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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 o ... n 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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Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC ... more

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Exploring the Intersection of Sanitation, Hygiene, Water, and Health in Pastoralist Communities in Northern Tanzania

Barasa, V.; Waldman, L. IDS (2022) CC

This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, used on its own, is not enough to understand the complexities of sanitation, hygiene, water, and ... more

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mhGAP Intervention Guide Mental Health Gap Action Programme Version 2.0 for mental, neurological and substance use disorders in non-specialized health settings
recommended

Tarun Dua, Nicolas Clark, Neerja Chowdhary et al. World Health Organisation (WHO) (2016) C_WHO

The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules - Essential Care and Practice that includes general guid ... more

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Security Survey for Health Facilities
recommended

International Committee of the Red Cross (ICRC) (2017) C1

The purpose of the survey is to identify the level of preparedness required by a health-care facility to be able to continue operating during, or following a conflict-related security event.
The survey method provides a measure of the securit ... more

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Antenatal Guidelines for Primary Health Care in Crisis Conditions

Cristina Otero Garcia ICRC (2005)

These guidelines are designed for ICRC and other health professionals – nurses, midwifes, doctors – who either lack experience in antenatal care or are not used to working in countries where medical in ... more

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Global progress report on WASH in health care facilities: Fundamentals first

World Health Organization WHO; UNICEF (2021) C_WHO

The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This ... more

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Mobile Health for Asthma and Chronic Obstructive Respiratory Disease (mBreatheFreely)

World Health Organization (WHO) World Health Organization (WHO), International Telecommunication Union (ITU) (2018) C_WHO

The document is a handbook on implementing the mBreatheFreely program, an mHealth initiative by the World Health Organization (WHO) and the International Telecommunication Union (ITU) aimed at improving the management of asthma and COPD through mobi ... more

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Lung health in Africa: challenges and opportunities in the context of COVID-19

Ozho, O.B.; Mbatchou Ngahane, B.H.; Zar, H.J.; et al. American Journal of Physiology - Lung Cellular and Molecular Physiology (2021) CC2

The article discusses the challenges and opportunities for lung health in Africa in the context of the COVID-19 pandemic. It highlights the strain on healthcare systems, the increase in chronic respiratory diseases like asthma and COPD, and the limi ... more

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Ethiopia Emergency Health Appeal

World Health Organisation (WHO) (2023) C_WHO

Ethiopia faces unprecedented public health risks with over 17.4 million people in need of health assistance due to a compounded security, epidemiological, environmental and socio-economic hardships ... more

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Peru - Health Indicators

World Health Organization WHO HDX (2022) C_WHO

Contains data from World Health Organization's data portal covering the following categories: Mortality and global health estimates, Sustainable development goals, Millennium Development Goals (MDG ... more

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Climate-Smart Healthcare : Low-Carbon and Resilience Strategies for the Health Sector

The World Bank Group (2017) CC

Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak ... more

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Standard Operation Procedure - for facility and equipment maintenance management in primary health care clinics in Iraq

UNAIDS et al. (2013) CC

USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (P ... more

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Assessing health systems in Guinea for prevention and control of priority zoonotic diseases: A One Health approach

Standleya C. J., Carlinb E. P., Sorrella E. M. et al. Elsevier (2019) CC

To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and contro ... more

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Beat the heat: Child health amid heatwaves in Europe and Central Asia

UN Children's Fund UNICEF (2024) CC

Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months. "Around half of children across Eur ... ope and Central Asia – or 92 million children – are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia. Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region. As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to: - Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans Invest in heat health action plans and primary health care to more adequately support heat-related illness among children - Invest in early warning systems, including heat alert systems - Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress - Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure - Secure the provision of safe water, particularly in countries with deteriorating water quality and availability. UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress. more

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Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health | Sustainable Development Goals - Resource Centre

Whitmee S., Haines A. et al. (2015) C2

By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially, ... more

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Faith-based health-care

The Lancet Series (2015) CC

In July 2015, The Lancet published a series on faith-based health care. The Executive Summary states that “this Series argues that building on the extensive experience, strengths, and capacities of faith-based organisations (eg, geographical cover ... more

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Guidelines for developing inclusive water, sanitation and hygiene infrastructure

Arup; International Labour Organization ILO; UN Children's Fund UNICEF; UNOPS; WaterAid (2024) CC

Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue. Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased ... more

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Operation Manual for Regional Medical Equipment Maintenance Workshops and Medical Equipment Maintenance Guidelines

Ministry of Health Uganda; Health Infrastructure Division (2015) C1

A guide for Regional Workshop and Hospital Technicians

mhGAP Intervention Guide Mental Health Gap Action Programme Version 2.0 for mental, neurological and substance use disorders in non-specialized health settings recommended

Security Survey for Health Facilities recommended

mhGAP Intervention Guide Mental Health Gap Action Programme Version 2.0 for mental, neurological and substance use disorders in non-specialized health settings
recommended

Security Survey for Health Facilities
recommended