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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
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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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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
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country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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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
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he Council has focused on reimagining how to put Health for All at the heart of government decision-making and private sector collaboration at regional, national and international levels.
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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.
The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie
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ty and other partners. The pivotal meeting sought to leverage political commitment, scientific innovation and community engagement to reshape the trajectory of malaria control in high burden African countries, and beyond.
At the end of the meeting and in the weeks that followed, Ministers of Health from the 11 “High Burden High Impact” African countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda and United Republic of Tanzania) signed the Yaoundé Declaration, pledging their “unwavering commitment” to the principle that “no one should die from malaria given the tools and systems available.” Success in reducing malaria morbidity and mortality will hinge on efforts by countries to translate this political commitment into actions and resources that will save lives.
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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.
El propósito de esta guía es brindar orientaciones clínicas actualizadas en TB/VIH con énfasis en aspectos de diagnóstico, incluidas nuevas técnicas, así como de tratamiento vigente, sin perder de vista un enfoque de salud pública. Al recopilar y consolidar en una sola guía las últimas rec
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omendaciones de la Organización Mundial de la Salud en el tema, se busca elaborar un documento de referencia y consulta frecuente, que unifique y estandarice el manejo de la coinfección TB/VIH de manera integral en establecimientos de salud con base en el principio de “dos enfermedades, un solo paciente”. También busca sustentar la actualización de normas y guías nacionales sobre la coinfeccion y complementar el trabajo coordinado que debe existir entre los programas de prevencion y control de TB y VIH a todo nivel en el marco las doce actividades de colaboración TB/VIH recomendadas internacionalmente.
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Vector control, alongside case management, remains the most effective approach to controlling and eliminating malaria. Key interventions, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs), have significantly reduced malaria transmission in many African countries. This
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has enabled some countries to transition from the control phase to the elimination phase.
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Access to safe, effective and quality-assured health products and technologies is crucial for achieving universal health coverage and primary health care goals. The continued growth of the aging population; increasing burden of noncommunicable diseases; growing burden of mental health issues; climat
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e change; shifting patterns of vector borne diseases, fungal disease and waterborne diseases; antimicrobial resistance; and new infectious hazards create an ongoing need for equitable access to safe, effective and quality-assured health products and technologies, and renewed investments in research and development for innovative health products and technologies.
The coronavirus pandemic exposed the inequalities in access to health products, highlighting the need for longer-term strategies to strengthen access to health products and technologies outside of and in emergency situations. While technological and scientific advances present an opportunity to increase access to health products and technologies, the risk of increasing inequality due to higher prices for new health products and technologies; the persisting problem of substandard and falsified medical products; a lack of skilled workforce in many low- and middle-income countries; and a lack of data for decisionmaking and for measuring progress present significant challenges.
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This document on logistics management information systems (LMIS) was developed to address the increasing need for harmonization and standardization of core indicators for managing medicines and health products for neglected tropical diseases (NTDs) at country level (i.e. for last-mile logistics). It
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thereby responds to requests from Members States, pharmaceutical groups, financial donors and implementing partners for guidance from the World Health Organization (WHO) for a transparent, standardized reporting mechanism and key indicators for in-country logistics. More importantly, this document will also guide the last-mile logistics process and is relevant for the health workforce working at different levels of national health information systems. It can be adapted and used for any health products depending on the needs of the country or health programmes.
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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
Early Adolescent Skills for Emotions (EASE) is an evidence-based group psychological intervention to help 10–15-year-olds affected by internalizing problems (e.g. stress and symptoms of anxiety, depression) in communities exposed to adversity. Published by the World Health Organization (WHO) and U
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nited Nations Children’s Fund (UNICEF), EASE aims to support adolescents and their caregivers with skills to reduce distress. The EASE training manual accompanies the EASE intervention manual and is designed to be used to train EASE helpers (those who deliver the EASE intervention to adolescents and caregivers) and EASE trainers/supervisors (those who will go on to train/supervise future EASE helpers).
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The 2022 report reviews the global malaria diagnostics market and technological landscape to support Unitaid’s 2023–2027 strategy for quality malaria case management. The report highlights the stalled progress of malaria control efforts, the gaps in access to diagnostics and the public health im
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plications of P. falciparum HRP2/3 gene deletions, which compromise the accuracy of the widely used HRP2-detecting rapid diagnostic tests (RDTs). The report analyses the malaria RDT market, noting supplier diversification, price trends and production shifts resulting from the pandemic. It also addresses the emerging point-of-care G6PD testing market, which is required to ensure the safe radical cure of P. vivax infections. It surveys technological innovation, including digital microscopy, hemozoin tests, nucleic acid detection and biosensors, while emphasising that RDTs and microscopy will remain the mainstay of case management in the near term. The report identifies market shortcomings, access barriers and opportunities to improve malaria case management and diagnostic coverage.
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To contribute to the availability of basic knowledge and skills for the provision of palliative care in
the African region, the African Palliative Care Association (APCA) has developed a competencybased core curriculum framework for use in introductory training on palliative care. The curriculum
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is based on the APCA Standards for Providing Quality Palliative Care Across Africa to ensure that care providers are trained to the appropriate competence for their cadre and level of skill. This curriculum therefore aims to facilitate the development of the best basic skills and attitudes required for the delivery of palliative care services that meet the desired standards of palliative care. The curriculum incorporates theoretical, practical, mentorship and supervision components that are critical to the effective application of knowledge in practice.
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In the absence of a such a measure, and building on the success of developing the APCA African
Palliative Outcome Scale (POS) for adults, the African Palliative Care Association has developed the
APCA African Children’s POS. The tool has been validated across diseases, countries, settings and
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languages and used in both quality improvement and research studies. Moreover, feedback on the
tool from doctors and nurses who have used it has been very supportive, with providers perceiving
it as an easy-to-use instrument that helps them undertake holistic assessments that in part entail
discussing difficult issues.
This booklet is a practical guide intended to help users employ the APCA African POS correctly.
Following a discussion of the origins and background to the APCA African PPOS, the guide discusses
the measurement of outcomes, the development of the tool and its use (including the analysis of
collected data), before finishing with illustrative examples of the use of the questionnaire.
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This Toolkit for ensuring rights-based and ethical use of digital technologies in HIV and health programmes is derived from the comprehensive UNDP Guidance on the rights-based and ethical use of digital technologies in HIV and health programmes document. The foundational UNDP Guidance document outli
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nes key ethical, human rights and technical considerations for countries adopting digital technologies for health, detailing human rights risks, norms and standards, and provides a practical checklist for assessment.
The Toolkit serves as a quick reference guide for UNDP staff, governments, partners, technology developers, and civil society organizations, designed to provide practical guidance for implementing ethical digital health solutions by distilling and structuring the in-depth information from the broader UNDP Guidance into six easy-access modules. Each module addresses a specific key issue by outlining definitions, ethical principles, key considerations, and recommendations that align with the comprehensive framework established by the UNDP Guidance.
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Epidemics and pandemics are some of the biggest threats to a safe and healthy world. But with effective preparedness and response measures, we can reduce their impacts and even stop them in their tracks.
Through the Programmatic Partnership with the European Union, 24 local Red Cross and Red Cres
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cent Societies have been working to keep communities healthy and safe from epidemics and pandemics with technical assistance, advocacy support and coordination from IFRC and European National Societies. They do so by equipping communities with knowledge and tools to stop the spread of diseases and by setting up systems so they can report outbreaks quickly, enabling a rapid response from authorities. National Societies have also significantly developed their own epidemic preparedness and response capacity.
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The ILO has joined forces with Gallup to carry out a groundbreaking global survey covering 50 countries that sheds further light on the causes of the persistence of HIV-related stigma and discrimination in the world of work.
Building true health security in a global age. Findings and recommendations of the Global Council. In landmark findings based on two years of research and convenings around the world, the new report shows that high levels of inequality are linked to outbreaks becoming pandemics and that inequality i
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s undermining national and global responses, making pandemics more disruptive, deadly, and longer in duration. The report also shows that pandemics increase inequality, fuelling a cycle that research shows is visible not just for COVID-19, but also for AIDS, Ebola, Influenza, Mpox and beyond.
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