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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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Community health workers to improve uptake of maternal healthcare services: A clusterrandomized pragmatic trial in Dar es Salaam, Tanzania

Geldsetzer, P.; Mboggo, E.; Larson, E.; et al. (2019) CC2

PLoS Med 16(3): e1002768. https://doi.org/10.1371/journal.pmed.1002768 Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to de... more

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Teachers for All: Inclusive Teaching for Children with Disabilities Collaborating globally to promote Inclusive Development

Ingrid Lewis and Sunit Bagree International Disability and Development Consortium’s Inclusive Education Task Group (2013) CC

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Fight for what counts. Investment Case

The Global Fund (2022) CC

Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the countries in which the Global Fund invests.

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TB and HIV concept note - Investing for impact against tuberculosis and HIV

The Global Fund To fight AIDS, Tuberculosis and Malaria (2015) C2

Single TB and HIV Concept Note Albania 2016-2018 27 April 2015

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Migration in Malawi

International Organization for Migration IOM (2015) C2

A country Profile 2014

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India: Operational Guidelines for Financial Management

National AIDS Control Organisation (NACO), Ministry of Health & Family Welfare, Government of India (2007) C1

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South Sudan - Emergency Livelihood Response Programme 2021-2023

Food and Agriculture Organization of the United Nations FAO (2021) CC

The situation in South Sudan has proven to be unpredictable and volatile. New hotspots of violent conflict and civil unrest have continued to emerge and levels of severe acute food insecurity have become progressively worse. In addition to years of fighting and political instability, the country fac... more

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Child Poverty in Tanzania

Lucia Ferrone, Sudhanshu Handa, Milline Jethro Mbonile UN Children's Fund and Government of the United Republic of Tanzania (2016) CC

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Forced Out: LGBT People in Azerbaijan

D. van der Veur ILGA-Europe (The European Region of the international Lesbian and Gay Association); COC Netherlands (2007) C2

Report on ILGA-Europe/COC fact-finding mission

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HIV/AIDS and Mobility in South Asia

International Labour Organization; UNDP; UNAIDS (2010) C2

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Successful Community Nutrition Programming: Lessons from Kenya , Tanzania, and Uganda

LINKAGES, L., Regional Centre for Quality of Health Care, R. and United Nations Children's Fund , U. (2002) CC

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Family planning saves lives and promotes resilience in humanitarian contexts

CARE, International Rescue Committee, Save the Children, Women's Refugee Commission (2017) C1

Globally, it is estimated that 128.6 million people are currently in need of humanitarian assistance. Of these individuals, approximately one-fourth are women and girls of reproductive age. Although family planning is one of the most life-saving, empowering, and cost-effective interventions for wome... more

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WASH Climate Resilient Development: Appraising and prioritising options for climate resilient WASH

United Nations Children’s Fund (UNICEF), Global Water Partnership (GWP) (2017)

This Technical Brief focuses on appraising and prioritising options for climate resilience with a view to informing water, sanitation and hygiene (WASH) programme and project design.
This Technical Brief:
- provides a simple scorecard/checklist approach to use as a starting point for appr... more

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Undernutrition: Lessons From Niger

Manuel Sanchez-Montero and Núria Salse Ubach ACF International Network and Tripode (2011)

Harmonising proven strategies beyond the emergency phase. Zero Hunger Phase 2

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Appraisal Report, HIV/AIDS Control Support Project Benin

OCSD, Social Development Department, Central and West Regions African Development Fund (2004) C2

The project will support preventive actions, traditional medicine and the coordination and implementation capacities of the national framework for HIV/AIDS control.

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Management of Severe Acute Malnutrition in children: Working towards results at scale

United Nations Children’s Fund (UNICEF) (2015)

The objectives of this guidance document are to:
1. Strengthen the capacity of country teams to effectively scale up and manage programmes to address severe acute malnutrition
2. Extend the geographic reach of quality treatment for SAM to all vulnerable communities in need
3. Maximize... more

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Under Siege - Impact of COVID-19 on Girls in Africa

ACPF, Plan International (2020) CC

The COVID-19 pandemic has exacerbated and added yet another layer of vulnerability to an already dire web of vulnerabilities of girls in the African continent, which constitute about 49% of the total child population. Critically, gender equality and girls’ multidimensional vulnerability have been ... more

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Shifting official development assistance during COVID-19: earmarking, donor concentration and loans

Woskie L., Wenham C. BMJ Global Health (2024) CC

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... more

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Early Moments Matter for every child

United Nations Children's Fund (UNICEF) (2017)

This report presents data and outlines best practices and policies that can put governments on the path to providing every child with the best start in life. It outlines the neuroscience of early childhood development (ECD), including the importance of nutrition, protection and stimulation in the ea... more