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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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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

Development assistance for health (DAH) plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically focused on infectious diseases and maternal and child health, there is a lack of comprehensive analysis of DAH trends, strategic shifts and the... 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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Community Health Worker Training Curriculum - Facilitator's Guide

Baylor Tingathe Community Outreach Programme Baylor College of Medicine Children’s Foundation Malawi (2016) CC

This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un... more

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LESOTHO: Health Sector Strategic Plan 2012/13-2016/17

Government of Lesotho (2013) C2

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Uganda: The National Policy Guidelines and Service Standards for Reproductive Health Services

Reproductive Health Division Community Health Department Ministry of Health Uganda (2002)

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Ukrainian Prioritized Multisectoral Mental Health and Psychosocial Support Actions During and After the War: Operational Roadmap

World Health Organisation (WHO) (2022) C_WHO

The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years. According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system. The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council). This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country. The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan. Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine. As well as information on the context in Ukraine, the Roadmap includes: • a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and • a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2). more

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Promoting human rights in mental health WHO QualityRights training to act, unite and empower for mental health (P I L O T V E R S I O N)

World Health Organization WHO (2017) C_WHO

This document has been developed to provide training and guidance on how to integrate a human rights approach in mental health and related areas, based on international human rights instruments, in particular the UN Convention on the Rights of Persons with Disabilities (CRPD).

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Emerging and re-emerging human infectious diseases: A systematic review of the role of wild animals with a focus on public health impact

Cupertino, M. C.; Resende, M. B.; et al (2020) C2

Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological age... more

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Responding to child maltreatment: a clinical handbook for health professionals

World Health Organisation (WHO) (2022) C_WHO

This handbook is intended primarily for front-line health care providers who are likely to see children (among other clients) in their day-to-day practice. These may include general practitioners, nurses, midwives, gynaecologists, paediatricians, mental health professionals, first responders and st... more

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Guidelines on Mental Health and Psychosocial Support

Internationl Committee of the Red Cross ICRC (2018) C1

These ICRC guidelines outline the organization’s approach to mental health and psychosocial support (MHPSS) during and after armed conflict and other situations of violence. They provide a framework for harmonizing MHPSS programmes within the organization, and an insight into its strategic process... more

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Transforming health systems: the vital role of water, sanitation and hygiene

WaterAid (2018) C1

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Health Problems and Health Care Seeking Behaviour of Rohingya Refugees

Y. Arafat, R.Kabir, A.A.Masud (2017) CC

DOI10.5281/zenodo.344972

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Sexual and Reproductive Health for HIV-Positive Women and Adolescent Girls

Engender Health, ICW (2006)

Manual for Trainers and Programme Managers

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Health at a Glance: Latin America and the Caribbean 2020

OECD; The World Bank (2020) C1

Thefirst report on Latin America and the Carribean presents key indicators on health and health systems in 33 Latin America and the Caribbean countries. . Analysis is based on the latest comparable data across almost 100 indicators including equity, health status, determinants of health, health car... more

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Maintaining essential health services: operational guidance for the COVID-19 context interim guidance

WHO (2021) CC

Countries around the world are facing the challenge of increased demand for care of people with COVID-19, compounded by fear, misinformation and limitations on movement that disrupt the delivery of health care for all conditions. Maintaining essential health services: operational guidance for the CO... more

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Ebola Virus Disease in Africa: Epidemiology and health facility related transmission

Shears, Paul, T.J.D. O'Dempsey (2015)

A review of current literature and up date data from the field, April 2015. This report has been published in part in J Hosp Inf. 2015;90:1-9. http://www.ncbi.nlm.nih.gov/pubmed/?term=ebola+nosocomial+shears

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Success Factors for Women’s and Children’s Health

Cambodia, Ministry of Health, PMNCH, WHO, World Bank, AHPSR et al. (2015) C_WHO

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Refugee and Migrant Health System Review: Challenges and Opportunities for Long-term Health system Strengthening in Uganda

Government of Uganda; World Health Organization WHO (2024) C_WHO

Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re... more

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Namibia: Community - Based Health Care Policy

Ministry of Health and Social Services (MOHSS) (2007) C1