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Towards Mapping the Fiscal Space: Health Sector Financing Strategy in Mozambique

N’weti, Wemos (2024) CC

This paper was commissioned by N´weti and Wemos as part of the project “Equitable health financing for a strong health system in Mozambique”. Its purpose is to contribute to the debate of the Mozambican Ministry of Health’s draft Health Sector Financing Strategy (HSFS) 2025 – 2034

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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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Technical note on accelerating P. falciparum elimination in the Americas

Pan American Health Organization (PAHO) (2023) C_WHO

All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the e... more

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World Drug Report 2022 Booklet 2 Global Overview of Drug Demand and Supply

United Nations Office on Drug and Crime UNODC (2022) C1

Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs. The first chapter of the booklet begins with the latest estimates of the number of people who use drugs, the distribution of those users by type of drug... more

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Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019
recommended

GBD 2019 Human Resources for Health Collaborators The Lancet (2022) CC

A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Vol.399 Issue 10341 p.2129-2154 Human resources for health (HRH) include a range of occupations that aim to promote or improve human health. The UN Sustainable Development Goals (SDGs) and the WHO Health Workforce 2030 s... more

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Snapshot report: The state of communication, community engagement and accountability across the Ukraine response (30 September 2022)

CDAC Network Reliefweb OCHA Services (2022) C2

Since the first edition of the CDAC snapshot of communication, community engagement and accountability (CCEA) across the Ukraine response was published in May 2022, a conscious effort has been made by international, national and local responders to ramp up CCEA action. Progress has been made in esta... more

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The POPI act vs Medical Records

Prof Frank Peters Faculty of Health Sciences, University of Pretoria South Africa (2020) CC

The Protection of Personal Information (POPI) Act Confidentiality: providing and protecting information • Health care practitioners hold information about patients that is private and sensitive. • The National Health Act (Act No. 61 of 2003) provides that this information must not be given to... more

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Legal environment Assessment for HIV in Ukraine

USAID (U.S. President’s Emergency Plan for AIDS Relief) (2017) C2

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Comptes de la Santé RDC 2013 - Rapport Narratif

Programme National des Comptes de la santé (PNCNS), Ministère de la Santé Publique RDC (2015) C_WHO

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The Greenmark Standard for Green Buildings

Otieno, N. Green Africa Foundation; Ministry of Health Kenya, et al. (2019) CC

The Government recognizes the critical role of the built environment in addressing climate change and environmental degradation. To this end, it has identified and empowered the Kenya Building Research Centre to champion and coordinate the government’s green building agenda in relation to climate ... more

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Warehouse information system assessment

MSH Management Sciences for Health (MSH) (1996) C1

PURPOSE: To assess the appropriateness of computerizing a health facility warehouse. If users are interested in receiving technical assistance to improve and/or computerize the logistics information system, Management Sciences for Health (MSH) will analyze the responses to determine the initial step... more

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Tuberculosis and HIV coinfection in Europe: looking at one reality from two angles

M. J. van der Werfa; C. Ködmön; P. Zucs Wolters Kluwer Health; PMC (2016) C2

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Children affected by HIV/AIDS in South Africa

R. Smart; HIVAIDS Consultant Save the Children (UK) South Africa Programme; The Department of Social Development (2003) C2

A Rapid Appraisal of Priorities, Policies and Practices

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Nexus approaches in humanitarian settings - A guidance note for the Protection Cluster

A global NGO network for principled and effective humanitarian action (ICVA) (2023) C2

This Guidance Note is meant to help protection cluster coordinators apply nexus approaches in a practical way by, providing concrete steps and means to address prevalent or longstanding protection issues, risk patterns, trends and chronic vulnerabilities. The guidance calls for a practical, problem-... more

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Integrating Clinical Research into Epidemic Response: The Ebola Experience

Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta National Academies of Sciences, Engineering, and Medicine (2017) C1

The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Repub... more

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Joint Radiation Emergency Management Plan of the International Organizations

International Atomic Energy Agency (2017) C1

This Joint Emergency Management Plan of the International Organizations (Joint Plan) describes the interagency framework of preparedness for and response to an actual, potential or perceived nuclear or radiological emergency independent of whether it arises from an acci... more

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Analysis of the Situation of Children and Women in Bangladesh 2015

UNICEF (2015)

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Prevención de las infecciones nosocomiales

Organización Mundial de la Salud (2002)

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Systematic review and meta-analysis of the adolescent HIV continuum of care in South Africa: the Cresting Wave

B. C. Zanoni; M. Archary; S. Buchan; I. T. Katz; J. E. Haberer BMJ Global Health; Pub Med (2016) C2

Zanoni BC, et al. BMJ Glob Health 2016;1:e000004. doi:10.1136/bmjgh-2015-000004

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Comprehensive Literature Review on Village Based Health Workers in Myanmar: Extending Services to Communities

The Republic of the Union of Myanmar, Ministry of Health and Sports (2017) C1

The main goal of the National Health Plan (NHP) 2017-2021 is to extend access to a basic Essential Package of Health Services (EPHS) to the entire population while increasing financial protection. In order to extend service delivery to all communities, the NHP calls for all health workers (whether c... more

Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019 recommended

Measuring the availability of human resources for health and its relationship to universal health coverage for 204 countries and territories from 1990 to 2019
recommended