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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 o
...
n 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
The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NC
...
Ds) into existing health programs for HIV/AIDS, tuberculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
more
These guidelines are designed for ICRC and other health professionals – nurses, midwifes, doctors – who either lack experience in antenatal care or are not used to working in countries where medical in
...
frastructure is underdeveloped or non-existent
more
The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential Care and Practice that includes general guid
...
elines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
more
Security Survey for Health Facilities
recommended
The purpose of the survey is to identify the level of preparedness required by a health-care facility to be able to continue operating during, or following a conflict-related security event.
The survey method provides a measure of the securit ... y and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
The survey method provides a measure of the securit ... y and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
The report identifies major global gaps in WASH services: one third of health care facilities do not have what is needed to clean hands where care is provided; one in four facilities have no water services, and 10% have no sanitation services. This
...
means that 1.8 billion people use facilities that lack basic water services and 800 million use facilities with no toilets. Across the world’s 47 least-developed countries, the problem is even greater: half of health care facilities lack basic water services. Furthermore, the extent of the problem remains hidden because major gaps in data persist, especially on environmental cleaning.
This report also describes the global and national responses to the 2019 World Health Assembly resolution on WASH in health care facilities. More than 70% of countries have conducted related situation analyses, 86% have updated and are implementing standards and 60% are working to incrementally improve infrastructure and operation and maintenance of WASH services. Case studies from 30 countries demonstrate that progress is being propelled by strong national leadership and coordination, use of data to direct resources and action, and the mutual benefits of empowering health workers and communities to develop solutions together.
more
This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, used on its own, is not enough to understand the complexities of sanitation, hygiene, water, and
...
health. It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
more
Contains data from World Health Organization's data portal covering the following categories:
Mortality and global health estimates, Sustainable development goals, Millennium Development Goals (MDG
...
s), Health systems, Malaria, Tuberculosis, Child health, Infectious diseases, Neglected Tropical Diseases, World Health Statistics, Health financing, Tobacco, Substance use and mental health, Injuries and violence, HIV/AIDS and other STIs, Public health and environment, Nutrition, Urban health, Noncommunicable diseases, Noncommunicable diseases CCS, Negelected tropical diseases, Infrastructure, Essential health technologies, Medical equipment, Demographic and socioeconomic statistics, Health inequality monitor, Health Equity Monitor, Child malnutrition, TOBACCO, Neglected tropical diseases, International Health Regulations (2005) monitoring framework, 0, Insecticide resistance, Oral health, Universal Health Coverage, Global Observatory for eHealth (GOe)
more
Ethiopia faces unprecedented public health risks with over 17.4 million people in need of health assistance due to a compounded security, epidemiological, environmental and socio-economic hardships
...
throughout the country. Specifically, the prolonged drought and localized conflicts have negatively impacted public health systems, whose access has become severely hindered because of physical constraints, infrastructure, equipment damages, lack of available healthcare workforce and negative coping mechanisms resulting from livelihoods deterioration. Whereas the World Health Organization (WHO) assistance has been critical to coordinate humanitarian efforts in affected areas, additional efforts are required in the coming months to address ongoing epidemic outbreaks and support the recovery process in conflict-affected areas (Afar, Amhara, Tigray and Gambelia) that are now accessible.
more
Mobile Health for Asthma and Chronic Obstructive Respiratory Disease (mBreatheFreely)
World Health Organization (WHO)
World Health Organization (WHO), International Telecommunication Union (ITU)
(2018)
C_WHO
The document is a handbook on implementing the mBreatheFreely program, an mHealth initiative by the World Health Organization (WHO) and the International Telecommunication Union (ITU) aimed at improving the management of asthma and COPD through mobi
...
le technology. It provides a framework for governments and policymakers to develop, launch, and evaluate national mHealth programs. The guide covers areas such as operations management, content development, promotion strategies, technology infrastructure, and monitoring and evaluation. It emphasizes the importance of mHealth in enhancing self-management, prevention, and treatment of chronic respiratory diseases, particularly in low- and middle-income countries. The handbook also includes examples of successful programs and practical tools for adaptation and implementation.
more
Lung health in Africa: challenges and opportunities in the context of COVID-19
Ozho, O.B.; Mbatchou Ngahane, B.H.; Zar, H.J.; et al.
American Journal of Physiology - Lung Cellular and Molecular Physiology
(2021)
CC2
The article discusses the challenges and opportunities for lung health in Africa in the context of the COVID-19 pandemic. It highlights the strain on healthcare systems, the increase in chronic respiratory diseases like asthma and COPD, and the limi
...
ted resources for managing these conditions. The pandemic has exacerbated issues like delayed diagnosis and treatment, while also impacting child lung health and increasing risks for those with tuberculosis. It emphasizes the importance of leveraging global partnerships and strategies to improve healthcare infrastructure and response in Africa.
more
As of December 31, 2020, Brazil had the second-highest burden of COVID-19 worldwide. Given the absence of federal government coordination, it was up to the local governments to maintain healthcare provision for non-COVID health issues. In this descr
...
iptive study, we aimed to discuss the SUS functionality and resilience, describing the impact of the pandemic on non-COVID health services delivery while considering the regional inequalities of the allocation of financing health system, health infrastructure and health workforce.
more
Climate change is damaging human health now and is projected to have a greater impact in the future. Low- and middle-income countries are seeing the worst effects as they are most vulnerable to climate shifts and least able to adapt given weak
...
health systems and poor infrastructure. Low-carbon approach can provide effective, cheaper care while at the same time being climate smart. Low-carbon healthcare can advance institutional strategies toward low-carbon development and health-strengthening imperatives and inspire other development institutions and investors working in this space. Low-carbon healthcare provides an approach for designing, building, operating, and investing in health systems and facilities that generate minimal amounts of greenhouse gases. It puts health systems on a climate-smart development path, aligning health development and delivery with global climate goals. This approach saves money by reducing energy and resource costs. It can improve the quality of care in a diversity of settings. By prompting ministries of health to tackle climate change mitigation and foster low-carbon healthcare, the development community can help governments strengthen local capacity and support better community health.
more
In July 2015, The Lancet published a series on faith-based health care. The Executive Summary states that “this Series argues that building on the extensive experience, strengths, and capacities of faith-based organisations (eg, geographical cover
...
age, influence, and infrastructure) offers a unique opportunity to improve health outcomes”.
An estimated 84% of the world’s population is religiously affiliated. Faith is a powerful force in the lives of individuals and communities worldwide.
more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (P
...
HC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system through achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
more
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and contro
...
l. We partnered with the government ministries responsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
more
By almost any measure, human health is better now than at any time in history. Life expectancy has soared from 47 years in 1950–1955, to 69 years in 2005–2010, and death rates in children younger than 5 years of age have decreased substantially,
...
from 214 per thousand live births in 1950–1955, to 59 in 2005–2010. But these gains in human health have come at a high price: the degradation of nature’s ecological systems on a scale never seen in human history. A growing body of evidence shows that the health of humanity is intrinsically linked to the health of the environment, but by its actions humanity now threatens to destabilise the Earth’s key life-support systems.
As a Commission, we conclude that the continuing degradation of natural systems threatens to reverse the health gains seen over the last century. In short, we have mortgaged the health of future generations to realise economic and development gains in the present.
Despite present limitations, the Sustainable Development Goals provide a great opportunity to integrate health and sustainability through the judicious selection of relevant indicators relevant to human wellbeing, the enabling infrastructure for development, and the supporting natural systems, together with the need for strong governance.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Eur
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ope and Central Asia – or 92 million children – are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue.
Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased
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health complications for older people, persons with disabilities and children. They also reinforce cycles of poverty, inequality and deprivation – particularly for women, children and marginalized groups, who are disproportionately impacted by a lack of equitable access to water and sanitation.
Launched on World Water Day, the guidelines address the knowledge gap on ways to practically implement inclusive approaches to WASH infrastructure development, particularly in developing countries and fragile contexts.
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This document is developed using technical input from the Interim Guidance on Scaling-up COVID-19 Outbreak in Readiness and Response Operations in Camps and Camp-like Settings and Key Considerations for Selecting Health
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Infrastructure for the Response to COVID 19 in addition to other technical guidance documents developed by WHO and referenced accordingly.
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