the aid library

The cost of the reemergence of monkeypox: An overview of health financing in Africa

Sokunbi T.O., Akinbi E.O. Health Policy OPEN (2024) CC

This study aims to provide an overview of health financing in Africa and to examine the impact of the reemergence of mpox on health ... more

The future of health in Mozambique: Collaborative efforts for sustainable financing

N’weti, Wemos (2024) CC

As part of the project ‘Equitable health financing for a strong health system in Mozambique’, N’weti and Wemos developed this policy brief wi ... more

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” ... more

Financing global health security: estimating the costs of pandemic preparedness in Global Fund eligible countries

Eaneff S., Boyce M.R., Graeden E., et al. BMJ Global Health (2022) CC

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 ... more

Financing health system elements in Africa: A scoping review

Karamagi H.C., Njuguna D., Kidane S.N., et al. PLOS One (2023) CC

Countries that are reforming their health systems to progress towards Universal Health Coverage (UHC) need to consider total resource requirements over the long term to plan for the implementation a ... more

Financing health in sub-Saharan Africa 1990– 2050: Donor dependence and expected domestic health spending

Apeagyei A.E., Lidral-Porter B., Patel N., et al. PLOS Global Public Health (2024) CC

In 2021, global life expectancy at birth was 74 years whereas in sub-Saharan Africa it was 66 years. Yet in that same year, $92 per person was spent on health in sub- Saharan Africa, which is roughly one fifth of what the next lowest geographic regi ... more

Financing Global Health 2023: The Future of Health Financing in the Post-Pandemic Era

Apeagyei A.E., Dieleman J.L., Leach-Kemon K., et al. Institute for Health Metrics and Evaluation (IHME) (2024) CC

IHME’s Financing Global Health report provides an overview of health spending around the world, with a special focus on investments in ... more

Redefining Debt‑to‑Health, a triple‑win health financing instrument in global health

Hu Y., Wang Z., Zhou S., et al. Globalization and Health (2024) CC

As a recognized win–win-win approach to international debt relief, Debt-to-Health(D2H)has successfully translated debt repayments into investments in health-related projects. Although D2H has expe ... more

From lemming to leader: Moving beyond Gross Domestic Product (GDP) to bring health financing assistance into the 21st century

Nassiri-Ansari's T., Schwalbe N., Lehtimaki S. PLOS Global Public Health (2024) CC

Nearly 90 years after Simon Kuznets first introduced Gross Domestic Product (GDP) for the limited purpose of measuring economic growth (by measuring the monetary value of all local goods and services within a given period of time), calls continue to mount for decision-makers to stop using GDP and it ... more

Financing Global Health 2023: The Future of Health Financing in the Post-Pandemic Era - Malaria report

Institute for Health Metrics and Evaluation (IHME) - University of Washington (2024) C2

The document is part of the Financing Global Health 2023 series by the Institute for Health Metrics and Evaluation (IHME) and focuses specifically ... more

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 vulnerabi ... lities. 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

The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income co ... more

Global Health Financing in Turbulent Times: A Detailed Analysis of The Global Fund's Resource Mobilization and Recovery Efforts

Kiai G.N. Aidspan (2024) CC

This article provides an in-depth analysis of the Global Fund's strategic initiatives in resource mobilization and recovery amid global economic fluctuations and geopolitical challenges. It highlights the Fund's successful conversion of pledges and innovative ... more

Health Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic change ... more

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 glob ... more

Financing for equity for women’s, children’s and adolescents’ health in low- and middleincome countries: A scoping review

Bou-Karroum L., Iaia D.G. , El-Jardali F., et al. PLOS Global Public Health (2024) CC

Over the past few decades, the world has witnessed considerable progress in women’s, children’s and adolescents’ health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping ... more

Political economy analysis for health financing: A ‘how to’ guide

World Health Organization (WHO) (2024) CC

This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more co ... more

Public financing of health in developing countries: a cross-national systematic analysis

Lu, C.; Schneider, M.T.; Gubbins, P.; Leach-Kemon, K.; Jamison, D.; Murray, C.J.L. (2010) CC

Government spending on health from domestic sources is an important indicator of a government's commitment to the health of its people, and is essential for the sustainability of ... more