in perception and awareness. ... more

Health workers’ education and training on antimicrobial resistance: curricula guide recommended

Health workers’ education and training on antimicrobial resistance: curricula guide
recommended