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Publication Years
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2
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 o
...
n 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
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 underfun
...
ding, and recent reductions in official development assistance have been registered. To create fiscal
space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
more
Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States do
...
llars (USD) 12.7 billion, representing 108% of the country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
more
This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in he
...
alth financing. The report points out the need to improve public financial management within the health sector, for more efficient financial systems. It focuses on better resourceraising and utilization mechanisms. The matrix highlights the need for consolidation of fragmented health financing arrangements, for a more efficient health system. It also emphasizes the need for enhancing strategic purchasing of health services, to improve the overall efficiency and quality of care. Additionally, the report stresses the critical
role of leveraging data and information systems for more evidence-based informed decision-making. These recommendations are crucial for advancing Kenya’s health financing system and moving closer to the UHC goal.
more
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 the
powerful impact they have in reducing preventable
death and disease — a particularly glaring act of
neglect in a world that has experienced a massive
pandemic.
more
Noncommunicable diseases (NCDs) (e.g., cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases) and mental health conditions (e.g., Alzheimer’s disease and related dementias, depression, anxiety, autism spectrum disorders) are
...
the world’s leading cause of preventable illness, disability, and death. This report examines the dangers posed by current and rising rates of noncommunicable diseases and mental health conditions (NMHs) in South America, beyond their health risks, by demonstrating their considerable negative impact on economic growth. An analytical model was developed that projects the macroeconomic effects of NMHs over the period 2020–2050 in ten South American countries: Argentina, Bolivia (Plurinational State of), Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Uruguay, and Venezuela. The results showed that the macroeconomic impact of NMHs in South America indicates significant economic shortfalls resulting from NMHs. Overall, the total GDP loss due to NMHs in South America amounts to USD 7.3 trillion (2022 international USD) over the period 2020–2050
more
Health in All Policies (HiAP) promotes health and equity. It is based on the recognition that our greatest health challenges for example, non-commu
...
nicable diseases, health inequities and inequalities, climate change, and spiraling health care costs are highly complex and often linked through the social determinants of health (SDH). In this context, promoting healthy communities, and in particular health equity across different population groups, requires that we address the social determinants of health, such as public transportation, education access, access to healthy food, economic opportunities, and more. While many public policies work to achieve this, conflicts of interest may arise. Alternatively, unintended impacts of policies are not measured and addressed. This requires innovative solutions, and structures that build channels for dialogue and decision-making that work across traditional government policy siloes. Hence, HiAP could be adopted to ensure commitment from the highest decision makers within government to address the social determinants of health.
more
Universal health coverage (UHC) has a central place in achieving the Sustainable Development Goals (SDGs) by 2030, as
it is a major target (3.8) under SDG 3 (Ensuring healthy lives and promote well-being for all at all ages). The World
...
Health
Organization defines Universal Health Coverage (UHC) as a means through which all people and communities can use the
promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective,
while also ensuring that the use of these services does not expose the user to financial hardship. UHC brings hope of better
health and protection for the world’s poorest.
more
Promoting and protecting the mental health and psychosocial wellbeing of children, adolescents, and their caregivers remains undamental to achieving the Sustainable Development Goals (SDGs), with a direct contribution to SDG 3 (Good
...
Health and Well- eing). In 2024, UNICEF accelerated the scale-up of integrated, multisectoral MHPSS programming. These efforts contributed to the strengthening of national and subnational child and adolescent mental health systems by supporting programming across the continuum of care, investing in workforce development, advancing data systems and evidence generation, and promoting institutional leadership and coordination mechanisms. UNICEF’s growing reach, particularly through health, education, and child protection systems, reflects a strategic commitment to embedding MHPSS in sustainable development frameworks and in responses that bridge humanitarian action and development programming.
more
This guideline includes 48 updated and new evidence-based recommendations related to MNS conditions. The guideline is targeted towards non-specialized health workers at primary- or secondary-level healthcare facilities, or those working at the distr
...
ict level including basic inpatient and outpatient services.
more
The Guide on HIV Services for Adolescents Living with HIV (ALHIV) describes
organization of adolescent-friendly services to guide heath management teams and health
care workers (HCWs) on their roles. It also outlines important aspects to consider
...
when
offering comprehensive care to adolescents and their parents/caregivers at health facilities
and in the community. Comprehensive care should include the provision of quality clinical
and psychosocial support (PSS) services with clear linkages to the community. These
services need to be adolescent-friendly at any health facility with clear prescription of
minimal standards, and has to be integrated into existing services at the health facility
more
This document consolidates, for the first time, WHO recommendations on the prevention, testing, treatment and monitoring of hepatitis B and C, and includes testing strategies for hepatitis D. Drawing on a decade of evidence-based guidance issued between 2015 and 2025, it provides a single, practical
...
handbook to support global progress toward eliminating viral hepatitis by 2030.
The document also highlights simplified service delivery models that promote decentralization, integration with primary care and related programmes such as HIV and tuberculosis, as well as task sharing and differentiated care to expand access and improve efficiency. It further underscores the need for robust data and monitoring systems to support effective programme implementation.
more
Climate Information For Public Health: A Curriculum For Best Practices
Laurence Cibrelus; Gilma Mantilla
International Research Institute for Climate and Society
(2011)
C1
CIPH Curriculum for Best Practices. Putting Principles to Work
2nd edition. Essential guideline for humanitarian assistance
A public health emergency operations centre (EOC) is a central location for coordinating operational information and resources for strategic management of pugencies and events. EOCs provide communication and information tools and services blic
...
health emer-
and a management system during a response to an emergency or event. This report lays out components and characteristics of an emergency operations plan, providing a suggested structure for plans and procedures. The planning process, and that of coducting a hazard analysis or needs assessment, are also discussed as key steps
more
This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB transmission within populations. The emphasis is on early and rapid diagnosis, and proper mana
...
gement of TB patients.
more
This guidance document is designed to ensure that the process of iteratively managing the health risks of climate change is integrated into the overall National Adaptation Planning (NAP) process, including through assessing risks; identifying, prior
...
itizing, and implementing adaptation options; and monitoring and evaluating the adaptation process.
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You can download the handbook, worksheets and quick reference cards from the website!
The HHEAT is an ethical analysis tool designed to help humanitarian healthcare workers make ethical decisions. It consists of 3 components: (1) a summary card highlighting key questions, (2) a handbook providing a
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n overview of the tool, and (3) a worksheet for recording the decision-making process. The tool was inspired by research examining ethical challenges and moral distress experienced by humanitarian workers. The HHEAT has been tested and validated by humanitarian workers and experts from the fields of humanitarian medicine and nursing, as well as applied ethics.
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International Journal for Equity in Health 2014, 13:24
