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Nepal at the Crossroads: Setting the Stage for Improved Social Health Protection

Ministry of Health and Population, Nepal; Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH; Health Sector Support Program (HSSP) (2010) C1

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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 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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Latest health spending trends: Navigating beyond the recent crises

Mueller M., Morgan D. Organisation for Economic Co-operation and Development (OECD) (2024) CC

With the COVID-19 pandemic and the ensuing energy and cost-of-living crises, many OECD countries have had to face significant economic and societal challenges over the last five years. The succession of crises has had important implications for health systems and the available resources allocated to... more

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The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal ... more

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The environmental footprint of health care: a global assessment

Lenzen, M.; A. Malik, M.Li, et al. (2020) CC

Lancet Planet Health 2020; 4: e271–79

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Global Health Education Competencies Tool-Kit

Astle. B.; C.A.Faerron-Guzman; A. Landry, et al. Consortium for Universities for Global Health (2018) CC

2nd edition. The tool kit provides learning objects and curricular content to support the competencies for those proficiency/trainee levels

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Tracking aid flows for development assistance for health

Vassall A.; Shotton J.; Klein O. et al Global Health Action (2014) CC

he global architecture for providing development assistance for health (DAH) has become increasing complex in the last decade, with many new funding agencies entering the health sector. This study presents a detailed picture of European Union (EU) and EU member state originating DAH between 2006 ... more

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medmissio fact sheet - U.S. Economic Power and ODA Contributions for Health

Tilman Rüppel and Joachim Rüppel medmissio (2025) CC

This publication discusses official development assistance (ODA) provided by the USA with a focus on health, HIV/AIDS, tuberculosis and malaria. It also refelcts upon ODA by the USA in comparison to other donors and funding targets.

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Health Sector Gender Policy

Ministry of Health, Ghana (2009) C1

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Ghana Health Financing Strategy 2015

Ministry of Health, Ghana (2015) C1

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Community Health Insurance in India - An overview

Economic and Political Weekly (2004)

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Nigeria: National Strategic Health Development Plan (NSHDP) 2010 - 2015

Federal Ministry of Health Nigeria (2010) C1

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Attracting Poor People to public health facilities to access free health care: a n assessment of the Integrated Social Health Protection Scheme

Deutsche Gesellschaft für International Zusammenarbeit (GIZ) Population Council; Socieux (2017) CC

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Projected Health Financing Transitions: Timeline and Magnitude

Rachel Silverman Center for Global Development (2018) C2

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Strengthening the collection, analysis and use of health workforce data and information: a handbook

World Health Organisation (WHO) (2023) C_WHO

Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d... more