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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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The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

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 ... more

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The cost of austerity: The toll of IMF conditionalities on access to health in Zambia

Make Way, Wemos (2024) CC

Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the ... 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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Health Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th... more

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Health Taxes: A Compelling Policy for the Crises of Today

The Task Force on Fiscal Policy for Health Report 2024 Bloomberg (2024) CC

For this report, the Task Force commissioned additional background papers on health taxes to update the evidence, assess short-term revenue potential, and understand the role of health taxes in the current era of multiple crises. We find that health taxes continue to be underutilized despite th... more

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Why Is There So Little Contractually Contingent Financing?

Dissanayake R. Center for Global Development (2024) CC

Most foreign aid comes in one of two forms: either we pay a person or an institution today in exchange for delivering some beneficial activity in the future, or we observe something bad happen to them and then give them support to recover from it. This kind of aid is simple to design and deliver, b... more

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A healthy return: Investment case for a sustainably financed WHO

World Health Organization (WHO) (2022) CC

There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.

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Country Office Annual Report 2022 Namibia-Update on the context and situation of children

UNICEF (2022) C_UNICEF

In 2022, Namibia had an estimated population of 2.6 million people, where 51 per cent per cent are females and 52.5 per cent of households in urban areas, with fast-growing urban informal settlements which lack access to basic services. Namibia has a young population; 42 per cent are children (0-17 ... more

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Disability-inclusive Employment Promotion: Lessons learned from five GIZ projects

Deutsche Gesellschaft für Internationale Zusammenarbeit GIZ (2019) CC2

In the initial chapters, you will find different approaches that describe how to support job creation for entrepreneurs or employees who live with disabilities. The interventions are often initiated by the readiness to find and pick the right opportunities, such as an engaged entrepreneur or an open... more

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ECSA report. Eastern, Central and Southern African Region - Education and Labor Markets for Nurses

World Bank Group; International Council of Nurses (2021) CC2

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... more

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Theory of Change

Nutrition and Food Security Alliance of Namibia; UNFPA; UNICEF; et al. (2020) CC2

Early Identification and Early Intervention Services for Young Children with Developmental Delays and Disabilities in Namibia Republic of Namibia Namibia Regional Consultations Report

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2022 Annual Report Working to Achieve Transformative Results

United Nations Population Fund UNFPA (2022) C1

Access to safe and voluntary family planning is an inalienable human right that cannot be denied. In 2022, UNFPA continued to work with Government and partners to make this a reality in Namibia by providing strategic support to the national family planning programme and ensuring universal access ... more

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Social and Behaviour Change Communication Strategy for Prevention of Re-establishment of Malaria Transmission in Timor-Leste

Ministry of Health Democratic Republic of Timor-Leste; World Health Organization WHO (2025) C_WHO

The Social and Behaviour Change Communication (SBCC) Strategy for the Prevention of the Re-establishment of Malaria Transmission in Timor-Leste forms part of the National Strategic Plan (NSP) for 2021–2025. The strategy aims to support Timor-Leste's efforts to sustain malaria elimination by promot... more

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Strategic Malaria Communication Guide for Central America 2015-2020

Amazon Malaria Initiative AMI (2015) CC

The Strategic Malaria Communication Guide for Central America is intended to facilitate the shift from malaria control to elimination by strengthening communication and advocacy initiatives throughout the region. Based on interviews and a review of literature, the guide offers National Malaria Progr... more

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A toolkit for mass distribution campaigns to increase coverage and use of long-lasting insecticide-treated nets: Communication

The Alliance for Malaria Prevention AMP (2021) CC

This chapter of the AMP LLIN Mass Campaign Toolkit outlines the strategic communication approaches that are essential before, during and after long-lasting insecticide-treated net (LLIN) distribution campaigns. It emphasises the importance of setting up a national communications sub-committee under ... more

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Message Guide for the Fight Against Malaria in Malawi

Ministry of Health of Malawi (2023) CC

This document was developed by the Ministry of Health in Malawi in collaboration with national and international partners. It introduces a Social and Behaviour Change (SBC) malaria message guide that is aligned with the National Malaria Communication Strategy (NMCS) for the period 2023–2030. The g... more

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WHO guidelines for malaria - arabic version

World Health Organisation (WHO) (2024) C_WHO

The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-friendly and easy-to-navigate online platform. The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-frie... more

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Surveillance and control of Anopheles stephensi: country experiences

World Health Organization WHO (2024) C_WHO

Anopheles stephensi is an invasive mosquito species which has been found spreading across Africa. While this species presents a new challenge for malaria control on the continent, its surveillance and management have been ongoing in Asia for many years. This document aims to summarize key lessons fr... more