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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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Contributions of WHO to South Africa’s health agenda: evaluation of the Country Cooperation Strategy 2016-2020: abridged version

World Health Organization WHO (2022) C_WHO

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Let our Actions Count. South Africa's National Strategic Plan on HIV, TB and STIs 2017-2022.
recommended

South African National AIDS Council, et al. (2017) C1

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South Africa’s capacity to conduct antimicrobial stewardship

Chetty, S. Southern African Journal of Infectious Diseases (2021) CC

Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for anti... more

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Integrating mental health into South Africa’s health system: current status and way forward

Schneider, M.; E. Baron, E. Breuer, et al. (2016) CC

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“Complicit in Exclusion” South Africa’s Failure to Guarantee an Inclusive Education for Children with Disabilities

Human Rights Watch (2015) C2

This report from Human Rights Watch found that South Africa has failed to guarantee the right to education for many of the country’s children and young adults due to widespread discrimination against children with disabilities in enrollment decisions. Human Rights Watch research in five out of Sou... more

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Let our Actions Count. South Africa's National Strategic Plan on HIV, TB and STIs 2017-2022. Summary

South African National AIDS Council (2017) C1

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South Africa’s protracted struggle for equal distribution and equitable access – still not there

Hendrik CJ van Rensburg (2014) CC

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OAU Convention governing the specific aspects of refugee problems in Africa/La convention de l’OUA régissant les aspects propres aux problèmes des réfugiés en Afrique

Organization of African Unity (OAU) Organization of African Unity (OAU) (1969) CC2

The Organisation of African Unity (OAU) Convention Governing the Specific Aspects of Refugee Problems in Africa takes into account the unique aspects of the refugee situation on the African Continent. The 1951 Geneva Convention definition of refugees as "persons fleeing a well-founded fear of persec... more

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Return of the Rebel: Legacies of War and Reconstruction in West Africa’s Ebola Epidemic

Lind, J. and Ndebe, J. IDS (2015)

Practice Paper in Brief 19

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Congo, Forgotten: The Numbers Behind Africa’s Longest Humanitarian Crisis

Human Rights Watch, Congo Research Group - Groupe d’Étude sur le Congo (2019) CC

This report used the results of the Tracker’s first two years to examine the general trends of conflict in North and South Kivu, the main factors contributing to the violence, and the broader challenges for peacekeeping efforts.

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Pastoral care as a resource for development in the global healthcare context: Implications for Africa’s healthcare delivery system

Agbiji E., Agbiji O.M. AOSIS (2016) C1

HTS Teologiese Studies/Theological Studies ISSN: (Online) 2072-8050, (Print) 0259-9422

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Troca de Informacao Sobre Saude Diretrizes e padrões

Africa Center for Disease Control and Prevention (2023) CC

A aplicação da tecnologia digital de saúde está crescendo rapidamente na África, com o objetivo de melhorar a prestação de serviços de saúde e alcançar de forma mais eficaz comunidades remotas e carentes. A falta de diretrizes e padrões habilitadores em todo o continente, por outro ... more

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The Critical Role of Community Health Workers in COVID-19 Vaccine Roll Out
recommended

African Union; Africa CDC Centres for Disease Control and Prevention (2021) CC

Since the emergence of COVID 19 in December 2019, various public health responses measures have been implemented to control the pandemic. Among measures taken by the Africa CDC was the launch of PACT initiative to accelerate COVID 19 testing. Key to the initiative is the engagement of Community Heal... more

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Eswatini

Africa Center for Disease Control and Prevention (2023) CC

The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr... more

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Protecting Kids: Mpox Guidelines for Schools

Africa CDC (2024) C_CDC

The safety of children is a top concern for parents and school authorities in the current mpox outbreak, as those under 15 face elevated risks, particularly in the hardesthit Northwestern and Eastern regions of the Democratic Republic of the Congo.

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Certified African Regional professionals: Level 1 Biological Waste Management

Africa Center for Disease Control and Prevention (2023) CC

The Africa Centres for Disease Control and Prevention (Africa CDC) Biosafety and Biosecurity Initiative was launched by the Africa CDC in April 2019 with the aim of strengthening the African Union (AU) Member States’ biosafety and biosecurity systems and enabling them to comply with national and i... more

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Declaração sobre o Uso de Dexametasona nos Pacientes gravemente com Doenças da COVID-19

African Union; Africa CDC Centres for Disease Control and Prevention (2020) C1

Africa Centers for Disease Control and Prevention (Africa CDC) está ciente dos comunicados de imprensa sobre os resultados preliminares de um grande ensaio clínico aleatório realizado no Reino Unido, que incluía dexametasona, um corticosteróide, como um dos medicamentos utilizados para o tratam... more

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Asthma Action Plan

Allergy Foundation South Africa (2024) CC2

You can’t cure asthma. However, you can take steps to control the disease and prevent its symptoms. For example: -Learn about your asthma and ways to control it -Follow your written asthma action plan -Use medicines as your doctor prescribes (Here’s how to use your inhaler device) -Identif... more

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Nouveau coronavirus (2019-nCoV)

African Union; Africa CDC Centres for Disease Control and Prevention (Safeguarding Africa's Health) African Union; Africa CDC Centres for Disease Control and Prevention (Safeguarding Africa's Health) (2020) C2

Accessed: 02.04.2020

Let our Actions Count. South Africa's National Strategic Plan on HIV, TB and STIs 2017-2022. recommended

The Critical Role of Community Health Workers in COVID-19 Vaccine Roll Out recommended

Let our Actions Count. South Africa's National Strategic Plan on HIV, TB and STIs 2017-2022.
recommended

The Critical Role of Community Health Workers in COVID-19 Vaccine Roll Out
recommended