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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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...ve implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept).
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Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program’s strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant servi...ces. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts.
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This document is to support local authorities, leaders and policy-makers in cities and other urban settlements in identifying effective approaches and implementing recommended actions that enhance the prevention, preparedness and readiness for COVID-19 in urban settings, to ensure a robust response ...and eventual recovery. It covers factors unique to cities and urban settings, considerations in urban preparedness, key areas of focus and preparing for future emergencies.
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Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report says. In high-income countries, that rate is 3 deaths per 1,000. Newborns from the riskiest places to give birth are up to 50 times more likely to die than those from the safest places.
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The report also notes that 8 of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. If every country brought its newborn mortality rate down to the high-income average by 2030, 16 million lives could be saved.
More than 80 per cent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, the report says. These deaths can be prevented with access to well-trained midwives, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact and good nutrition.
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Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion... per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
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OECD Development Policy Tools
Recognising that donor policies and responses constantly evolve, this guidance recommends that donors operating in situations of forced displacement prioritise three broad areas of work, where they can best contribute to existing capacities at the national, regiona...l and global levels.
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This report presents findings from research conducted by Economist Impact to assess the health, demographic, social and economic impacts associated with different scenarios for financing the HIV epidemic across 13 selected countries in Sub-Saharan Africa. The sponsorship of UNAIDS towards this repor...t is gratefully acknowledged. However, the findings and ideas expressed herein represent those of Economist Impact. They do not necessarily reflect the views and opinions of UNAIDS, nor do they engage the responsibility of UNAIDS.
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The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on health continually rose between 2000 and 2018 and reach...ed US$ 8.3 trillion or 10% of global GDP. The data also show that out-of-pocket spending has remained high in low and lower-middle income countries, representing greater than 40% of total health spending in 2018. We also report and summarize the data on expenditures for PHC, as well as by disease and intervention, including for immunization. The report also analyzes the available data on budget allocation in response to the COVID-19 crisis. In addition, we combine World Bank/IMF projections of the macroeconomic and fiscal impact of the crisis with an analysis of the historical determinants of health spending patterns and UHC indicators, and based on this, we draw out the likely implications of 2020 for future health spending, highlighting key policy and monitoring concerns.
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The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential Care and Practice that includes general guid...elines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
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Non-communicable diseases (NCDs) & injuries and mental health conditions constitute a serious impediment to achieving the vision of Agenda 2063 to build an integrated, prosperous, and peaceful Africa driven by its own citizens. Each year, these conditions cause millions of premature deaths and disab...led lives across Africa. These conditions also lead to annual economic loss of multiple billion US-Dollars. Their burden both in terms of disease morbidity/mortality and socio-economic impact is increasing.
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Medical devices are used for the prevention, diagnosis and treatment of illness and diseases and for rehabilitation. WHO developed guidance on medical device donation in 2011, which has been now reviewed, with new evidence, new references on considerations for medical device solicitation and provisi...on, risks associated with inappropriate donations, the responsibilities of donors and recipient, and the steps they should follow before, during and after a donation. It includes three sections: description of major problems that may be faced during the donation process, listing of best practices for donors and recipients and addressing situations requiring special attention. It also has three annexes for further reading: the criteria for the acceptability of a donation, literature review on donations of medical devices between 2010 and 2023 and a flyer. This document is intended to improve the quality of medical devices donations, including medical equipment, single-use medical devices and in-vitro diagnostics, to provide maximum benefit to all stakeholders. The considerations can be used to develop institutional or national policies and regulations for medical devices donations. This document is intended for use by any organization, expert or practitioner involved in the donation, procurement, management of medical devices, including health workers, biomedical engineers, health managers, policymakers, donors, nongovernmental organizations and academic institutions.
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Better Parenting Nigeria is a parenting education program whose goal is to see that families have the knowledge and skills needed to raise healthy, safe and resilient children. The program aims to ensure that:
The caregiver-child relationship is strengthened;
Caregiver capacity to understa...nd family needs and access resources and services is
increased; and
Caregiver capacity to protect children from all forms of harm and exploitation is
improved.
This Facilitator’s Manual is for the facilitator to use to support the community discussions, provide targeted messaging, and recommend suggestions for knowledge and experience sharing. It should be used hand-in-hand with the Community Discussion Guide.
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Version 2 (unedited). The Basic Needs Analysis (BNA) is a multi-sector needs analysis approach that can be applied in both sudden onset and protracted emergencies. The methodology comprises the Guidance (this document) presenting the conceptual BNA framework and related processes, and a Toolbox, whi...ch includes tools, templates, training materials, and examples drawn from its first pilot, in Borno State(Nigeria).
The BNA is conceived to go hand in hand with the Facilitator’s Guide for the Response Options Analysis and Planning (a separate document), as it is part of a broader response planning process (see The BNA within the ). It shall be carried out with other assessments on the operational environment and would not add any value if undertaken in isolation.
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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including ...disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
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Child marriage is a widespread practice across Turkana, a nomadic pastoralist region in Kenya. This report explores the issue through the voices of those girls affected by it.
The Contingency Fund for Emergencies (CFE) provides WHO with rapid and flexible resources to respond to disease outbreaks and other health emergencies. The annual report provides an overview of the use and impact of the Fund over the previous year.
This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ...how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national TB response in accelerating efforts towards elimination. The document will also be inform...ative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, termed progress and ambitious, aimed at strengthening co...mprehensive health service delivery to achieve SDG 3 and universal health coverage in low-income and middle-income countries (Stenberg et al., 2017). Out of the 47 countries in the WHO African region only eight, on average, met the recommended threshold of spending a minimum of US$ 249 per capita on health during the period from 2012 to 2020. In 2020, this achievement was observed in only five countries while the remaining countries spent less than US$ 249 per capita, with health expenditures ranging from US$ 16.4 to US$ 236.6, highlighting significant disparities across the region.
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