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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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Policy for Improving Mental Health

World Health Organisation (WHO) (2023) C_WHO

This document presents a policy to guide and support Member States of the Pan American Health Organization (PAHO) and the Pan American Sanitary Bureau (PASB) in their technical cooperation to improve mental health as a priority for advancing health, social, and economic development in the Region in ... more

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Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015

Global Burden of Disease Health Financing Collaborator Network Lancet (2018) CC

Background: Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved e... more

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WHO framework for meaningful engagement of people living with noncommunicable diseases, and mental health and neurological conditions

World Health Organisation (WHO) (2023) C_WHO

The overall objective of the framework is to support WHO and Members States in meaningful engagement of people living with NCDs, and mental health and neurological conditions to co-create and enhance related policies, programmes and services. This framework will contribute to advancing understanding... more

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The Planetary Health Diet in Theory and Practice

Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) (2019) CC

On the global scale, the impacts of the current food system on the environment are severe. The agro-industrial revolution has made it possible to increase food production at a price.

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Red and processed meat in the context of health and the environment: many shades of red and green: information brief

World Health Organisation (WHO) (2023) C_WHO

There is growing international consensus that food systems transformation is important to address the challenges of malnutrition in all its forms, the burden of noncommunicable diseases (NCDs), environmental sustainability, increasing inequality and ensuring the welfare of workers and animals. In li... more

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Three models of community mental health services In low-income countries

A. Cohen, J. Eaton, B. Radtke, et al. (2011) CC

International Journal of Mental Health Systems December 2011, 5:3 Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse serv... more

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COP24 special report: health and climate change
recommended

World Health Organization WHO WHO (2018) C_WHO

Exposure to air pollution causes 7 million deaths worldwide every year and costs an estimated US$ 5.11 trillion in welfare losses globally. In the 15 countries that emit the most greenhouse gas emissions, the health impacts of air pollution are estimated to cost more than 4% of their GDP. Actions to... more

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Achieving Health Equity in Contested Areas of Southeast Myanmar

Davis, Bill; Jolliffe, Kim The Asia Foundation (2016) C1

In many of Myanmar’s contested regions, healthcare services are provided through two parallel governance systems – by the government’s Ministry of Health, and by providers linked to ethnic armed organizations. Building upon efforts to build trust between these two actors following ceasefires s... more

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Lessons from case studies of integrating mentalhealth into primary health care in South Africa and Uganda

Petersen, I.; et al. (2011) CC

Petersenet al.International Journal of Mental Health Systems2011,5:8http://www.ijmhs.com/content/5/1/8

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Mental Health and Integration in Asia Pacific

Chee H. Ng (2018) CC

This brief report examines the extent to which community-based treatment and integration support are provided for people living with mental illness across 15 selected Asia-Pacific economies. Some of the key findings are discussed in light of the diversity of economies and cultural contexts. BJPSYCH... more

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Toolkit for implementation of the WHO intrapartum care and immediate postnatal care recommendations in health-care facilities

World Health Organization WHO (2023) C_WHO

This toolkit was developed to provide detailed information and resources to support implementation of the WHO intrapartum and immediate postnatal care recommendations at the health-care facility level. The careful design of this toolkit is based on a rigorous evidence-based approach that includes im... more

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Briefing note on addressing mental health and psychosocial aspects of COVID-19 Outbreak- Version 1.1
recommended

Inter-Agency Standing Committee IASC (2020) CC

This briefing note summarises key mental health and psychosocial support (MHPSS) considerations in relation to the 2019 novel coronavirus (COVID-19) outbreak.

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Building Back Better: Sustainable Mental Health Care After Emergencies

World Health Organization (WHO) (2013) C_WHO

Emergencies, in spite of their tragic nature and adverse effects on mental health, are unparalleled opportunities to build better mental health systems for all people in need. This WHO publication shows how this was done in 10 diverse emergency-affected areas

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Infection Control Assessment Tool for Primary Health Care Facilities

SIAPS USAID (2013) C1

Nosocomial or health-facility-acquired infections are a serious issue, representing one of the most significant causes of morbidity and mortality in healthcare systems and consuming many scarce resources, especially in developing countries. Although much has been done, particularly in the hospital s... more

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Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana

Kallam, B.; C. Pettitt-Schieber, M. Owen, et al. (2019) CC

International Journal for Quality in Health Care, 2018, 30(9), 724–730 Promoting hand hygiene in a neonatal intensive care unit.

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Sierra Leone Health Facility Survey 2014

UNICEF (2014) C1

Assessing the impact of the EVD outbreak on health systems in Sierra Leone. Survey concluded 6-17 October 2014

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Establishing a national laboratory quality system for HIV diagnosis and monitoring in resource-limited settings: Experience from Senegal

Mbengue M.A.S., Moussa S., Papa A. D. et. al. African Journal of Laboratory Medicine (2016) C2

Senegal has adopted the World Health Organization–Joint United Nations Programme on HIV/AIDS recommended 90-90-90 targets.5 The adoption of this strategy means that the country is expected, by 2020, to have 90% of its population living with HIV diagnosed, 90% of all those diagnosed receiving susta... more

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Global Health Education Competencies Tool-Kit

Astle. B.; C.A.Faerron-Guzman; A. Landry, et al. Consortium for Universities for Global Health (2018) CC

2nd edition. The tool kit provides learning objects and curricular content to support the competencies for those proficiency/trainee levels

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Developing health centres and hospital s indices for Syria, based on HeRAMS dataset 2014

World Health Organization (2017) C_WHO

This research paper uses the Health Resources and services Availability Mapping System (HeRAMS) database to develop two composite indices – one for health centres and one for hospitals – in order to analyse and assess the health facilities’ performance across time and to evaluate the di... more

COP24 special report: health and climate change recommended

Briefing note on addressing mental health and psychosocial aspects of COVID-19 Outbreak- Version 1.1 recommended

COP24 special report: health and climate change
recommended

Briefing note on addressing mental health and psychosocial aspects of COVID-19 Outbreak- Version 1.1
recommended