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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Bull World Health Organ 2022;100:50–59 | doi: http://dx.doi.org/10.2471/BLT.21.286689
Review
Drake AL et al. Journal of the International AIDS Society 2019, 22:e25271 http://onlinelibrary.wiley.com/doi/10.1002/jia2.25271/full | https://doi.org/10.1002/jia2.25271
Driving progress towards rabies elimination: Results of Gavi’s Learning Agenda on rabies and new WHO position on rabies immunization
Burkina Faso has approximately 10.5 million inhabitants and is divided into 30 provinces. The study took place in the districts of Tougan, Nouna, and Solenzo, in provinces Sourou and Kossi, in north-west Burkina Faso. There is one medical centre in every district capital and 6 to 14 health centres i...n the surrounding villages. Each health centre covers a population of 10 000 to 15 000. The staff of one health centre generally consists of one nurse, a nurse aid and a midwife as well as one drug vendor for the nearby village pharmacy. The health personnel are trained and paid by the state.
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From policy to practice: how the TB-HIV response is working
“The HIV community must place much more focus on TB co-infection than
it has done to date. TB takes the lives of over 1000 people living with HIV
every day, a number which is absolutely unacceptable. This report highlights that
TB d...oesn’t have to be a death sentence for people living with HIV, but we need
more action. By joining forces, the HIV and TB community can finally give this
deadly issue the attention it deserves.”
– Mike Podmore, Director STOPAIDS
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The objectives of the meeting were to agree on coordinated and aligned support to the 3 countries’ national health recovery plans (Guinea, Liberia, Sierra Leone); to identify cross-cutting areas and opportunities for integration; to identify ways to improve implementation modalities; and to identi...fy actions including technical assistance needed to support the countries in the process of building resilient health systems.
The outcomes of the meeting consisted in proposed country action plans to move forward with the implementation of the recovery plans. The action plans includes:priorities and areas of work; activities needed to improve implementation modalities; technical assistance needs.
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16-17 march 2015, Geneva, Switzerland
Meeting report
Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
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A public health emergency operation center (PHEOC) serves as a hub for better coordinating the preparation, response, and recovery for public health emergencies. A functional PHEOC is critical for the implementation of the International Health Regulations (IHR 2005). The Framework for a Public Healt...h Emergency Operations Centre provides high-level guidance for establishing or strengthening a PHEOC. To establish and/or strengthen a PHEOC, it is vital for Member States to align with standardized policies, guidelines, and tools.
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This publication aims to provide examples of better palliative care practices for older people to help those involved in planning and supporting care-oriented services most appropriately and effectively. Examples have been identifi ed from literature searches and from an international call... for examples through various organizations, including the European Association of Palliative Care and the European Union Geriatric Medicine Society. Some examples consider how to improve aspects within the whole health system; specifi c smaller examples consider how to improve palliative care education, support in the community, in hospitals or for specifi c groups of people, such as people in nursing homes and people with dementia and their families. Some examples await rigorous evaluation of effectiveness, and more research is needed in this fi eld, especially the cost–effectiveness and generalizability of these initiatives.
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Relevance and effectiveness of World Bank support for public sector capacity building in Sub-Saharan Africa from 1995 to 2004. Benin is part of a six country case study.
Report of Meeting: 4 November 2014, Roma
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...ess the emergency.
MAAP reviewed 819,584 AMR records from 2016-2019, from 205 laboratories across Burkina Faso, Cameroon, Eswatini, Gabon, Ghana, Kenya, Malawi, Nigeria, Senegal, Sierra Leone, Tanzania, Uganda, Zambia, and Zimbabwe. MAAP also reviewed data from 327 hospital and community pharmacies and 16 national-level AMC datasets.
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