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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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Burkina Faso Report to the Global Board (October 2012)

The Hunger Project (2012) C2

Over the reporting period, THP-Burkina Faso (THP-Burkina) maintained a continuous focus on ensuring the selfreliance of the health program in each of its epicenters. Building upon its exclusive use of government-run health clinics at its epicenters, THP-Burkina developed a firstever partnership agre... more

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Northeast Nigeria Health Sector - Humanitarian Response Strategy 2025 - 2027 (December 2024)

Government of Nigeria; Health Cluster; World Health Organization WHO (2024) CC

The protracted humanitarian situation in northeastern Nigeria, particularly in Borno, Adamawa, and Yobe (BAY) States, remains a concern due to ongoing insecurity, displacement, food insecurity, disease outbreaks, and climate-related shocks. To address these complex challenges, the health sector has ...developed a comprehensive humanitarian response strategy aligned with the three States Development plans, Durable Solutions for the Population Displacement Plan, and the Humanitarian Need Response Plan for 2025. This strategy aims to reduce morbidity and mortality among crisisaffected populations by ensuring timely, equitable, and effective delivery of lifesaving health services, while strengthen the resilience of health system and enhancing local and national capacities for sustainable health response in protracted emergency. Supported by an in-depth analysis of the ongoing health humanitarian response using the Strengths, Weaknesses, Opportunities, and Threats (SWOT) methodology, the strategy is guided by three key objectives: 1. Provide access to lifesaving interventions and sustain an effective response to the prolonged health emergency. 2. Prevent, mitigate, and prepare for health risks from all hazards and respond to all health emergencies. 3. Advance the primary health care approach and essential health system capacities for universal health coverage. To achieve these objectives, the strategy employs the “Five C” framework which refers to: • Collaborative Surveillance: Enhancing collaborative efforts for effective monitoring. • Community Protection: Implementing community-based protection measures. • Safe and Scalable Care: Ensuring care that is both secure and scalable. • Access to Countermeasures: Facilitating access to necessary countermeasures. • Emergency Coordination: Coordinating emergency responses efficiently. These proactive approaches are designed to be more anticipatory and preemptive rather than reactive, aiming to meet the needs of the crisis-affected population by providing lifesaving interventions, enhancing preventive and anticipatory actions, and ensuring the resilience of the health system. All actions are guided by International Humanitarian Standards and the Humanitarian Principles. The implementation of the health humanitarian response strategy will involve collaboration with local authorities, non-governmental organizations (NGOs), and international organizations. The strategy emphasizes localization and resource mobilization, efficient logistics and supply chain management, mainstreaming protection, and the deployment and training of healthcare workers. Continuous monitoring and periodic evaluation will ensure the effectiveness of the response. Cross-sector collaboration with sectors such as WASH, Nutrition, Education, and Protection will be crucial to enhance the quality and reach of health interventions. Additionally, sustainability and transition approaches will ensure long-term health outcomes and benefits, bridging the gap from humanitarian to development efforts. By adopting this comprehensive approach, the humanitarian response in northeastern Nigeria, particularly in BAY States, can be effectively guided, ultimately reducing the suffering of affected populations. more

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Influencing food environments for healthy diets

Food and Agriculture Organization of the United Nations FAO (2016) C2

Food environments are usually defined as the settings with all the different types of food made available and accessible to people as they go about their daily lives. That is, the range of food in supermarkets, small retail outlets, wet markets, street food stalls, coffee shops, tea houses, s...chool canteens, restaurants, and all the other venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing, marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems and food environments are challenged in supporting consumer choices that are consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges. more

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Survey on human resource capacity in public health - Supply chain management in Burkina Faso

Bioforce Development Institute – Burkina Faso Country Survey (2011) C2

This survey is part of a series of eight country surveys conducted in the context of the People that Deliver Initiative (peoplethatdeliver.org). This global initiative, which brings together the world’s largest organizations, aims to improve health services performance through the professionalizat... 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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Benin: Rapid Assessment of Sexual and Reproductive Health and HIV Linkages

IPPF, UNFPA, WHO, UNAIDS (2011) C2

This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and The tool – developed by IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives in 2009 – supports national assessments of the bi-directional linkages between sexu... more

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Botswana: Rapid Assessment of Sexual and Reproductive Health and HIV Linkages

IPPF, UNFPA, WHO, UNAIDS (2011) C2

This summary highlights the experiences, results and actions from the implementation of the Rapid Assessment Tool for Sexual and Reproductive Health and HIV Linkages in Botswana. The tool – developed by IPPF, UNFPA, WHO, UNAIDS, GNP+, ICW and Young Positives in 2009 – supports national assessmen... more

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An Advocate’s Guide: Strategic Indicators for Universal Access to Sexual and Reproductive Health and Rights
recommended

TK Sundari Ravindran Asian-Pacific Resource & Research C0entre for Women (ARROW) (2015) C1

This guide was prepared to enable advocates to use data when advocating for universal access to SRHR at the national, regional and global levels. It is a direct outcome of the Strategic SRHR Indicators workshop held in Kuala Lumpur, Malaysia on 21-22 August for the project “Strengthening the N... more

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COVID-19 and Human Development: Exploring global preparedness and vulnerability

reliefweb (2020) C2

The United Nations Development Programme (UNDP) today released two new data dashboards that highlight the huge disparities in countries’ abilities to cope with and recover from the COVID-19 crisis. The pandemic is more than a global health emergency. It is a systemic human development crisis, a... more

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A Checklist for Implementing Rural Pathways to Train, Develop and Support Health Workers in Low and Middle-Income Countries

O'Sullivan, B.; et al. (2020) CC

Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin... more

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World Bank Group Approach and Action Plan for Climate Change and Health

World Bank Group (2017) C1

Climate change (CC) impacts on health outcomes, both direct and indirect, are sufficient to jeopardize achieving the World Bank Group’s visions and agendas in poverty reduction, population resilience, and health, nutrition and population (HNP). In the last 5 years, the number of voices calling for... more

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When the Drugs Don’t Work – Antibiotic Resistance as a Global Development Problem

The Dag Hammarskjöld Foundation and ReAct (2019) C2

This paper focuses on the Sustainable Development Goals related to poverty, economic growth, inequality, health, food production and the environment. It presents concrete examples of the underlying and complex aspects of antibiotic resistance and its impacts across different Sustainable Development ... more

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Training Manual: Climate and Health

International Federation of Medical Students’ Associations (IFMSA) (2016) C1

The project was developed by the International Federation of Medical Students’ Associations (IFMSA), in line with the Federation’s statement “a world in which students are equipped with knowledge, skills and value to take on health leadership roles locally and globally so to... 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 health systems and poor infrastructure. Low-carbon appro... more

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Operational Guidance Mental Health & Psychosocial Support Programming for Refugee Operations

UN High Commissioner for Refugees UNHCR (2013) C1

This operational guidance on MHPSS provides a practical orientation and tools for UNHCR country operations. It covers specific points of good practice to consider when developing MHPSS programming and offers advice on priority issues and practical difficulties, while also providing some background i... more

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Caring for Child Survivors of Sexual Abuse: Guidelines for health and psychosocial service providers in humanitarian settings (First Edition)
recommended

Erikson, Abigail IRC, International Rescue Committee (2012) C2

The International Rescue Committee (IRC) and the United Nations Children’s Fund (UNICEF) have newly developed "Caring for Child Survivors of Sexual Abuse Guidelines" for health and psychosocial providers in humanitarian settings - “CCS Guidelines”. The CCS Guidelines are based on global resear... more

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An EAPC white paper on multi-disciplinary education for spiritual care in palliative care

Megan Best, Carlo Leget, Andrew Goodhead and Piret Paal BMC Palliative Care (2020) CC

The EAPC White Paper addresses the issue of spiritual care education for all palliative care professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and educati... more

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Taking Stock: Sexual and Reproductive Health and Rights in Climate Commitments - an East and Southern Africa Review

UNFPA (2024) CC

Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres... more

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IASC Reference Group Mental Health and Psychosocial Support Assessment Guide

Inter-Agency Standing Committee IASC (2012) C1

The purpose of this document is to provide agencies with a guide with three tools containing key assessment questions that are of common relevance to all actors involved in Mental Health and Psychosocial Support (MHPSS) independent of the phase of the emergency. This guide will be useful for rapid a... more

An Advocate’s Guide: Strategic Indicators for Universal Access to Sexual and Reproductive Health and Rights recommended

Caring for Child Survivors of Sexual Abuse: Guidelines for health and psychosocial service providers in humanitarian settings (First Edition) recommended

An Advocate’s Guide: Strategic Indicators for Universal Access to Sexual and Reproductive Health and Rights
recommended

Caring for Child Survivors of Sexual Abuse: Guidelines for health and psychosocial service providers in humanitarian settings (First Edition)
recommended