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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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Plan Strategique National de Lutte contre le Paludisme 2020-2023 - République de Congo

Programme National de Lutte contre le Paludisme (PNLP) Ministère de la Santé Publique, Hygiène et Prévention – République Démocratique du Congo (2023) C2

Le Plan Stratégique National de Lutte contre le Paludisme de la RDC vise à renforcer la communication pour le changement social et comportemental (CSC/CCC) dans la lutte contre le paludisme. Il a pour objectif d’améliorer les connaissances, attitudes et pratiques des populations pour encourager... more

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Continuidad de los servicios de salud esenciales: herramienta de evaluación de los centros
recommended

Organización Mundial de la Salud OMS (2021) C_WHO

módulo del conjunto de evaluaciones de la capacidad de los servicios de salud en el contexto de la pandemia de COVID-19: orientaciones provisionales, 12 de mayo de 2021; La herramienta de evaluación de la continuidad de los servicios sanitarios esenciales: Herramienta de evaluación de instalacion... more

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Global disparities in arrhythmia care: Mind the gap

Sharif, Z.; Ptaszek, L.M. Heart Rhythm O2 (2022) CC

Delivery of comprehensive arrhythmia care requires the simultaneous presence of many resources. These include complex hospital infrastructure, expensive implantable equipment, and expert personnel. In many low- and middle-income countries (LMICs), at least 1 of these components is often missing, res... more

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Tropical Medicine Point-of-Care Testing. Update 2022
recommended

Cheesbrough, M. THT Books (2022) C1

To meet the need for laboratory diagnosis to be integrated in community care, the new 2022 Update describes point-of-care tests that can be performed both in district laboratories and peripheral healthcare facilities by non-specialist staff. Also included are recently developed self-tests.

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Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19
recommended

African Union; Africa CDC Centres for Disease Control and Prevention; AMREF; ASLM; et al. (2021) CC

ASLM in collaboration with the Africa Centres for Disease Control and Prevention, and in partnership with the Clinton Health Access Initiative, Amref and Last Mile Health present the Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19. This framework aims to pr... more

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Tests diagnostiques pour le dépistage du SARS-CoV-2 : orientations provisoires, 11 septembre 2020

World Health Organization WHO (2020) C_WHO

Available in Arabic, Chinese, English, French, Portuguese, Russian and Spanish https://apps.who.int/iris/handle/10665/334254

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Cameroon: ASSURER UN TRAITEMENT APPROPRIE DU PALUDISME SIMPLE: PROGRAMME DE FORMATION POUR LE PERSONNEL DE SANTE

REACT Cameroun (2010) CC

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Quality assurance workbook for radiographers and radiological technologists

Lloyd, Peter J. (2001)

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Digital Health Technologies, Virtual Care and Community-Based Monitoring Solutions for TB Programmes

Stop TB Partnership; WHO (2021) C_WHO

Information note

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Guidance on pooled testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
recommended

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

The purpose of this document is to provide guidance on the use of pooled sample testing strategy in coronavirus disease (COVID-19) testing laboratories of the African Union Member States for scaling up SARS-CoV-2 nucleic acid testing capacity with the available resources. The current document descr... more

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Collection of Dried Blood Spots (DBS) from Infants for PCR Testing

Centers for Disease Control and Prevention (CDC) (2018) C1

This clinical job aid provides health care workers with information on how to collect specimens for early infant diagnosis on dried blood spots, as well as drying and packaging for transport.

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Laboratory biosafety manual
recommended

World Health Organization WHO WHO (2020) C_WHO

4th edition The WHO Laboratory Biosafety Manual (LBM) has been in broad use at all levels of clinical and public health laboratories, and other biomedical sectors globally, serving as a de facto global standard that presents best practices and sets trends in biosafety. LBM encouraged countries t... more

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Basic malaria microscopy. Part 1: Learner's guide
recommended

World Health Organization (2020) C_WHO

second edition

External Link

Tuberkulosescreening bei asylsuchenden Kindern und Jugendlichen < 15 Jahren in Deutschland. Stellungnahme

Robert-Koch-Institut RKI (2015) C1

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Guide des techniques de prélèvement d’échantillons pour la confirmation en laboratoire de l’infection à Mycobacterium ulcerans (‎ulcère de Buruli)‎

Organisation Mondiale de la Santé OMS (2008) C_WHO

Guide de techniques

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Priorities for Tuberculosis Bacteriology Services in Low-Income Countries International Union

Hans L. Rieder, Armand Van Deun, Kai Man Kam, Sang Jae Kim, T. Martin Chonde, Arnaud Trébucq, Richard Urbanczik International Union Against Tuberculosis and Lung Disease (2007) CC

Second Edition

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Malaria Profile Nepal 2016

World Health Organization WHO (2016) C_WHO

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National Guidelines for Diagnosis and Treatment of Malaria

Ministry of Health and Social Welfare, The United Republic of Tanzania (2006) C1

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Technical Guide: Sputum Examination for Tuberculosis by Direct Microscopy in Low-Income Countries

International Union Against Tuberculosis and Lung Disease (2000) C1

A technical guide for sputum smear microscopy, initiated by the International Union against Tuberculosis, is designed to be an easy to use reference standard for the collection, storage and transport of sputum specimens and for the examination of sputum smears by direct microscopy. This edition incl... more

Continuidad de los servicios de salud esenciales: herramienta de evaluación de los centros recommended

Tropical Medicine Point-of-Care Testing. Update 2022 recommended

Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19 recommended

Guidance on pooled testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recommended

Laboratory biosafety manual recommended

Basic malaria microscopy. Part 1: Learner's guide recommended