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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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Capacity Building for Malaria: How to Advise Guide

United States Agency for International Development USAID; Human Resources for Health in 2030 HRH2030 (2021) C_CDC

Developed under the USAID-supported HRH2030 Capacity Building for Malaria (CBM) initiative, this guide offers a comprehensive framework for advising National Malaria Control Programmes (NMCPs) through the use of long-term technical advisors (LTTAs). It sets out key practices for implementing partner... more

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The Strategic Framework for Malaria Social and Behaviour Change Communication 2018-2030

The RBM Partnership to End Malaria (2018) C1

Social and Behaviour Change Communication (SBCC) is essential for the effective control, prevention and elimination of malaria. The 2018–2030 Strategic Framework for Malaria SBCC guides countries and partners in strengthening capacities, refining strategies and sharing best practices, all of which... more

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Lil Mosquito, Big Problem Campaign: Phase II

Breakthrough ACTION Guyana; Ministry of Health of Guyana (2025) C1

In 2023, Breakthrough ACTION and Guyana’s Ministry of Health refined the 'Lil Mosquito, Big Problem' malaria campaign using human-centred design. Phase II introduced peer-led videos (Miners' Buzz), community champions, incentives for volunteer testers and a transport network to improve supply deli... more

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Rethinking communications for governance of malaria programs

Opigo, J.; Guyer A. L. (2023) CC

PLOS Glob Public Health 3(7): e0001132. https://doi.org/10.1371/journal. pgph.0001132 This paper proposes a framework for strategic communications for malaria governance that involves five key elements: knowing the audience, defining the message, designing a medium, identifying a messenger, and ... more

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Advancing equity in diabetes technology

Diabetes Africa (2024) CC

This toolkit suggests several approaches to addressing technology access disparities. At its core is a comprehensive checklist that helps teams systematically evaluate their current practices and identify opportunities for improvement. This structured self-assessment tool spans both team-level a... more

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Risk communication and community engagement readiness and response toolkit: ebola disease

World Health Organization WHO (2025) C_WHO

This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers and partners to plan and implement readiness and response activities for Ebola disease outbreaks. The toolkit conta... more

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Risk communication and community engagement readiness and response toolkit: yellow fever

World Health Organisation (WHO) (2024) C_WHO

This toolkit is a comprehensive set of practical tools and resources designed to support country-level risk communication and community engagement (RCCE) practitioners, decision-makers, and partners to plan and implement readiness and response activities for yellow fever outbreaks. The toolkit conta... more

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Implementation guidance on counselling women to improve breastfeeding practices

World Health Organization WHO (2025) C_WHO

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

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Intubation et extubation du patient de réanimation

Societé francaise d'anesthésie et de réanimation (SFAR) (2018) C2

Recommandations formalisées d'experts

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Patient Decontamination in a Mass Chemical Exposure Incident: National Planning Guidance for Communities

US Department of Homeland Security, US Department of Health and Human Services (2014) C1

"Patient decontamination principles are set forth here from a strategic perspective, rather than a tactical one. The principles are meant to guide, but not specify, operational practices. The guidance is evidencebased to the extent possible and the supporting evidence is documented and briefly dis... more

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Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives
recommended

Brakarsh, J.; L. Steinitz Catholic Relief Services CRS (2018) CC

Singing to the Lions is a free training package (facilitator’s guide, supplement and video) by CRS, that is designed to help children and youth lessen the impact of violence and abuse in their lives. The main component is a three-day workshop where participants learn skills that can help them tran... more

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Tracking aid for the WHA nutrition targets: Global spending in 2015 and a roadmap to better data

Alimonte, Mary D'; Thacher, Emily; LeMier, Ryan; Clift, Jack Results for Development (R4D) (2018) C1

In 2017, the World Bank and partners created the Global Investment Framework for Nutrition as a roadmap towards achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scal... more

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Care of the Newborn Reference Manual

Diana Beck, Frances Ganges, Susan Goldman, Phyllis Long Save the children (2004)

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HIV and young men who have sex with men

World Health Organization; UNFPA; UNAIDS; etc al. (2015) C_WHO

Technical Brief Damon Barrett, Gonçalo Figueiredo Augusto, Martiani Oktavia, Jeanette Olsson, Mira Schneiders and Kate Welch provided background papers and literature reviews which informed this technical series.

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Heat waves and human health

Lee, V.; F. Zermoglio; K.L.Ebi; et al. USAID (2019) C1

Emerging evidence and experience to inform risk management in a warming world

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Improving Prison Conditions by Strengthening the Monitoring of HIV, HCV, TB and Harm Reduction (Italy)

A. Scandurra, Dr. S. Libianchi, G. Parisi Associazione Antigone; European Union (2015) C2

Mapping Report - Italy.

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Zambia: Drought (Food Insecurity) Emergency Appeal n° MDRZM012

International Federation of Red Cross And Red Crescent Societies IFRC (2019) C1

A “catastrophic” combination of drought and communities’ declining resilience has left an estimated 2.3 million people facing severe acute food insecurity – up from an estimate of 1.7 million people a month ago. Communities across southern Africa have been affected by drought since late 2... more

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Reporting on Gender-Based Violence in Syria Crisis: A Journalist's Handbook

U N Population Fund (2015)

The handbook is the first comprehensive collection of practical tips for journalists on how to report on GBV in the context of Syria crisis, building upon internationally recognised ethical principles. It gives an overview of techniques to guarantee the safety, confidentiality and dignity of survivo... more

Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives recommended

Singing to the Lions. A Guide to Overcoming Fear and Violence in Our Lives
recommended