4. Central African Republic
Clashes throughout 2018 in the capital Bangui and a number of major towns illustrate the deadly threat posed by armed groups – a mix of pro-government militias, ex-rebels, bandits and local “self-defence” units – that control much of the countr...y. MINUSCA, the UN peacekeeping force, has failed to neutralise these groups and, as a result, is mistrusted by the general public. Likewise, the national army, slowly being deployed in parts of the country, has been unable to constrain the armed groups’ predatory activities. The humanitarian situation remains dire, with more than one million people internally displaced or fleeing to neighbouring countries and 2.5 million in need of assistance, according to the UN.
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Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a...id flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
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The risks of the use of nuclear, radiological, biological or chemical (NRBC) weapons are heterogeneous. Each risk has its own implications for developing and deploying any capacity to assist victims of an NRBC event and, in parallel, for the health and security of the people bringing this assistance.... At an international level, there are no plans for assisting the victims of an NRBC event which are both adequate and safe. Recognizing
the realities of the contexts associated with each risk throws up numerous challenges; such recognition is also a prerequisite for addressing these challenges. The realities that have to be considered relate to:
1. developing, acquiring, training for and planning an NRBC response capacity;
2. deploying a response capacity in an NRBC event;
3. the mandates and policies of international organizations pertaining to NRBC events. The challenges that will pose the greatest difficulty for a humanitarian organization are those for which the solutions are ‘non-buyable’ and which involve making extremely difficult decisions. Attempting to assist victims of an NRBC event without a reality-based approach might generate ineffective and unacceptably dangerous situations for those involved.
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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 l...ack 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.
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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 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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According to WHO, around 22% of adults in conflict settings have mental health conditions.
This is almost triple to non-conflict settings. There is no generally accepted estimate for children but it is clear that children who are refugees, IDPs or who live in conflict settings have high levels of m...ental health issues.
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The Cost of Security Risk Management for NGOs explores the costs related to safety and security management for aid programmes. It aims to assist all aid practitioners to determine their risk management expenditure more accurately, and demonstrate an evidence-based approach when presenting this infor...mation to donors.
The paper will be particularly relevant to those responsible for programme planning and management, donor proposal writing, as well as safety and security risk management.
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This EISF report provides an analysis of the issues surrounding the relationship between NGO’s and their local partners. It includes a section on the topic and its background, responsabilities towards the partner organisation and particularly in terms of security, how to enable and help the partne...r in developing a project from start to finish, the challenges of developing that capacity in the partner organisation. It also includes three anexes, namely a Partner Security Level Assessment, a Checklist of organisational security perspectives and Participants.
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On Sunday 16th December 2018, some villages in the Province of Mai-Nambiar, Democratic Republic of Congo, neighboring the district of Makotimpoko in the Republic of Congo (CongoBrazzaville) were affected by inter-ethnic conflict between the Banunu and the Batende. The fighting has resulted in 400 fa...talities and the destruction of property. A large number of the population of the conflict affected areas were forced to cross the river Congo and find refuge in several localities in the Cuvette (Konda and Youmba) and Plateaux (Makotimpoko, Bouemba, Patrick) areas in Congo-Brazzaville.
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The purpose of this Emergency Response Framework (ERF) is to clarify WHO’s roles and responsibilities in this regard and to provide a common approach for its work in emergencies. Ultimately, the ERF requires WHO to act with urgency and predictability to best serve and be accountable to populations... affected by emergencies.
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The disaster and Red Cross Red Crescent response to date
9 March 2019: Tropical Cyclone Idai forms over Northern Mozambique Channel. CVM preparedness and early warning actions underway
13 March 2019: IFRC Surge Capacity is deployed to Maputo
14 March 2019: 342,562 Swiss francs allocated from th...e IFRC’s Disaster Relief Emergency Fund (DREF) to meet the immediate shelter, WASH and health needs of 1,500 households
15 March 2019: Tropical Cyclone Idai makes landfall in Beira,
Mozambique.
17 March 2019: IFRC Surge Capacity arrival in Beira with CVM to conduct preliminary assessments.
19 March 2019: IFRC issues an Emergency Appeal for 10 million Swiss francs for 75,000 people for 12 months.
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In 2020, UNRWA will continue to support Palestine refugees affected by the protracted crisis through providing relief assistance and ensuring access to essential education and health services. Drawing on its existing structures, supply chains and capacities, the Agency will continue to adapt its int...erventions to respond to ongoing and evolving needs in an effective and agile manner. In Syria, it is expected that the spontaneous return of Palestine refugees from within and outside the country will continue in areas that experience relative calm and where basic infrastructure is rehabilitated, as observed in Sbeineh and Khan Eshieh camps in recent years. In 2020, UNRWA will increase its efforts to rehabilitate its facilities and restore its services in areas of spontaneous return, including in Dera’a, where small scale returns have been observed in 2019.
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