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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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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Tanzania

Africa Center for Disease Control and Prevention (2023) CC

The Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) project has conducted a multi-year, multi-country study that provides stark insights on the under-reported depth of the antimicrobial resistance (AMR) crisis across Africa and lays out urgent policy recommendations to addr... more

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Uganda

Africa Center for Disease Control and Prevention (2023) CC

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Senegal

Africa Center for Disease Control and Prevention (2023) CC

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Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2021

World Health Organization WHO (2021) C_WHO

9 June 2021 Since its launch, GLASS has expanded in scope and coverage and as of May 2021, 109 countries and territories worldwide have enrolled in GLASS. A key new component in GLASS is the inclusion of antimicrobial consumption (AMC) surveillance at the national level highlighted in this fourth G... more

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Antimicrobial Resistance Background Document

National Department of Health South Africa (2019) C1

Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 ... more

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Eswatini

Africa Center for Disease Control and Prevention (2023) CC

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Gender and One Health context analysis for HEAL

Eba, B.; Wieland B., Flintan F., et al. (2020) CC

The One Health approach can help achieve progress and promotes synergies on national and global priorities by generating synergies at the human-animal-environmental interface. While evidence is still scare, it is likely that the approach is highly cost-effective and improves effectiveness of core pu... more

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Atlas of Palliative Care in the Eastern Mediterranean Region

Osman, H.; A. Rihan; E. Garralda, et al. BALSAM; ICS; Atlantes (2020) C_WHO

The Atlas of Palliative Care in the Eastern Mediterranean Region is the first systematic attempt to assess the status of resources, activities, and needs of palliative care in the region. It provides a comparative picture of the current state of palliative care in simple and clear graphics, utilisin... more

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Zambia

Africa Center for Disease Control and Prevention (2023) CC

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WHO guideline: the use of safety-engineered syringes for intramuscular, intradermal and subcutaneous injections in health care settings

World Health Organization WHO (2016) C_WHO

Injection practices worldwide and especially in low- and middle-income countries (LMICs) include multiple, avoidable unsafe practices that ultimately lead to the large-scale transmission of bloodborne viruses among patients, health care providers and the community at large.

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Rehabilitation considerations during the COVID-19 outbreak

Pan American Health Organization PAHO, World Health Organization WHO (2020) C_WHO

Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung function; − Physical deconditioning and muscle weakness; − Delirium and other cognitive impairment... more

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Analysing the effectiveness of targeting under AB PM-JAY in India

World Health Organisation (WHO) (2022) C_WHO

This report presents key findings from a study carried out on ‘Assessing the effectiveness of targeting mechanisms under PMJAY’. It provides a detailed analysis of potential inclusion and exclusion errors in two select states in India (Haryana and Uttarakhand) to inform National Health Authority... more

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The impact of transition from global fund support to governmental funding on the sustainability of harm reduction programs

S. Ibisevic; G. Shaw; Dr. S. Godinjak; Dr. Z. Cardaklija; et al. Eurasian Harm Reduction Network; ICASO (2016) C2

A case study from Bosnia and Herzegovina Eurasian Harm Reduction Network The case study was prepared by Samir Ibisevic, President of PROI between March and June 2016 and edited by Graham Shaw. EHRN is grateful to all who contributed to this document, especially: Dr. Serifa Godinjak, Chairperson... more

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Recommendations for Implementing Antimicrobial Stewardship Programs in Latin America and the Caribbean: Manual for Public Health Decision-Makers

Pan American Health Organization PAHO (2018) C2

As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro... more

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Whole-genome sequencing for surveillance of antimicrobial resistance

World Health Organization WHO; Global Antimicrobial Resistance and Use Surveillance System (GLASS) (2020) C_WHO

Whole-genome sequencing (WGS) provides a vast amount of information and the highest possible resolution for pathogen subtyping. The application of WGS for global surveillance can provide information on the early emergence and spread of AMR and further inform timely policy development on AMR control.... more

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Zimbabwe

Africa Center for Disease Control and Prevention (2023) CC

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Ghana

Africa Center for Disease Control and Prevention (2023) CC

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Mapping Antimicrobial Resistance and Antimicrobial Use Partnership (MAAP) Country Report Cameroon

Africa Center for Disease Control and Prevention (2023) CC

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A framework for the quantification and economic valuation of health outcomes originating from health and non-health climate change mitigation and adaptation action

World Health Organization WHO (2023) C_WHO

This report presents a framework to link science, policy and practice for a comprehensive assessment of climate mitigation and adaptation investments and their impact on human health.The framework proposes to use weather and climate data to forecast health impacts over time, as well as biophysical a... more