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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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Proposals for ODA Reform: A Review of Key Approaches

Calleja R., Casadevall-Bellés S. Center for Global Development (2024) CC

Questions concerning the relevance and reform of official development assistance (ODA), and how ODA and broader development finance could—or should—change to better reflect shifting demands are not new, with academics and policymakers suggesting a range of options for reform. In this background ... more

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Tackling malaria in countries hardest hit by the disease: ministerial conference report, Yaoundé, Cameroon, 6 March 2024

World Health Organisation (WHO) (2024) C_WHO

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... more

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Community deployment of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine: a field guide

World Health Organization WHO (2024) C_WHO

The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st... 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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Social and Behavior Change Communication SBCC for Malaria in Pregnancy: Strategy Development Guidance

Health Communication Capacity Collaborative HC3; USAID (2017) CC

This Implementation Kit (I-Kit), developed by the Health Communication Capacity Collaborative (HC3), which is funded by USAID and based at the Johns Hopkins Center for Communication Programs, offers structured guidance for improving social and behavioural change communication (SBCC) strategies relat... more

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Current Developments in Malaria Vaccination: A Concise Review on Implementation, Challenges, and Future Directions

Sallam, M.; A.O.Al-Kathib, K.S.Al-Mazhoum, et al. Dove Press (2025) CC

Clinical Pharmacology: Advances and Applications, 2025:17 29–47

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National Strategic Plan for Malaria Elimination in Bangladesh: 2021-2025

National Malaria Elimination Programme - Directorate General of Health Services Ministry of Health & Family Welfare - Government of Bangladesh (2021) C2

The National Strategic Plan for Malaria Elimination 2021–2025 outlines Bangladesh’s roadmap to achieve zero indigenous malaria cases by 2030, with an interim goal to reduce transmission to near-zero levels by 2025. The strategy builds upon earlier successes in malaria control and shifts focus to... more

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Manual for Indoor Residual Spraying in Urban Areas for Aedes aegypti Control

Pan American Health Organization PAHO (2019) C1

The Manual for Indoor Residual Spraying in Urban Areas for Aedes aegypti Control is intended not only for operational personnel and middle and senior management of programs responsible for the prevention and control of Aedes-borne diseases, but also for the academic community involved in Aedes resea... more

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Manual para aplicar rociado residual intradomiciliario en zonas urbanas para el control de Aedes aegypti

Pan American Health Organization PAHO (2019) C1

Manual para aplicar rociado residual intradomiciliario en zonas urbanas para el control de Aedes aegypti no solo está dirigido al personal operativo y los mandos medios y directivos de los programas de prevención y control de las enfermedades transmitidas por Aedes, sino también a la comunidad ac... more

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Manual para aplicação de borrifação residual em áreas urbanas para o controle do Aedes aegypti

Pan American Health Organization PAHO (2019) C1

O Manual para aplicação de borrifação residual em áreas urbanas para o controle do Aedes aegypti não se dirige apenas ao pessoal operacional e aos gerentes e gestores de nível médio dos programas de prevenção e controle das doenças transmitidas pelo Aedes, mas também à comunidade acadê... more

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Guidance Note for GBV Case Managers in Gaza: Understanding and Responding to the Link between Food Scarcity and Gender-Based Violence

Gender Based Violence Area of Responsibility GBV AoR; United Nations Population Fund UNFPA (2025) CC

The Gaza Strip is experiencing one of the most severe food security crises globally, with the entire population of approximately 2.1 million people now facing crisis-level food insecurity or worse (IPC Phase 3+). As of May 2025, more than one in five Gazans—about 470,000 people—are at risk of s... more

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Guidance Note for Humanitarian Actors in Gaza: Understanding the Link between Food Scarcity and Gender-Based Violence

Gender Based Violence Area of Responsibility GBV AoR; United Nations Population Fund UNFPA (2025) CC

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Integration of HIV testing and linkage in family planning and contraception services: implementation brief

World Health Organisation (WHO) (2021) C_WHO

This implementation brief addresses integration of HIV testing services into family planning (FP) services. It is intended as a practical resource for national health programmes seeking to introduce or scale up HIV testing and linkage to HIV prevention, sexually transmitted infection, and antiretrov... more

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Uganda National Guidelines for Tuberculosis Infection Control in Health Care Facilities, Congregate Settings and Households

Dr. Nathan Kenya Mugisha, Ministry of Health Uganda (2008) C1

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HEARTS. Protocoles thérapeutiques basés sur des données factuelles

Organisation Mondiale de la Santé OMS, et al. (2018) C_WHO

Guide technique pour la prise en charge des maladies cardiovasculaires dans le cadre des soins de santé primaires

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Interagency List of Priority Medical Devices for Essential Interventions for Reproductive, Maternal, Newborn and Child Health

World Health Organization WHO (2017) C_WHO

The objective of this project was to list the medical devices required to provide the essential reproductive, maternal, newborn and child health interventions defined by existing WHO guidelines and publications, in order to improve access to these devices in low- and middle-income countries, support... more

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Food safety and antimicrobial resistance research: A One Health perspective

Hung Nguyen-Viet International Livestock Research Institute ILRI (2019) C2

Food safety and antimicrobial resistance research: A One Health perspective. Presented at the Emerging Pathogens Institute Seminar Series, Gainesville, Florida, 26 July 2019

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Involving male partners in maternity care in Burkina Faso: a randomized controlled trial

Daniele M.A., Ganaba R., Sarrassat S. et. al. Research (2018) C2

Bull World Health Organ 2018;96:450–461 | doi: http://dx.doi.org/10.2471/BLT.17.206466 The aim of our study was to determine whether an intervention designed to involve the male partners of pregnant women in Burkina Faso in facility-based maternity care influences care-seeking and healthy practi... more

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Nutrition in the First 1,000 Days: State of the World’s Mothers 2012

Safe the children (2012)