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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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Sierra Leone: Isolation Capacity

Government of Sierra Leone; World Health Organization (WHO) (2016) C_WHO

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Key messages for social mobilization and community engagement in intense transmission areas

World Health Organization (2014)

The messages should be used to inform, educate and engage different audience groups depending on their level of risk, vulnerability, presence in contact areas, care of patients with Ebola, or engagement or attendance of burials.

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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended

UN High Commissioner for Refugees UNHCR (2020) C2

The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from ... more

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Essential Health Services Package for UHC

Ministry of Health & Sanitation Sierra Leone (2022) CC

In Sierra Leone, Health care delivery is organized around a three-tier system i) primary level constituting peripheral health units (community health centers, community health posts, and maternal and child health posts secondary level constituting district hospitals tertiary level comprising region... more

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Christian Responses to Health and Development

German Institute for Medical Mission (2014) C2

In 1964 medical mission was challenged and called to define its distinctiveness and its special role in the context of that particular time. The consultation "Tuebingen I" clearly stated: "The Christian church has a specific task in the field of health and healing"1, and developed a conce... more

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Community-Centered Responses to Ebola in Urban Liberia: The View from Below

Sharon Alane Abramowitz, et al. (2014)

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Ebola Outbreak in West Africa: Impact on Health Service Utilisation in Sierra Leone

Assessment Capacities Project (2015)

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Soins cliniques pour les survivants de la maladie à virus Ebola: Guide provisoire
recommended

Organisation mondiale de la Santé (OMS) (2016) C_WHO

Ce document présente des recommandations sur les soins cliniques et le dépistage du virus chez les survivants de la maladie à virus Ebola. Il s'adresse principalement aux professionnels de santé qui dispensent des soins primaires aux personnes ayant survécu.
Table des matières
... more

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Health workforce development and retention in Guinea: a policy analysis post-Ebola

van de Pas R., Kolie D., Delamou A., Van Damme W. BMC - Biomed Central (2019) CC

The state of the Guinean health workforce is one of the country’s bottlenecks in advancing health outcomes. The impact of the 2014–2015 Ebola virus disease outbreak and resulting international attention has provided a policy window to invest in the workforce and reform the health system. This re... more

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Management of healthcare workers returning from Ebola-affected areas

European Centre for Disease Prevention and Control (2015) CC2

Infection prevention and control measures for Ebola virus disease

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Symptom- and Laboratory-Based Ebola Risk Scores to Differentiate Likely Ebola Infections

S. Oza, A.A. Sesay, N.J. Russel, et al. (2017) C_CDC

Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 23, No. 11, November 2017

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Infection Rates and Risk Factors for Infection Among Health Workers During Ebola and Marburg Virus Outbreaks: A Systematic Review

Saranya A, Selvaraj E Lee, Mason Harrell, et al. (2018) CC

The Journal of Infectious Diseases, jiy435, https://doi.org/10.1093/infdis/jiy435. Many outbreaks reported high proportions of infected HWs. Similar HW infection rates and exposure risk factors in both past and recent EVD and MVD outbreaks emphasize the need to improve the implementation of approp... more

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Investigation and public health management of people with possible Ebola virus disease infection

European Centre for Disease Prevention and Control ECDC (2019) C1

This document aims to provide guidance to EU/EEA public health authorities, public health professionals and healthcare practitioners for the management of persons having had contact with cases of Ebola virus disease (EVD) after visiting or working in an area that is affected by EVD; also covered is ... more

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Sierra Leone: Report on the Training of Nurses on the Prevention and Care of Viral Haemorrhagic Fevers Diseases

SIERRA LEONE NURSES ASSOCIATION (2014) C1

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Health workers’ experiences of coping with the Ebola epidemic in Sierra Leone’s health system: a qualitative study

Joanna Raven, H. Wurie and S. Witter BMC Health Services Research (2018) CC

BMC Health Services Research BMC series – open, inclusive and trusted201818:251; https://doi.org/10.1186/s12913-018-3072-3

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Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings

Centers of Disease Control CDC (2014)

CDC has developed this slide set for use by staff development, infection control, and occupational health personnel for training healthcare personnel on how to select and use personal protective equipment PPE to protect themselves from exposure to microbiological hazards in the healthcare setting

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COVID-19 Infection Prevention and Control: Your Questions Answered
recommended

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

In the strategies for effective infection prevention and control (IPC), what does triage entail at hospitals? Triage includes screening at the entrance, identification of cases and isolation if necessary. There should be a triage (screening) area where visitors to the hospital are interviewed using... more

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Infection Control outside the VHF Treatment Facility

MSF (2008)

This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requirements for infection control and supporting activi... more

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Clinical management of patients with viral haemorrhagic fever. A pocket guide for the front-line health worker
recommended

World Health Organization, Regional Office for Africa; (2016) C_WHO

The purpose of this pocketbook is to provide clear guidance on current best management practices for VHF across health-care facilities

Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings recommended

Soins cliniques pour les survivants de la maladie à virus Ebola: Guide provisoire recommended

COVID-19 Infection Prevention and Control: Your Questions Answered recommended

Clinical management of patients with viral haemorrhagic fever. A pocket guide for the front-line health worker recommended

Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended

Soins cliniques pour les survivants de la maladie à virus Ebola: Guide provisoire
recommended

COVID-19 Infection Prevention and Control: Your Questions Answered
recommended

Clinical management of patients with viral haemorrhagic fever. A pocket guide for the front-line health worker
recommended