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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Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal
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space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
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The world is facing a sustainable development crisis. The 2024 Financing for Sustainable Development Report: Financing for Development at a Crossroads finds that financing challenges are at the heart of the crisis and imperil the SDGs and climate action. The window to rescue the SDGs and prevent a c...limate catastrophe is still open but closing rapidly. Financing gaps for sustainable development are large and growing – the estimates by international organizations and others are coalescing around $4 trillion additional investment needed annually for developing countries. This represents a more than 50% increase over the pre-pandemic estimates. Meanwhile, the finance divide has not been bridged, with developing countries paying around twice as much on average in interest on their total sovereign debt stock as developed countries. Many countries lack access to affordable finance or are in debt distress. Weak enabling environments are preventing progress. Average global growth has declined, while policy and regulatory frameworks still do not set appropriate incentives. Public budgets and spending is not fully aligned with SDGs. Private investors are not incentivised to invest enough in SDGs and climate action. The world is at a crossroads. This is the last chance to correct course if we want to achieve the SDGs by the 2030 deadline. Only an urgent, large-scale and sustainable investment push can help us achieve our global goals. Next year’s Fourth International Conference on Financing for Development in 2025 will be a once in 80-year opportunity to support coherent transformation of financing.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover...nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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Challenges and Opportunities. This report presents a comprehensive assessment of the education and labor markets for nurses in the ECSA region. It documents the main challenges to train and deploy nurses and discusses opportunities for government and private sector employers to overcome these chall...enges. The report provides empirical evidence to support the expansion of nursing education within the region with a focus on private sector engagement, effective labor market regulation, and regional collaboration. A regional focus for investment may be necessary to create enough potential deals, reduce individual country and regulatory risks, encourage good private institutions to move across borders within the region, and seek to create regional standards for regulation.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal...th information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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This publication provides a problem analysis of the U.S. cuts in global health and derives concrete recommendations for action for medical actors. The focus is on analyzing the direct effects on health-specific development cooperation.
PLOS Glob Public Health 3(7): e0001132. https://doi.org/10.1371/journal.
pgph.0001132
This paper proposes a framework for strategic communications for malaria governance that involves five key elements: knowing the audience, defining the message, designing a medium, identifying a messenger, and ...selecting the timing
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Fragile Beginnings. The Fragile Beginnings series examines the growing body of research on the unique vulnerabilities of children: in utero and at birth, during infancy and childhood and throughout adolescence. Its purpose is to enable evidence-based advocacy and action on children’s environmental... health
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The Ghana National Malaria Strategic Plan 2021–2025 aims to reduce malaria mortality by 90% and malaria cases by 50% (using 2019 as baseline) and to achieve pre-elimination in at least six districts by 2025. The plan focuses on scaling up prevention measures like distributing insecticide-treated n...ets, indoor residual spraying, seasonal chemoprevention, and prevention in pregnancy. It also emphasizes universal access to prompt diagnosis and effective treatment, strengthening health system governance, improving supply chains, mobilizing resources, and enhancing surveillance. Special attention is given to vulnerable groups and high-burden areas to ensure equity and sustainability in the fight against malaria.
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Integrated Outbreak Analytics (IOA) applies a multidisciplinary approach to understanding outbreak dynamics and to inform outbreak response. It aims to drive comprehensive, accountable, and effective public health and clinical strategies by enabling communities, and national and subnational health a...uthorities to use data for operational decision-making. IOA embraces a holistic perspective of outbreak dynamics throughout: from the trigger questions to the data that are collected or accessed, to the interpretation of results and the recommendations that follow. In addition, IOA promotes co-development and monitoring of evidence informed actions.
The IOA toolkit aims to provide a clear understanding of IOA and highlight the importance of using an integrated, holistic approach to manage outbreak responses. It provides step-by-step guidance for setting up IOA and putting IOA principles into action. Finally, this toolkit provides guidance on applying IOA in humanitarian and emergency contexts, offering a practical and adaptable approach to informing public health emergency responses.
Developed based on the model from the Democratic Republic of the Congo (DRC), its creation involved extensive consultation with experts experienced in IOA applications. The toolkit was piloted in Tanganyika Province, DRC, as well as Somalia and Sudan, demonstrating its adaptability to diverse emergency scenarios. It builds upon an existing array of tools, templates, reports, case studies, animations, and publications used by stakeholders in diverse contexts.
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Breastfeeding is a cornerstone of healthy infant nutrition, development and survival. It is critical for countries* to improve breastfeeding rates in order to achieve global targets for newborn and child health and survival, as well as economic growth and environmental sustainability
This publication provides an overview of evidence and guidance on the growing challenge of workplace heat stress in the context of climate change. It highlights the health and productivity risks faced by billions of workers, especially in manual labor sectors. The report details the physiological, s...ocioeconomic, and mental health impacts of heat stress and outlines evidence-based strategies for prevention and mitigation. It emphasizes the need for occupational heat action programmes, stakeholder collaboration, and tailored interventions to protect vulnerable workers, reduce productivity losses, and support sustainable development in a warming world.
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Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must b...e added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
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mBio, Vol. 6 Issue 2, March/April 2015
Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. In this review, the authors address what we know and what ...we do not know about Ebola virus transmission. They also hypothesize that Ebola viruses have the potential to be respiratory pathogens with primary respiratory spread.
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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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In the battle against diseases like Zika and dengue, knowledge is power. Climate change is shifting the
distribution of mosquitoes and to new areas. Empowering communities is essential in reaching and pro-
tecting the most vulnerable individuals and households. Vector control programmes, community... empow-
erment and awareness campaigns are proven strategies to reduce the burden of vector-borne diseases.
Red Cross and Red Crescent volunteers can play a key role in community and school outreach activities for Zika, dengue and chikungunya prevention. These community-based activities need to be sustained to
ensure long-lasting disease control.
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March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.