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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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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

Development assistance for health (DAH) plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically focused on infectious diseases and maternal and child health, there is a lack of comprehensive analysis of DAH trends, strategic shifts and the... 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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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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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 concrete evidence, recognition and integration of political economy issues within health financing, and... more

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Tackling malaria in countries hardest hit by the disease: ministerial conference report, Yaoundé, Cameroon, 6 March 2024

World Health Organisation (WHO) (2024) C_WHO

The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie... more

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Translating Community Research Into Global Policy Reform For National Action

S. Dilmitis; A. Welbourn; F. Anam; et al. ICW Latina; ICW WA; UNAIDS; et al. (2018) C2

Translating Community Research Into Global Policy Reform For National Action: A Checklist For Community Engagement To Implement The WHO Consolidated Guideline On The Sexual And Reproductive Health And Rights Of Women Living With HIV 3rd edition | December 2018

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World Cities Report 2020 - The Value of Sustainable Urbanization: Key findings

UN-HABITAT (2020) C1

The World Cities Report 2020 shows that the intrinsic value of sustainable urbanization can and should be harnessed for the wellbeing of all. The Report provides evidence and policy analysis of the value of urbanization from an economic, social and environmental perspective, including the unquantifi... more

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Incheon Strategy to “Make the Right Real” for Persons with Disabilities in Asia and the Pacific

Economic and Social Commission for Asia and the Pacific (ESCAP) (2012) C2

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Young Children with Special Needs - Training for early childhood caregivers and teachers

Catholic Relief Services (CRS) & Hilton Foundation (2016) C1

MODULE 5 RESOURCE GUIDE | This guide is part of a series of manuals that focuses on six topics in Early Childhood Development (ECD): different programming approaches, basic concepts, assessments, early childhood environments, children with special needs and child protection, and the health, safety a... more

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Universal Health Coverage Health Advocacy Guide

UHC2030 (2018) C1

A guide to promote health systems strengthening to achieve universal health coverage.

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Trauma symptoms in children after the tsunami

Gunaratne, C., Kremer, P.J., Lewis, A.J. & Clarke, V. Sri Lanka Journal of Child Health (2013) CC

Limited research has examined factors associated with psychological distress following natural disasters among non-Western child populations. Conditions associated with trauma-related symptoms following the 2004 tsunami in a sample of 265 Sri Lankan child survivors (53.6% female, aged 3 to 17) were... more

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Système de gestion de la qualité au laboratoire: manuel

Organisation Mondiale de la Santé OMS (2013) C_WHO

Ce manuel a été conçu dans le but de fournir un matériel de référence complet sur le système de gestion de la qualité au laboratoire pour toutes les personnes intervenant dans les processus de laboratoire, tant au niveau de la gestion, de l’administration que du travail technique.

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Dépistage en laboratoire des cas suspects d’infection humaine par le nouveau coronavirus 2019 (2019-nCoV)

Organisation Mondiale de la Santé (OMS) (2020) C_WHO

Lignes directrices provisoires 17 janvier 2020 Le présent document a été rédigé en s’appuyant sur divers documents existants de l’OMS, y compris les lignes directrices de l’OMS relatives au dépistage en laboratoire du MERS-CoV (1-11). À mesure que de nouvelles informations seront r... more

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Informer sur les violences à l’égard des filles et des femmes: manuel pour les journalistes

UNESCO (2022) CC

À l’ère des évolutions numérique, démocratique, sociétale et politique, la communication est devenue plus que jamais une passerelle d’idées et d’initiatives révolutionnaires, capable de créer des communautés plus fortes, plus informées et plus impliquées que jamais. L’émergence ... more

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Climate-induced migration and health issues - A toolkit for policymakers

International Institute for Environment and Developmend (IIED) OCHA Services Reliefweb (2022) C2

Loss and damage is an urgent concern, driven by the increasingly harmful effects of climate change. Communities are experiencing new types and forms of climate impact, of higher frequency and intensity, which they are not equipped to handle. These impacts compel vulnerable communities to migrate to ... more

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IRC Health Strategy 2023-2027

International Rescue Committee (2023) CC

The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC’s program portfolio globally and encompasses thr... more

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Food And Nutrition In Disasters

PAHOWorld Health Organization (2000)