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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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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

The Council was established in late 2020 by Dr Tedros Adhanom Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t... more

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Health Taxes: A Compelling Policy for the Crises of Today

The Task Force on Fiscal Policy for Health Report 2024 Bloomberg (2024) CC

For this report, the Task Force commissioned additional background papers on health taxes to update the evidence, assess short-term revenue potential, and understand the role of health taxes in the current era of multiple crises. We find that health taxes continue to be underutilized despite th... more

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A healthy return: Investment case for a sustainably financed WHO

World Health Organization (WHO) (2022) CC

There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.

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Intégrer la question du genre dans la lutte contre le paludisme pour répondre à un double objectif

RBM Partenariat pour en finir avec le paludisme; Malaria No More (2021) C1

Cette note d'information souligne l'importance d'intégrer une approche sensible au genre dans les efforts de lutte contre le paludisme dans le monde entier. Il montre que la prise en compte des vulnérabilités et des besoins spécifiques à chaque sexe - en particulier ceux des femmes et des enfan... more

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Data requirements and protocol for determining comparative efficacy of vector control products

World Health Organization WHO (2024) C_WHO

The aim of this protocol is to support the conduct of entomological comparative efficacy assessments for vector control products and the associated non-inferiority analysis. This evidence is used to inform discussions within the guidelines development context as to whether a new vector control prod... more

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SuperBetter Children for Health

Children for Health (2022) C1

SuperBetter Children is a health and wellbeing curriculum designed to be integrated into school programmes or offered as an extracurricular activity.

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Climate Change & Heat and Impact on Health
recommended

Liebau, L.; and S. Mauder (2022) CC

MEDBOX Issue Brief no.23. The intent of this Issue Brief is to raise awareness about heat waves as a result of climate change and its impact on health. More information on the topic of climate change and planetary health you can find in our PLANETARY HEALTH TOOLBOX www.planetaryhealthbox.org

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Guidelines for Management of ST-Elevated Myocardial Infarction

Directorate General of Health Services Ministry of Health & Family Welfare Government of India (2022) CC

Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi... more

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Options for the decontamination and reuse of respirators in the context of the COVID-19 pandemic
recommended

European Centre for Disease Prevention and Control ECDC (2020) C1

Guiding principles for reuse are: Respirators which have been visibly contaminated (e.g. during procedure at intubated patients, such as suction cleaning of airways, taking probes, extubation attempts, etc.) or are damaged or not fitting, should be discarded and cannot be taken for re-use or de... more

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Directrices sobre la respuesta de salud pública a la farmacorresistencia del VIH previa al tratamiento. Julio 2017

Pan American Health Organization (PAHO) (2019) C_WHO

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Strategic Plan 2016-2020

Myanmar Red Cross Society (2016) C1

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Point of Entry Field Manual for Technical Staff working at Airport Health Organisations, Port Health Organisations and Border Quarantine Organisations

Government of India, Directorate General of Health Services, Public Health- International Health division (2015) C1

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Protocolo antirrábico humano

Arbo, A.; F. Ayala; C. Martinez; et al. Progama Nacional de Control de Zoonosis (2013) C1

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Guía de Autocuidado y Alimentación para las Personas con VIH

Valdez Cazeneuve, R.; T.Samudio, P.Ovelar, et al. PRONASIDA (2012) C1

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State of the world's sanitation: An urgent call to transform sanitation for better health, environments, economies and societies. Summary

World Health Organization WHO (2020) C_WHO

For the first time WHO and UNICEF bring together the data on sanitation coverage and investment, and how it impacts health, economies, and the environment. Citing evidence on what works from successful countries and global guidelines, WHO and UNICEF call for strong government leadership and investme... more