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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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Disruption in essential health services in Mexico during COVID-19: an interrupted time series analysis of health information system data

Doubova SV, Leslie HH, Kruk ME, et al. BMJ Global Health (2021) CC

INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat... more

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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas

Pan American Health Organisation PAHO (2022) C_WHO

The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several factors at diffe... more

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Culture, Context and the Mental Health and Psychosocial Wellbeing of Syrians

Hassan, G, Kirmayer, LJ, Mekki- Berrada A., et al. UNHCR (2015) C1

The document is primarily meant to inform mental health and psychosocial support (MHPSS) staff, such as: psychologists, psychosocial counsellors, social workers, psychiatrists, psychiatric nurses, and others who are involved providing individual or group counselling, psychotherapy and/or psychiatric... more

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Research and Evaluation Agenda for HIV and Maternal Health in sub-Saharan Africa

Kendall, Tamil; Danel, Isabella (2014) C1

Women and Health Initiative Working Paper No. 1. Women and Health Initiative
Improving maternal health in the context of the sub-Saharan African HIV epidemic requires greater understanding of the relationships between HIV disease and maternal morbidity and mortality, integrated and effective resp... more

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Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation, second edition.

World Health Organization WHO (2023) C_WHO

The World Health Organization (WHO) is releasing the second edition of its Global Accelerated Action for the Health of Adolescents (AA-HA!) guidance. The document aims to equip governments to respond to the health and well-being challenges, opportunities and needs of adolescents. The guidance pro... 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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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI

Robert Koch Institut RKI (2023) CC

The greatest risk to persons engaging in international medical emergency response is poor preparation. The In Control handbook hopes to provide a remedy. At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin...gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated. Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all. The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world. The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards. more

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Toolkit for engaging in social media activities promoting prudent antibiotic use

European Centers for Disease Control and Prevention ECDC (2012) C_CDC

This guidance document is based on research of social media activity related to antibiotic use at EU level, as well as on a survey of the social media activities of EAAD partner organisations, mostly EU umbrella organisations of patients and health professionals. The research showed that there is al... more

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Papua New Guinea Demographic and Health Survey 2016-18 Key Indicators Report

National Statistical Office Port Moresby, Papua New Guinea, The DHS Program (2019) C2

The DHS report itself explains the purpose was, “to obtain and provide information on basic indicators of social progress including fertility, childhood mortality, reproductive and child health, nutritional status of children, and awareness of HIV/AIDS and other health-related issues” in PNG. Th... more

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Monkeypox outbreaks outside endemic regions: scientific and social priorities
recommended

A. Zumla; Valdoleiros, S. R.; Haider, N.; et al. The Lancet (2022) CC

As the world recovers from the shock of the COVID-19 pandemic and reflects on lessons learnt from failure of global public health systems to contain the global outbreak of SARS-CoV-2, new infectious disease threats, caused by movement of people globally, remain omnipresent, and repeated calls for mo... more

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Guidance on mainstreaming biodiversity for nutrition and health

World Health Organization WHO (2020) C_WHO

This report aims to support countries in the necessary transition toward healthier, more sustainable diets by integrating biodiversity in food-based interventions to support nutrition and health. It is intended to help guide decision-makers in the health, nutrition and other sectors, to: Consider... more

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Health Sector Integrated Refugee Response Plan 2019 - 2024

Uganda Government (OPM) (2022) CC

Uganda hosts approximately 1.1 million refugees making it Africa’s largest refugee hosting country and one of the five largest refugee hosting countries in the world. Most recently, throughout 2016- 2018, Uganda was impacted by three parallel emergencies from South Sudan, the Democratic Republic o... more

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Brazil‘s Social Policy Response to Covid-19: Healthcare and Poverty Alleviation

Massard da Fonseca, E.; Arantes Beatriz, L. B.; Portella, C. Global Dynamics of Social Policy; Deutsche Forschungsgemeinschaft (2022) CC

During the pandemic, Brazil has provided its citizens with support in the areas of long-term care and disability, the labor market, social assistance, education, and pensions. This report focuses on two social policy areas, health-care and family benefits (including labor policies), as these were th... more

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Code Red for Health response in Latin America and the Caribbean: Enhancing peoples' health through climate action

Yglesias_González; M.; et al. (2022) CC

The Lancet Regional Health - Americas 2022;00: 100248 Published online xxx https://doi.org/10.1016/j.lana.2022.100248. The Lancet Countdown report, discuss the overlapping social, climate and health challenges in Latin America and the Caribbean, and urge multisectoral and political action to trans... more

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Improving Care and Promoting Health in Populations: Standards of Care in Diabetes—2024

American Diabetes Association Professional Practice Committee Volume 47, Issue Supplement_1 January 2024 (2024) CC2

Ensure treatment decisions are timely, rely on evidence-based guidelines, capture key elements within the social determinants of health, and are made collaboratively with people with diabetes and care partners based on individual preferences, prognoses, comorbidities, and informed ﬁnancial conside... more

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Heat and health

The Lancet (2021) CC

Lancet 2021; 398: Series: Heat and Health Hot weather and heat extremes harm human health, with poverty, ageing, and chronic illnesses as aggravating factors. As the global community contends with even hotter weather in a changing climate, there is a pressing need to better understand the most eff... more

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Health Think Piece

UN Children's Fund UNICEF (2022) C_UNICEF

UNICEF Syria’s series of think pieces. Every day counts. An outlook on child protection for the most vulnerable children in Syria.To navigate the complex and continuously changing context and attain sustainable results for children, UNICEF – along with other UN agencies - seeks to make a shift i... more

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NAPHS for all: a country implementation guide for national action plan for health security (‎NAPHS)‎ - Second edition
recommended

World Health Organization WHO (2025) C_WHO

Lessons learned from recent public health events such as the COVID-19 pandemic, Ebola virus disease, Zika virus disease outbreaks, and other public health threats, including earthquakes and floods, have highlighted the need for countries to continuously develop, strengthen, and maintain capacities r... more

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Indonesia: Undang-Undang Republik Indonesia Nomor 24 Tahun 2011 Tentang Badan Penyelenggara Jaminan Sosial

President of the Republic of Indonesia (2011) C1

Laws of the Republic of Indonesia number 24 of 2011 concerning the legal health insurance

Monkeypox outbreaks outside endemic regions: scientific and social priorities recommended

NAPHS for all: a country implementation guide for national action plan for health security (‎NAPHS)‎ - Second edition recommended

Monkeypox outbreaks outside endemic regions: scientific and social priorities
recommended

NAPHS for all: a country implementation guide for national action plan for health security (‎NAPHS)‎ - Second edition
recommended