Getting to Zero
Sustainable Financing of National HIV Responses
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.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover...nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover...nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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This publication provides a problem analysis of the U.S. cuts in global health and derives concrete recommendations for action for medical actors. The focus is on analyzing the direct effects on health-specific development cooperation.
Access to safe, effective and quality-assured health products and technologies is crucial for achieving universal health coverage and primary health care goals. The continued growth of the aging population; increasing burden of noncommunicable diseases; growing burden of mental health issues; climat...e change; shifting patterns of vector borne diseases, fungal disease and waterborne diseases; antimicrobial resistance; and new infectious hazards create an ongoing need for equitable access to safe, effective and quality-assured health products and technologies, and renewed investments in research and development for innovative health products and technologies.
The coronavirus pandemic exposed the inequalities in access to health products, highlighting the need for longer-term strategies to strengthen access to health products and technologies outside of and in emergency situations. While technological and scientific advances present an opportunity to increase access to health products and technologies, the risk of increasing inequality due to higher prices for new health products and technologies; the persisting problem of substandard and falsified medical products; a lack of skilled workforce in many low- and middle-income countries; and a lack of data for decisionmaking and for measuring progress present significant challenges.
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SITUATION ANALYSIS AND RECOMMENDATIONS
This policy paper underscores that, although children do not represent a high-risk group for direct COVID-19 fatality, the pandemic posts far-reaching secondary impacts that heighten risks to African children’s rights and wellbeing.
Many of the countries in the European Region receiving refugees from Ukraine are already offering vaccination services to children and adults. This is important to mitigate the risk of COVID-19 transmission among people travelling or living in close quarters, to protect the refugees from diseases th...at may be circulating in the host country, and prevent any outbreaks of vaccine-preventable diseases such as measles and polio.
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In its resolution 34/16, the Human Rights Council decided to focus its next full-day meeting on “Protecting the rights of the child in humanitarian situations” and invited the Office of the High Commissioner to prepare a report on that issue, in close collaboration with relevant stakeholders. Th...e report is to be presented to the Human Rights Council at its thirty-seventh session to inform the annual day of discussion on children’s rights.
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The publication draws on pre-COVID data to highlight how children with disabilities face greater risks in the midst of this pandemic. It documents what has happened to services for children and adults with disabilities across the world and includes examples of what has been done to address disruptio...ns in services. It also discusses the challenges in generating disability-inclusive data during the pandemic.
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This document contains guidance for strengthening the disability inclusiveness of MHPSS responses and programmes in emergency settings. It is intended to supplement the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2007).
Overall Objective
To consider and add...ress the mental health and psychosocial support (MHPSS) requirements of persons living in emergency settings with all types of disabilities on an equal basis to the MHPSS requirements of all persons, using a human rights-based approach and implementing social-ecological frameworks.
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This study provides information about vulnerabilities within the targeted population and contributes to reflection within UNHCR on how to interpret their multisectorial Home Visit assessments. By exploring relationships between vulnerability indicators and other data collected, the report outlines k...ey trends and relationships. The report details predefined VAF indicators and then provides an in-depth descriptive analysis for each sector
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Published: March 28, 2017https://doi.org/10.1371/journal.pmed.1002271
PLoS Med 14(3): e1002271. https://doi.org/10.1371/journal.pmed.1002271
Building the competence and confidence of nurse and midwife educators
ICAP Nurse Capacity Initiative offers its Campus to Clinic Curriculum to empower nursing educators and mentors with a new area of expertise. It opens the door to teach in new ways with confidence. It can be adapted to different c...ommunities, cultures, and countries
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