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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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Promouvoir des Soins de Proximité en Afrique : L'exemple de la Médecine Générale Communautaire au Bénin; Promotion of community-based care in Africa: example of community general practice in Benin

Roland Caplain, Ismaïl Yacoubou, Didier Adedemy, Alidou Sani, Sandrine Takam, Dominique Desplat Cairn Info (2014) C2

Des efforts considérables ont été menés pour apporter aux populations rurales du continent africain des soins de base. Mais la qualité de ces soins reste aujourd’hui peu satisfaisante car le médecin généraliste est le plus souvent absent en première ligne. Cette situation est paradoxa... more

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Policy Brief: Impact of COVID-19 in Africa

UN; UNSDG (2020) C2

It is too early to know the full impact of COVID-19 on Africa. To date the experience has been varied. There are causes for concern, but also reasons for hope. Early estimates were pessimistic regarding the pandemic’s impact on the continent. But the relatively low numbers of COVID-19 cases report... more

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Migration health: 2019 activities overview - Leave no migrant behind

International Organization for Migration IOM (2020) C1

Every year, nearly 250 million people move across borders temporarily or permanently for a job opportunity, studying, to flee a crisis back home, or for other reasons. Another 750 million move for similar reasons within the borders of their countries. With the understanding that human mobility affec... more

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Ending the neglect to attain the sustainable development goals. One health: approach for action against neglected tropical diseases 2021-2030

World Health Organization WHO (2021) C_WHO

This companion document to Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021-2030 ("the road map") aims to support a range of stakeholders - including countries in which neglected tropical diseases (NTDs) are endemic, international organi... more

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Malawi National STEPS Survey for Chronic Non-Communicable Diseases and their Risk Factors

Ministry of Health, Malawi; World Health Organization (WHO) (2010) C_WHO

Final Report

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Benefits of a one health approach: An example using Rift Valley fever

Rostal, M.K.; et al. (2018) CC

One Health 5 (2018) 34–36

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Guidelines for long-lasting insecticidal nets care, repurposing and disposal

Ministry of Health Uganda, WHO Uganda WHO Regional Office for Africa (2019) C_WHO

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Rwanda Malaria Strategic Plan 2020–2024

Ministry of Health, Rwanda; Rwanda Biomedical Centre (RBC) Ministry of Health, Republic of Rwanda (2020) C2

The Rwanda Malaria Strategic Plan 2020–2024 outlines Rwanda’s national strategy to reduce malaria morbidity and mortality by at least 50% compared to 2019 levels. The vision is a malaria-free Rwanda contributing to socioeconomic development. The plan includes strengthening prevention through lo... more

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World Disasters Report 2022: Executive Summary

International Federation of Red Cross and Red Crescent Societies IFR (2023) CC

The COVID-19 pandemic has been the biggest disaster in living memory, on almost any measure. More than 6.5 million people are confirmed to have died in less than three years, and the pandemic’s indirect impacts have touched the lives of virtually every community on the planet. Our World Disasters... more

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Framework for collaborative action on tuberculosis and comorbidities

World Health Organization WHO (2022) C_WHO

Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support coun... more

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WHO Report on the Global Tobacco Epidemic, 2019. Offering help to quit tobacco use

World Health Organization WHO (2019) C_WHO

The seventh WHO Report on the global tobacco epidemic analyses national efforts to implement the most effective measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce demand for tobacco. The report showed that while only 23 countries have implemented ce... more

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The First Few X (FFX) Cases and contact investigation protocol for 2019-novel coronavirus (2019-nCoV) infection

World Health Organization WHO (2020) C_WHO

The following protocol has been designed to investigate the First Few X cases (FFX) and their close contacts. It is envisioned that the FFX 2019-nCoV investigation will be conducted across several countries or sites with geographical and demographical diversity. Using a standardized protocol such a... more

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Actioning the Emergency Medical Teams’ initiative in the WHO African Region: strategic paper

World Health Organisation (WHO) (2023) C_WHO

Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), armies, and international organizations such as the ... more

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Water, sanitation and hygiene in healthcare facilities: practical steps to achieve universal access to quality care

World Health Organization WHO, Unicef (2019) C_WHO

Purpose of this document: to present eight practical steps that Member States can take at the national and sub-national level to improve WASH in health care facilities

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Managing epidemics: key facts about major deadly diseases

World Health Organization (WHO) (2018) C_WHO

Epidemics of infectious diseases are occurring more often, and spreading faster and further than ever, in many different regions of the world. The background factors of this threat are biological, environmental and lifestyle changes, among others. A potentially fatal combination of newly-discovered ... more

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“We know about schistosomiasis but we know nothing about FGS”

Mazigo, H.; Sanson, A.; Lambert, V.; et al. (2021) CC

A qualitative assessment of knowledge gaps about female genital schistosomiasis among communities living in Schistosoma haematobium endemic districts of Zanzibar and Northwestern Tanzania. PloS Neglected Tropical Diseases September 30, 2021 https://doi.org/10.1371/journal.pntd.0009789 Schistosoma... more

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Checking in on the Checklist

Buissonniere, M. Lifebox and Ariadne Labs (2019) CC

The report and an accompanying series of studies show the global uptake of the World Health Organization (WHO) Surgical Safety Checklist in its first ten years since its launch and recommend ways the Checklist can be more effectively used to improve surgical safety for millions at risk. The report ... more

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Antibiotic use and resistance in South Africa

Dr T Apalata, Dr C Bamford, Mr D Benjamin et al. South African Medical Journey SAMJ (2011) C2

Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infect... more

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GLI Guide to TB Specimen Referral Systems and Integrated Networks

Global Laboratory Initiative (GLI), Stop TB Partnership (2018) C1

This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... more