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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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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

The Council was established in late 2020 by Dr Tedros Adhanom Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t... more

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Political economy analysis for health financing: A ‘how to’ guide

World Health Organization (WHO) (2024) CC

This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within health financing, and... more

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WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended

New

World Health Organization WHO (2025) CC

The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of... more

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Guidelines for the Structure of Public Health Entomology Laboratories

Pan American Health Organization (PAHO) (2019) C_WHO

This document provides countries with recommendations for structuring a public health entomology laboratory network. The document will help countries to identify their areas of need and determine how the entomology network can be strengthened, especially in the context of a decentralized health syst... more

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Prevención del VIH para 2025 — Hoja de ruta

UNAIDS World Health Organization WHO (2022) C_WHO

Esta nueva hoja de ruta traza el camino a seguir para las acciones a nivel de país con el fin de alcanzar un ambicioso conjunto de objet ivos de prevención del VIH para 2025. Estos objetivos surgieron de la Declaración Política sobre el VIH y el sida de 2021, que la Asamblea General de las Nacio... more

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Guidelines for the management of cardiovascular diseases in India, Part I
recommended

Ministry of Health & Family Welfare, India (2020) C1

Accessed February 6, 2020

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Protect a Generation: The impact of COVID-19 on children's live

Save the Children International (2020) CC

An estimated 99% of children worldwide – or more than 2.3 billion children – live in one of the 186 countries that have implemented some form of restrictions due to COVID-191. Although children are not at a high risk of direct harm from the virus, they are disproportionately affected by its hid... more

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Health workforce governance for compassionate and respectful care: a framework for research, policy and practice

Cometto, G.; S. Assegid; G. Abiyu, et al. (2022) C1

BMJ Global Health 2022;7:e008007. doi:10.1136/ bmjgh-2021-00800

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Impact of COVID-19 in Africa: a scenario analysis to 2030 - July 2020

Cilliers, J.; et al. Institute for Security Studies ISS (2020) CC

This report presents three scenarios on the impact of COVID-19 in Africa using economic growth forecasts, mortality and efforts to ameliorate impact through social grants. Likely effects are examined on per capita income, poverty and the attainment of selected Sustainable Development Goals targets. ... more

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Applying a One Health Approach in Global Health and Medicine: Enhancing Involvement of Medical Schools and Global Health Centers

Machalaba, C.; et al. (2021) CC

Annals of Global Health, 87(1), p.30. DOI: http://doi.org/10.5334/aogh.2647

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Family planning and comprehensive abortion care toolkit for the primary health care workforce: volume 2

World Health Organisation (WHO) (2022) C_WHO

This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv... more

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Regional action framework for noncommunicable disease prevention and control in the Western Pacific

World Health Organisation (WHO) (2023) C_WHO

The Regional Action Framework for Noncommunicable Disease Prevention and Control provides a unified vision of objectives and recommended actions to combat the noncommunicable disease (‎NCD)‎ epidemic in the Western Pacific Region. Implementation should be supported by cross-sectoral coordination... more

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Working with Individuals, Families and Communities to Improve Maternal and Newborn Health. Module 4

World Health Organization WHO; PAHO Pan American Health Organization, Enfant du Monde (2017) C_WHO

A Toolkit for Implementation. Module 4: Training guide for facilitators of the participatory community assessment in maternal and newborn health

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Planetare Gesundheit – transformative Lehr- und Lernformate zur Klima- und Nachhaltigkeitskrise für Gesundheitsberufe

Wabnitz K., Galle S., Hegge L., et al. (2020) CC

Die Klimakrise stellt die größte Bedrohung der menschlichen Gesundheit im21. Jahrhundert dar. Die mit ihr einhergehenden Umweltveränderungen, die unter anderem zu Hitzewellen, Überflutungen und Unterernährung durch Ernährungsunsicherheit führen, wirken sich bereits heute negativ auf die Ge... more

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Guidance Note on Youth Integration into the Women Friendly Health Spaces (WFHS)

United Nations Population Fund UNFPA (2023) CC

UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &... more

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Climate change and health: vulnerability and adaptation assessment (Update)

World Health Organization WHO; PAHO; et al. (2021) C_WHO

In 2013 the World Health Organization (WHO) published the report Protecting health from climate change:vulnerability and adaptation assessment. The aim was to provide basic and flexible guidance on conducting national or subnational assessments of current and future vulnerability (the susceptibilit... more

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Sector Development Strategy for Pharmaceutical Manufacturing in Zimbabwe 2017-2022

UN Industrial Development Organization (2019) CC

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Psychosocial Support of Children Psychosocial Support of Children In Emergencies

United Nations Children's Fund (UNICEF) (2009) C1

‘Psychosocial Support of Children in Emergencies’ is a reference document for humanitarian workers who want to increase their understanding of the experiences of children in emergency situations and how to support them in mitigating the negative effects of these experiences and how to prevent fu... more

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Post-Synodal Apostolic Exhortation Amoris Laetitia (2016)

Pope Francis Vatican Press (2016) CC

Amoris laetitia: Post-Synodal Apostolic Exhortation on love in the family (19 March 2016)

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries recommended New

Guidelines for the management of cardiovascular diseases in India, Part I recommended

WHO guideline on preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries
recommended

New

Guidelines for the management of cardiovascular diseases in India, Part I
recommended