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.
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The report offers an overview of the progress the humanitarian sector has made and the obstacles it has faced over the past 10 years. Accountability is no longer just a fashionable term, there is now a shared understanding of what it takes to be accountable. From changes at policy level, to concrete... actions taken in the field, this report documents this sector-wide shift. It also shows that being accountable to the people we aim to serve is not just the right thing to do, it is also the best way to ensure programmes are relevant, effective, efficient and sustainable
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These Guidelines comprise a General Guidelines document that provides the basic parameters of DG ECHO humanitarian health assistance, complemented by specific Technical Guidance in annex.
COVID-19 has triggered the deepest global recession since the 1930s. Extreme poverty has risen for the first time in 22 years, and unemployment has increased dramatically. Women and young people aged 15 – 29 working in the informal sector are being hit the hardest. School closures have affected 91... per cent of students worldwide.
Political conflicts are more intense and taking a heavy toll on civilians, disproportionately affecting children. Women and girls are at increased risk of conflict-related sexual violence. Attacks against aid and health workers persist. For the ninth consecutive year, more than 90 per cent of casualties from explosive weapons in populated areas were civilians.
The last decade saw the highest-ever number of people internally displaced by conflict and violence, with many locked in a state of protracted displacement. There are an estimated 51 million new and existing IDPs, and the number of refugees has doubled to 20 million.
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In 2021, the Covid-19 pandemic continued to overlay other pre-existing and emerging crisis risks, driving need and complicating response. Following the rapid rise in demand for humanitarian assistance in 2020, needs remained at historically high levels in 2021. Growth in the volume of total internat...ional humanitarian assistance has stalled, with only slightly more provided in 2021 than in 2018.with the global economy under significant strain and donor governments facing increasing domestic costs, global aid is projected to decline further and faster.
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COVID-19 has triggered the deepest global recession since the 1930s. Extreme poverty has risen for the first time in 22 years, and unemployment has increased dramatically. Women and young people aged 15 – 29 working in the informal sector are being hit the hardest. School closures have affected 91... per cent of students worldwide.
Political conflicts are more intense and taking a heavy toll on civilians, disproportionately affecting children. Women and girls are at increased risk of conflict-related sexual violence. Attacks against aid and health workers persist. For the ninth consecutive year, more than 90 per cent of casualties from explosive weapons in populated areas were civilians.
The last decade saw the highest-ever number of people internally displaced by conflict and violence, with many locked in a state of protracted displacement. There are an estimated 51 million new and existing IDPs, and the number of refugees has doubled to 20 million.
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Updated 8 June 2021. Coronavirus is spreading globally. How can individuals, communities, humanitarian actors, local and national authorities best respond to uphold the rights of all affected people?
This edition of UNICEF’s annual Humanitarian Action for Children highlights UNICEF’s funding appeal, which sets out an ambitious agenda to address the major challenges facing children and young people living through conflict and crisis. It presents the investments needed in 2021 to save their li...ves and protect their futures.
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Examining the needs of at‐risk youth in the Middle East and North Africa: A multi‐method landscape analysis and systematic literature review
In 2022, humanitarian action will need to adapt to new and challenging realities. The COVID-19 pandemic is taking a heavy toll in developing countries, civilians continue to be the most affected by conflict and extreme poverty is rising. Climate change effects are devastating, forced displacement is... at record levels and 161 million people face acute food insecurity.
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Despite the stated centrality of protection in humanitarian action and a growing attention to protection activities, the evaluation of protection has received relatively little attention. This pilot guide seeks to fill this gap, providing insights and guidance to those evaluating protection in the c...ontext of humanitarian action
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The report offers an analysis of the broader challenges to securing humanitarian action and recommends areas for improvement. This study will contribute to improving the way humanitarians ‘do business’ in complex security environments.
Humanitarian Charter and Minimum Standards in Humanitarian Response.
The 2018 Sphere Handbook builds on the latest developments and learning in the humanitarian sector. Among the improvements of the new edition, readers will find a stronger focus on the role of local authorities and communities as ...actors of their own recovery. Guidance on context analysis to apply the standards has also been strengthened. New standards have also been developed, informed by recent practice and learning, such as WASH and healthcare settings in disease outbreaks, security of tenure in shelter and settlement, and palliative care in health. Different ways to deliver or enable assistance, including cash-based assistance, are also integrated into the Handbook.
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Conceived as part of the CWS-A/P project on regional security and risk management, this book presents a
collection of testimonies from aid workers in some of the most insecure and volatile environments in the world.
The participants recount a broad array of security incidents, such as kidnappings,... suicide bombings, mob
violence, road ambushes, and point-blank range shootings. Their narrative provides valuable information on
how organizations can manage security risks and streamline safety policies.
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The CHS is a voluntary and measurable standard, which means its application can be objectively assessed. The CHS Verification Scheme allows organisations to measure the extent to which they have successfully applied the CHS requirements, and allows them, to demonstrate that they have done so. The Sc...heme offers four verification options; although each option is stand alone, the indicators used in the self-assessment are common to all options.
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Annex I to: To stay and deliver, good practice for humanitarians in complex security environments
The principal findings of the report include that despite overall improvements in aid agencies’ security risk management, national aid workers perceive continued inequities in security suppor...t compared with their international counterparts. National aid workers, while less subject to major attacks per capita than international aid workers, nevertheless form the majority of victims, and their specific security needs require more attention.
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This paper aims to contribute to the reflection on effective practices to address protracted displacement, in support of the GP20 Plan of Action roll-out. It expands on the research conducted by Walter Kälin and Hannah Entwisle Chapuisat for the 2017 OCHA-commissioned study Breaking the Impasse: Re...ducing Protracted Internal Displacement as a Collective Outcome.1 That study provided a comprehensive picture of the impact of protracted internal displacement, as well as five country case studies in contexts of conflict and disasters.It also offered a road map for addressing such displacement through seven steps, including conducting joint analysis and defining collective outcomes.
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