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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
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 changes in health financing. The report points out the need to improve
...
public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
more
The resurgence of mpox in multiple African countries since 2022 has highlighted urgent gaps in preparedness, detection, and response capacities across the continent. While the mpox outbreak was initially classified as a Public Health Emergency of In
...
ternational Concern (PHEIC) and a Public Health Emergency of Continental Security (PHECS), the risk of continued transmission in high-risk areas of Africa remains significant, particularly due to persistent zoonotic reservoirs, cross-border spread, and fragile surveillance systems.
more
1. Provide treatment for mental disorders in primary care
2. Ensure wider accessibility to essential psychotropic drugs
3. Provide care in the community
4. Educate the public
5. Involve communities, families and consumers
6. Establish national
...
policies, programmes and legislation on mental health
7. Develop human resources
8. Link with other sectors
9. Monitor community mental health
10. Support relevant research.
more
Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog
...
. Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
more
Responding to a polio outbreak. Guidelines
recommended
The occurrence of a case of wild polio in a previously polio free area as presently in Syria, whether through importation, laboratory accident, or mutation of vaccine virus (VDPV), should be considered a public health emergency, that requires a rapi
...
d and high quality response as utmost priority
more
This document, accessible through the WHO's Regional Office for Africa, helps national authorities develop communication plans for outbreaks to ensure accurate information reaches the public, builds trust, and supports coordination among
...
public health partners
more
A Wake-Up Call: Lessons from Ebola for the world’s health systems
recommended
Save the Children
(2015)
Almost 30 countries vulnerable to a new Ebola-style Epidemic, jeopardising the future of millions of Children. The report ranks the world’s poorest countries on the state of their public health systems, finding that 28 have weaker defences in plac
...
e than Liberia where, alongside Sierra Leone and Guinea, the current Ebola crisis has already claimed 9,000 lives, and provoked an extraordinary international response to help contain it.
more
The document outlines comprehensive guidelines for managing cholera outbreaks in South Africa, focusing on prevention, diagnosis, treatment, and public health measures. It emphasizes the importance of rehydration therapy, sanitation, clean water acc
...
ess, and community involvement to control the spread of the disease. It also provides protocols for handling outbreaks, including case identification, laboratory confirmation, and multi-sectoral coordination to reduce morbidity and mortality rates.
more
The Strategy provides a high-level unifying framework to leverage existing capacities, address barriers and strengthen the use of genomic surveillance in the detection, monitoring and response to public health threats. Genomic surveillance is part o
...
f the broader surveillance and laboratory system, and its implementation should reinforce end-to-end capacities including sample collection, diagnostics, data sharing and analysis. The strategy aims to facilitate the connectivity between different disease control programs and surveillance networks. This interoperability will strengthen the cross-cutting essential public health laboratory functions underpinning genomics holistically. The strategy articulates the overarching goal, objectives and strategic actions needed. These are dependent on commitments from countries, partners and WHO for their implementation.
more
Guide to community engagement in WASH
recommended
A practioner's guide, based on lessons from Ebola.
This guide is a compilation of best practices and key lessons learned through Oxfam’s experience of community engagement during the 2014–15 Ebola response in Sierra Leone and Liberia. It aims to inform
...
public health practitioners and programme teams about the design and implementation of community-centred approaches
more
This document provides additional guidance for the responsible and prudent use of antimicrobials in food-producing animals, and should be read in conjunction with the Recommended International Code of Practice for Control of the Use of Veterinary Drugs CAC/RCP 38-1993. Its obj
...
ectives are to minimize the potential adverse impact on public health resulting from the use of antimicrobial agents in food-producing animals, in particular the development of antimicrobial resistance. It is also important to provide for the safe and effective use of veterinary antimicrobial drugs in veterinary medicine by maintaining their efficacy. This document defines the respective responsibilities of authorities and groups involved in the authorization, production, control, distribution and use of veterinary antimicrobials such as the national regulatory authorities, the veterinary pharmaceutical industry, veterinarians, distributors and producers of food-producing animals.
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Ending Cholera. A global roadmap to 2030
recommended
Ending Cholera—A Global Roadmap to 2030 operationalises the new global strategy for cholera control at the country level and provides a concrete path toward a world in which cholera is no longer a threat to public health
The report reviews progress with the task of planning and implementing measures necessary to secure a completely polio-free world. It also examines actions aimed at ensuring successful transfer of polio assets, innovations developed and lessons learned to countries’
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public health programmes and other global health priorities
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A Decision Makers Guide: Medical Planning and Response for a Nuclear Detonation
U.S. Department of Health & Human Services
(2017)
C1
Successful detonation of an improvised nuclear device (IND) would be a catastrophic event, causing an unprecedented number of injuries and lives lost, as well as economic, political, and social disruption. However, an effective medical response and an infrastructure prepared to protect itself from f
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allout could save tens of thousands of lives. Since 2001, all levels of government, academic institutions, and professional organizations have done significant work to enhance our ability to prepare for and respond to a nuclear detonation. The following manual is intended to simplify and translate the necessary protective actions and medical response modalities in order to make them more accessible and easier to translate into practice. The approach of this manual is to provide a common baseline application for various allied response disciplines (to include senior operational responders, emergency managers, public health advisors, and municipal, State, and Federal executives and elected officials). This manual will enhance mutual understanding of the basics of nuclear response.
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Disabled children: a legal handbook is an authoritative yet accessible guide to the legal rights of disabled children and their families in England and Wales. The handbook aims to empower disabled children and their families through a greater understanding of their rights and entitlements. It is es
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sential reading for the families of disabled children, their advocates and lawyers, voluntary and statutory sector advisers, commissioners, managers and lawyers working for public authorities, education, social and health care professionals, students and academics.
Each chapter has been adapted into a PDF for you to download for free
https://councilfordisabledchildren.org.uk/help-resources/resources/disabled-children-legal-handbook-2nd-edition
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In 2005, the World Health Organization (WHO) Member States adopted the revised International
Health Regulations (IHR) (2005). The Regulations provide a unique public health framework in the
form of obligations and reco
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mmendations that enable countries to better prevent, prepare for and
respond to public health events and emergencies of potential international concern, including chemical events.
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The recommendations in this guideline are intended to inform the development of relevant national- and local-level health policies and clinical protocols. Therefore, the target audience includes national and local public health policy-makers, implem
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enters and managers of maternal and child health programmes, health care facility managers, nongovernmental organizations (NGOs), professional societies involved in the planning and management of maternal and child health services, health care professionals (including nurses, midwives, general medical practitioners and obstetricians) and academic staff involved in training health care professionals.
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The strategic plan reflects shared commitments to enhance collaboration between environmental, animal (wildlife and domestic) and human health, and building new One Health workforce capacity through higher institutions of learning. The strategy also outlines interventions to be undertaken by governm
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ent institutions and other partners to enhance existing structures and pool together additional resources to prevent and control zoonotic diseases and other events of public health importance. Successful implementation of the strategy will contribute to the realization of vision 2020 by improving public health, food safety and security, and hence significantly improve the socioeconomic status of the people of Rwanda. It is in this regard that we call upon implementing institutions, bilateral and multilateral partners, civil society and the private sector to join us in implementing the One Health strategy in Rwanda.
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Overview: Risk communication and community engagement are essential for any disease outbreak response. This is particularly critical during outbreaks of Ebola which may create fear in the public and frontline responders alike due to severe presentat
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ion of symptoms, misunderstanding of the causes of illness and high fatality rates. This document outlines some of the key considerations for risk communication and community engagement response to Ebola outbreak in Democratic Republic of the Congo.
Ebola outbreaks have been associated with misinformation and false rumours. In the context of RCCE, rumours refer to unsubstantiated information, claims or beliefs about what is causing the disease or how it can be treated/cured. If not proactively addressed in culturally appropriate ways, misinformation and rumours can lead to the further rapid spread of the disease and unnecessary deaths, severe disease, suffering, and societal and economic loss.
The publication includes a 'Rumour Tracking Tool' (Annex II).
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