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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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Efficacité de la chimioprévention du paludisme saisonnier à l’échelle de l’Afrique de l’Ouest et de l’Afrique centrale : une étude d’observation

Partenariat ACCESS-SMC (2020) CC

Lancet 2020 ; 396 : 1829-40

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National Acceleration Plan For Paediatric HIV Services: Ghana 2016 - 2020

United Nations Children’s Fund (UNICEF) (2016) C1

In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current delivery of paediatric HIV care and support system and develop a road map for effecti... more

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Rwanda Health Statistics Booklet 2011

Ministry of Health, Rwanda (2012) C2

This booklet provides policymakers, planners, and other interested parties with insight into the current state of the Rwandan health sector. These statistics provide a basis for policies, strategies, and planned interventions to ensure they are responsive to the needs of the health sector and, cruci... more

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Asthma management in low and middle income countries: case for change

Mortimer, K.; Reddel, H. K.; Pitrez, P. M.; et al. (2022) CC2

Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ... more

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Guidelines for Rogi Kalyan Samities in Public Health Facilities

National Health Mission; Ministry of Health & Social Welfare India (2015) C1

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مبادئ توجيهيّة بشأن العلاج الدوائي لفرط ضغط الدم لدى البالغين
recommended

World Health Organization WHO (2021) C_WHO

The recommendations cover the level of blood pressure to start medication, what type of medicine or combination of medicines to use, the target blood pressure level, and how often to have follow-up checks on blood pressure. In addition, the guideline provides the basis for how physicians and other h... more

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Liberia: Ministry of Health and Social Welfare 2013 Annual Report

Ministry of Health and Social Welfare Liberia (2014) C1

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Rwanda: Health Sector Policy

Ministry of Health, Rwanda (2015) C2

The Health Sector Policy gives general orientations for the sector which are further developed in the various sub-sector policies guiding key health programs and departments. All health sub-sector policies will be updated in line with this new policy. The Health Sector Policy is the basis of nationa... more

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Social determinants approaches to public health: from concept to practice

Erik Blas, Johannes Sommerfeld and Anand Sivasankara Kurup World Health Organization WHO (2011) C_WHO

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British HIV Association guidelines for the treatment of HIV-1-positive adults with antiretroviral therapy 2015(2016 interim update)

British HIV Association (2016) CC

The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection, and at community advocates responsible for promoting the best interests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA ... more

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White Paper for Global Palliative Care Advocacy: Recommendations from a PAL-LIFE Expert Advisory Group of the Pontifical Academy for Life, Vatican City

C. Centeno, Sitte, T. de Lima L. et.al. Journal of Palliative Medicine (2018) C1

Journal of Palliative Medicine Volume 21, Number 10, 2018 DOI: 10.1089/jpm.2018.0248ad

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Сводное руководство ВОЗ по туберкулезу. Модуль 4: лечение. Лечение лекарственно-устойчивого туберкулеза‎

World Health Organization WHO (2021) C_WHO

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Guidelines for the Prevention and Contaiment of of Antimicrobial Resistance in South African Hospitals
recommended

NdOH South Africa National Department of Health South Africa (2018) C1

These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interr... more

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Perceptions and experiences of nurses about the mobile clinic work environment

Stemmet, C.L. (2016) C1

Thesis presented in partial fulfilment of the requirements for the degree of Master of Nursing Science in the Faculty of Health Sciences at Stellenbosch University. The mobile clinic health care services fulfil an essential role in delivering primary health care to the dwellers in the rural commun... more

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The National strategic plan for tuberculosis and leprosy control 2010-2015

Federal Ministry of Health Nigeria USAID (2011) C1

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Human Resources for Health Strategic Plan 2012-2016 (Sierra Leone)

Ministry of Health and Sanitation, Sierra Leone (2012) C1

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Palliative Care Toolkits and Training Manual
recommended

Worldwide Hospice Palliative Care Alliance (2014) CC

This toolkit has been written to empower health workers in resource-poor settings to integrate palliative care into the work they are doing by grafting the missing elements of care onto what is already in place. The WHPCA, Hospice UK and Palliative Care Works have led this updating of the Palliative... more