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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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Government Health Spending Outlook - Projections Through 2029: Diverging Fiscal Pressures, Uneven Constraints

The International Bank for Reconstruction and Development The World Bank (2024) CC

This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (SDGs). The findings reveal wide disparities in gove... more

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National spending on health by source for 184 countries between 2013 and 2040

Dieleman, J.; Templin, T.; Sadat, N. et al. (2016) CC

A general consensus exists that as a country develops economically, health spending per capita rises and the share of that spending that is prepaid through government or private mechanisms also rises. However, the speed and magnitude of these changes vary substantially across countries, even at simi...lar levels of development. In this study, we use past trends and relationships to estimate future health spending, disaggregated by the source of those funds, to identify the financing trajectories that are likely to occur if current policies and trajectories evolve as expected. Methods We extracted data from WHO's Health Spending Observatory and the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report. We converted these data to a common purchasing power-adjusted and inflation-adjusted currency. We used a series of ensemble models and observed empirical norms to estimate future government out-of-pocket private prepaid health spending and development assistance for health. We aggregated each country's estimates to generate total health spending from 2013 to 2040 for 184 countries. We compared these estimates with each other and internationally recognised benchmarks. Findings Global spending on health is expected to increase from US$7·83 trillion in 2013 to $18·28 (uncertainty interval 14·42–22·24) trillion in 2040 (in 2010 purchasing power parity-adjusted dollars). We expect per-capita health spending to increase annually by 2·7% (1·9–3·4) in high-income countries, 3·4% (2·4–4·2) in upper-middle-income countries, 3·0% (2·3–3·6) in lower-middle-income countries, and 2·4% (1·6–3·1) in low-income countries. Given the gaps in current health spending, these rates provide no evidence of increasing parity in health spending. In 1995 and 2015, low-income countries spent $0·03 for every dollar spent in high-income countries, even after adjusting for purchasing power, and the same is projected for 2040. Most importantly, health spending in many low-income countries is expected to remain low. Estimates suggest that, by 2040, only one (3%) of 34 low-income countries and 36 (37%) of 98 middle-income countries will reach the Chatham House goal of 5% of gross domestic product consisting of government health spending. Interpretation Despite remarkable health gains, past health financing trends and relationships suggest that many low-income and lower-middle-income countries will not meet internationally set health spending targets and that spending gaps between low-income and high-income countries are unlikely to narrow unless substantive policy interventions occur. Although gains in health system efficiency can be used to make progress, current trends suggest that meaningful increases in health system resources will require concerted action. Funding Bill & Melinda Gates Foundation. more

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Guía de profilaxis Antibiótica Quirúrgica

La Sociedad Argentina de Infectología S.A.D.I. (2017) C2

Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing... more

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Control, interrupción de la transmisión y eliminación de la enfermedad de Chagas como problema de salud pública. Guía de evaluación, verificación y validación

Organización Panamericana de la Salud OPS (2019) C_WHO

La enfermedad de Chagas, también llamada tripanosomiasis americana, sigue siendo endémica en 21 países de América Latina. Sin embargo, como consecuencia de las migraciones, la urbanización, la intensificación del turismo, la modificación de las estrategias agrícolas y el cambio climático, l...a enfermedad ha traspasado el marco rural y el ámbito latinoamericano que le dieron identidad durante decenios, y ha logrado instalarse en la periferia de las ciudades del área endémica y en países de América del Norte, Europa, Asia y Oceanía y transformarse en un problema de salud pública global. Teniendo en cuenta que el Chagas afecta a poblaciones en situación de pobreza en las que produce graves consecuencias para la salud y la economía de las personas infectadas, y que los recursos orientados a fomentar el desarrollo de proyectos de investigación, estrategias de control y planes de atención médica a los pacientes detectados son escasos, la Organización Mundial de la Salud (OMS) incorporó esta enfermedad al grupo de enfermedades infecciosas desatendidas (EID) en el año 2005. Se reconoce actualmente la naturaleza multidimensional de la enfermedad de Chagas, cuya caracterización contempla una intrincada trama de aspectos socioculturales, políticos, biológicos, ambientales y sanitarios. Parte sustancial de todo ello radica en el carácter zoonótico de la endemia y la consiguiente imposibilidad de su erradicación. Por ende, resulta muy complicada la construcción de la ruta crítica para enfrentar esta enfermedad, con la aspiración o el objetivo de su eliminación como problema de salud pública. El propósito de esta guía es ofrecer a los Estados Miembros un instrumento que permita actualizar y estandarizar los procesos de evaluación del control, verificación de la interrupción de la transmisión, y validación de la eliminación de la enfermedad de Chagas como problema de salud pública, en consonancia con: a) la Estrategia y plan de acción para la prevención, el control y la atención de la enfermedad de Chagas; b) el Plan de acción para la eliminación de las enfermedades infecciosas desatendidas y las medidas posteriores a la eliminación 2016-2022; c) el Plan de acción sobre entomología y control de vectores 2018-2023; d) guías o procedimientos operativos estandarizados existentes para la verificación o validación de la eliminación de otras enfermedades infecciosas desatendidas (EID) como la oncocercosis, la filariasis linfática y el tracoma, y e) Enfermedades tropicales desatendidas. Prevención, control, eliminación, erradicación. more

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Fortalecer la atención primaria de salud para hacer frente a la discriminación racial, promover servicios interculturales y reducir las desigualdades sanitarias: síntesis de la investigación

World Health Organization WHO (2022) C_WHO

Mientras los países se esfuerzan por avanzar hacia los Objetivos de Desarrollo Sostenible (ODS) y lograr la cobertura sanitaria universal, las desigualdades sanitarias provocadas por la discriminación racial y los factores interrelacionados siguen estando omnipresentes. Las desigualdades que sufre... more

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Agenda para las Américas sobre salud, medioambiente y cambio climático 2021-2030

Pan American Health Organization (2021) C2

Esta publicación presenta la Agenda para las Américas sobre salud, medioambiente y cambio climático 2021-2030. Esta agenda es un llamamiento al sector de la salud para que lidere la labor a fin de abordar los determinantes ambientales de la salud en la Región de las Américas. La Organización P... more

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خطة عمل منظمة الأغذية والزراعة بشأن مقاومة مضادات الميكروبات للفترة 2021-2025

Food and Agriculture Organization of the United Nations FAO (2021) CC

تلخِّص هذه الوثيقة خطة عمل منظمة الأغذية والزراعة بشأن مقاومة مضادات الميكروبات للفترة 2021-2025، والتي تمثِّل خريطة طريقٍ من أجل تركيز الجهود العالمية على التصدِّي لم... more

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Plan de Transition du Secteur Santé en République Centrafricaine 2015-2017

Ministère de la Santé et de la Population, République Centrafricaine (2015) CC

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Key considerations for monitoring shock-responsive social assistance: A guiding framework

SPACE - Social Protection Approaches to COVID-19: Expert Advice (2021) CC

June 2021. Shock-responsive social protection (SRSP) operates in contexts where rapid on-set disasters mean needs for assistance are acute and urgent. Monitoring and identifying problems in programme design and delivery are therefore critical. However, there is limited existing guidance on how to mo... more

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WHO policy on collaborative TB/HIV activities (Guidelines)

World Health Organization WHO (2012) C_WHO

Guidelines for national programmes and other stakeholders, for annexes see http://www.who.int/tb/publications/2012/tb_hiv_policy_9789241503006/en/

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Plan stratégique national de lutte contre le paludisme au Sénégal 2016-2020

Ba, M.; M. K.N. Ndiaye, A. K. Tfeil Programme national de lutte contre le paludisme - Sénégal (2015) C2

L’impact des interventions de lutte contre le paludisme, ces dernières années, a fortement modifié la répartition géographique du fardeau de la maladie. Cette nouvelle configuration impose une stratification plus opérationnelle permettant d’adapter les interventions aux caractéristiques �... more

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India Situation Analyses-Backdrop to the NHP 2017

Ministry of Health and Family Welfare, India (2017) C_WHO

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Let our Actions Count. Reflections on NSP 2012-2016 and moving forward to NSP 2017-2022

South African National AIDS Council (2017) C1

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National Primary Health Care Development Agency: Preparedness and response to coronavirus disease 2019 (COVID-19) at primary healthcare and community level
recommended

Government of Nigeria (2020) C1

This document sets out the preparedness and response plan of the Nigerian Primary Health Care System for COVID-19 Acute Respiratory Disease. It outlines the planning scenarios, key areas of work and priority activities required for the Primary Health Care Sector to quickly scale up its core capacity... more

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Plan Stratégique National de Santé Sexuelle et Reproductive 2019-2023

Ministère de la Santè Publique er de la Population, Haiti (2019) CC

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WHO Bangladesh Country Cooperation Strategy: 2020–2024

World Health Organization (WHO), Regional Office for South-East Asia (2022) C_WHO

Notable progress has also been made on other key health indicators such as reducing maternal, infant and child deaths and malnutrition, increasing immunization coverage, eliminating infectious diseases such as polio and reducing the incidence of malaria, tuberculosis and diarrhoeal diseases. But ... more

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DRAFT-Lesotho Measles Elimination strategic plan WHO Lesotho

World Health Organization WHO, Regional Office for Africa (2018) C_WHO

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Zambia Malaria Operational Plan FY 2019

US President's Malaria Initiative USAID (2019) C1

National Primary Health Care Development Agency: Preparedness and response to coronavirus disease 2019 (COVID-19) at primary healthcare and community level recommended

National Primary Health Care Development Agency: Preparedness and response to coronavirus disease 2019 (COVID-19) at primary healthcare and community level
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