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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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SAVE Advocacy Strategy - The Kenyan Case Study

Inerela + Kenya (International Network of Religious Leaders Living with or personally affected by HIV - Kenya Chapter); Christian aid (2019) C2

Accessed: 17.11.2019

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Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19
recommended

African Union; Africa CDC Centres for Disease Control and Prevention; AMREF; ASLM; et al. (2021) CC

ASLM in collaboration with the Africa Centres for Disease Control and Prevention, and in partnership with the Clinton Health Access Initiative, Amref and Last Mile Health present the Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19. This framework aims to pr... more

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Review of the national tuberculosis programme in Romania

P. de Colombani, V. Hollo, N. Jansen, et al. World Health Organization; European Centre for disease prevention and Control (2015) C_WHO

10–21 March 2014

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Community health workers, recipients’ experiences and constraints to care in South Africa – a pathway to trust

Nonhlanhla Nxumalo, Jane Goudge & Lenore Manderson AIDS Care Psychological and Socio-medical Aspects of AIDSHIV (2016) CC

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Cadre de l'Assurance Qualité Test de Diagnostic Rapide de l'Antigene COV-2-SARS
recommended

African Union; Africa CDC Centres for Disease Control and Prevention; AMREF; ASLM; et al. (2021) CC

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EPI Comprehensive Multiyear Plan 2012-2016

Republic of Senegal , Ministry of Public Health and Prevention, Department of Medical Prevention (2011) C1

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COVID-19 & Community Health Workers
recommended

African Union; Africa CDC Centres for Disease Control and Prevention (2021) CC

2-Day Orientation training Orientation Training, 1 Febr. 2021 Community Health Workers (CHWs) are an essential part of the Partnership to Accelerate COVID-19 Testing (PACT) Initiative • Africa CDC set up PACT to drive forward the Africa Union Joint Continental Strategy for COVID-19 Available in ... more

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Management of Type 2 Diabetes. Training Manual

WHO Collaborating Centre for Capacity Building and Research in Community-based Noncommunicable Disease Prevention and Control, All India Institute of Medical Sciences (AIIMS), New Delhi, India. World Health Organization WHO, India (2019) C_WHO

WHO Package of Essential NCD Interventions (PEN) Accessed March 18,2019

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Research and Development Priorities for COVID-19 in Africa

African Union; Africa CDC Centres for Disease Control and Prevention; World Health Organization WHO, et al. (2021) CC

February 2021. Improving our response to the ongoing COVID-19 pandemic in Africa requires regularly updated information, constant innovation, and considerable support towards research and development (R&D) for priorities that respond to the African realities. Shaping the research agenda and stimula... more

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Screening for sexually transmitted disease during the domestic medical examination for nearly arrived refugees

U.S. Department of Health and Human Services. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (2014) C_CDC

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Tuberculosis surveillance and monitoring in Europe 2020-2019 data

World Health Organization; European Centre for disease prevention and Control (2021) C_WHO

Surveillance Report

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Questions and Answers About Tuberculosis
recommended

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Disease Control and Prevention (2014) C_CDC

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Interim guidance on COVID-19 Rapid Antigen self-testing to African Union Member States

African Union; Africa CDC Centres for Disease Control and Prevention (2022) C1

This guidance addresses rationale, risk-based scenarios, practical considerations prior to adoption of the self-testing products, quality assurance, safety and ethical considerations, and data management considerations for COVID-19 self-testing. The Africa CDC recommends the use of rapid antigen sel... more

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Generic protocol for a population-based, age- and gender- stratified sero-survey study for SARS-CoV-2

African Union; Africa CDC Centres for Disease Control and Prevention (2020) C1

The number of confirmed COVID-19 cases detected and reported in each country is influenced by many factors including limited access and/or utilization of healthcare and COVID-19 testing, limited surveillance, lack of knowledge amongst the population about when to seek testing, an asymptomatic pres... more

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Reproductive Health Assessment Toolkit for Conflict-Affected Women (Cover)

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Centers for Disease Control and Prevention, Department of Health and Human Services, (2007)

This is only the cover of the book. Download the whole Toolkit at: www.cdc.gov/reproductivehealth/Refugee/ Understanding the reproductive health needs of conflict-affected women will enable organizations to implement and enhance programs and services to improve the health of women and their fam... more

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2nd International Conference on Re-emerging Infectious Diseases: Scientific Report

African Union; Africa CDC Centres for Disease Control and Prevention Africa CDC (2019) C_CDC

In 2007, WHO warned that infectious diseases are emerging and re-emerging at a rate that has not been seen before. The potential for infectious diseases to spread rapidly results in high morbidity and mortality, causing a potential global public health treat of major concern. Several factors are ... more

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Philippine Health Advisories

Department of Health, National Center for Health Promotion, National Center for Disease Prevention and Control (2012) C1

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Guidelines for screening for Tuberculosis infection and disease during the domestic medical examination for newly arrived refugees

U.S. Department of Human Services; Centers for Disease Control and Prevention; National Center for Emerging and Zoonotic Infectios Diseases (2012) C_CDC

Division of Global Migration and Quarantine April 16, 2012

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Neisseria gonorrhoeae Antimicrobial Resistance Surveillance: Consolidated Guidance

World Health Organization WHO (2020) C_WHO

Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas... more

Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19 recommended

Cadre de l'Assurance Qualité Test de Diagnostic Rapide de l'Antigene COV-2-SARS recommended

COVID-19 & Community Health Workers recommended

Questions and Answers About Tuberculosis recommended

Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing for Diagnosis of COVID-19
recommended

Cadre de l'Assurance Qualité Test de Diagnostic Rapide de l'Antigene COV-2-SARS
recommended

COVID-19 & Community Health Workers
recommended

Questions and Answers About Tuberculosis
recommended