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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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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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Hidden cities: unmasking and overcoming health inequities in urban settings

WHO, UN-HABITAT (2010) C_WHO

The World Health Organization (WHO) and United NationsHuman Settlements Programme (UN-HABITAT) joint globalreport, Hidden cities: unmasking and overcoming healthinequities in urban settings, exposes the extent to whichcertain city dwellers suffer disproportionately from a wide range of diseases and ... more

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Impact Evaluation Notes No.3 - Introduction To Mixed Methods In Impact Evaluation

Michael Bamberger InterAction, The Rockefeller Foundation (2012) C2

This is the third guidance note in a four-part series of notes related to impact evaluation developed by InterAction with financial support from the Rockefeller Foundation.This third guidance note, Introduction to Mixed Methods in Impact Evaluation, starts by explaining what a mixed methods (MM) imp... more

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Tracking Universal Health Coverage in the WHO African Region, 2022

World Health Organization WHO, Regional Office of Africa (2022) C_WHO

n 2015, Member States of the United Nations adopted the 2030 Agenda for Sustainable Development and its accompanying Sustainable Development Goals (SDGs), with the third goal of the agenda focusing on health – good health and well-being. This has the attainment of universal health coverage (UHC) a... more

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2014 Nigeria Polio Eradication Emergency Plan

National Primary Health Care Development Agency, Abuja, Nigeria (2013) CC

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The Status of the Wheelchair in Uganda

Mary Florence Mukisa Uganda National Action on Physical Disability (UNAPD); Uganda Ministry of Health; et al. (2010) C1

A Report of A survey study conducted to determine the demand, availability, quality of production, usage, and affordability of wheelchairs in Uganda. Accessed Febr. 12,2015

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Pandemic Influenza Risk Management
recommended

World Health Organization WHO (2017) C1

A WHO guide to inform & harmonize national & international pandemic preparedness and response The main updates from the 2013 interim guidance are: Alignment with other relevant United Nations policies for crisis and emergency management, and Inclusion of the significant development in re... more

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WHO tool for benchmarking ethics oversight of health-related research involving human participants: user guide

World Health Organization WHO (2023) C_WHO

Jointly developed by WHO’s Regulatory System Strengthening, Regulation and Safety Unit and the Health Ethics & Governance Unit, it is intended to assist countries in evaluating their capacity to provide appropriate ethical oversight of health-related research. In addition to assisting in capacity-... more

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Substance Abuse Policy in Thailand: Current Challenges and Future Strategies

Darika Saingam Ashdin Publishing Journal of Drig and Alcohol Research (2018) C2

Review Article

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The Georgian national HIV/AIDS strategic plan for 2016–2018

CCM Georgia (2019) C2

Endorsed by the CCM Georgia on April 15th 2015 Accessed: 26.09.2019

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Living Conditions among People with Activity Limitations in Malawi. A National Representative Study.

ME Loeb, Arne H Eide SINTEF Health Research (2004) C1

This research report provides results from the study on living conditions among people with disabilities in Malawi. Comparisons are made between individuals with and without disabilities and also between households with and without a disabled family member. Results obtained in Malawi are also comp... more

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Rwanda: July 2014 – June 2015 Annual Report - Tuberculosis and Other Respiratory communicable Diseases Control in Rwanda

Rwanda Biomedical Center - Institute of HIVAIDS, Disease prevention & Control (IHDPC), TB & Other Respiratory Communicable Diseases Division (2015) C2

This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management of TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018 ... more

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Why urban health matters

World Health Organization WHO; 1000 Cities 1000 Lives (2010) C_WHO

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Climate Change and Chagas Disease in the americas: A qualitative systematic review

Graves B.N. (2019) C2

Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expected over the next several decades under climate chan... more