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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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Guidance to facilitate monitoring and evaluation for antimicrobial resistance national action plans

Quadripartite: Food and Agriculture Organization of the United Nations FAO; UN Environment Programme UNEP; World Health Organization WHO; World Organisation for Animal Health WAHO (2023) CC

Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”. The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines. Its strategic objectives include: • improving the awareness and understanding of AMR; • strengthening the knowledge and evidence base through surveillance and research; • reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and • developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions. With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives more

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COVID-19 vaccination: supply and logistics guidance: interim guidance, 12 February 2021
recommended

World Health Organization WHO (2021) C_WHO

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Vacinação contra a COVID-19: orientações relativas ao abastecimento e logística, 12 Fevereiro 2021
recommended

World Health Organization WHO (2021) C_WHO

12 February 2021

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Principles for sharing COVID-19 doses with COVAX

Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO (2021) C_WHO

the Principles for Dose-Sharing provide a framework for higher-income economies to make additional volumes secured via bilateral deals available through the Facility primarily to AMC participants, on an equitable basis. These principles outline that such doses must be safe and effective, available a... more

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Harmonized health service capacity assessments in the context of the COVID-19 pandemic

World Health Organization WHO (2020) C_WHO

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Digital documentation of COVID-19 certificates: vaccination status: technical specifications and implementation guidance, 27 August 2021

World Health Organization WHO (2021) C_WHO

This is a guidance document for countries and implementing partners on the technical requirements for developing digital information systems for issuing standards-based interoperable digital certificates for COVID-19 vaccination status, and considerations for implementation of such systems, for the ... more

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Согласованные оценки потенциала служб здравоохранения в условиях пандемии COVID-19

World Health Organsiation WHO (2020) C_WHO

Временное руководство2 ноября 2020 г. Это временное руководство представляет собой обновление более ранней версии, опубликованной 31 мая 2020 г. в качестве «Согласован... more

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Solidarity in response to the COVID-19 pandemic

Rahman-Shepherd, A.; C. Clift; E. Ross; et al. The Chatham House (2021) CC

Has the world worked together to tackle the coronavirus? July 2021. This research paper assesses how the global community has responded to calls for greater solidarity in tackling the COVID-19 pandemic, and presents the insights of key stakeholders and experts in global health governance, health sec... more

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COVID-19 and mandatory vaccination: Ethical considerations and caveats

World Health Organization WHO (2021) C_WHO

13 April 2021 Policy Brief

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Preguntas frecuentes sobre la vacunación contra la COVID-19. Versión 6, 12 de febrero del 2022

Organización Mundial de la Salud OMS OPS (2022) C_WHO

Frequently asked questions on COVID-19 vaccination. Version 6, 12 February 2022

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Suite of health service capacity assessments in the context of the COVID-19 pandemic

World Health Organsiation WHO (2020) C_WHO

Interim guidance2 November 2020 This interim guidance, originally entitled “Harmonized health service capacity assessments in the context of the COVID-19 pandemic”, is an update to the earlier version published on 31 May 2020 as “Harmonized modules for health ... more

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COVID-19 & Vaccination
recommended

Mauder, S. (2021) CC

Issue Brief no.8. January 18,2021 Vaccination against the spread of the SARS-CoV-2 virus represents a milestone in the fight against the pandemic. Good communication and education of the population is essential for the success of the vaccination. Below is some information on vaccination strategies,... more

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Evaluaciones armonizadas de la capacidad de los centros de salud en el contexto de la pandemia de COVID-19

Organización Mundial de la Salud OMS (2020) C_WHO

Orientaciones provisionales 2 de noviembre de 2020 Estas orientaciones provisionales son una actualización de la versión anterior, publicada el 31 de mayo de 2020 bajo el título “Harmonized modules for health facility assessment modules in the context of the COVID-19 pandemic... more

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Coronavirus disease (COVID-19) training: Online training
recommended

World Health Organization WHO (2022) C_WHO

access free courses in more than 60 languages

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ACT-A Prioritized Strategy & Budget for 2021

World Health Organization WHO (2021) C_WHO

9 February 2021

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Continuidad de los servicios de salud esenciales: herramienta de evaluación de los centros
recommended

Organización Mundial de la Salud OMS (2021) C_WHO

módulo del conjunto de evaluaciones de la capacidad de los servicios de salud en el contexto de la pandemia de COVID-19: orientaciones provisionales, 12 de mayo de 2021; La herramienta de evaluación de la continuidad de los servicios sanitarios esenciales: Herramienta de evaluación de instalacion... more

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Ensuring a safe environment for patients and staff in COVID-19 health-care facilities
recommended

World Health Organization WHO (2020) C_WHO

A module from the suite of health service capacity assessments in the context of the COVID-19 pandemic, Interim guidance 20 October 2020. This assessment tool covers the following aspects: area distribution; surface availability versus foreseen occupancy rate; patient and staff flow... more

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Infection prevention and control health-care facility response for COVID-19
recommended

World Health Organization WHO (2020) C_WHO

A module from the suite of health service capacity assessments in the context of the COVID-19 pandemic, Interim Guidance 20 October 2020. This self-assessment tool is designed for acute health-care facilities (i.e. tertiary and secondary) but can be modified for the use in long-term care facilities... more

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Myths & COVID-19 Vaccinations
recommended

Mauder, S.; and P. Reijer (2021) CC

Issue Brief no. 16. 20 Sept 2021. Many studies have shown the effectiveness of vaccination against COVID-19 and that it protects against severe illness. A high vaccination rate is needed to combat the pandemic worldwide. Due to misinformation and myths, there is still a great hesitancy to vaccina... more

COVID-19 vaccination: supply and logistics guidance: interim guidance, 12 February 2021 recommended

Vacinação contra a COVID-19: orientações relativas ao abastecimento e logística, 12 Fevereiro 2021 recommended

COVID-19 & Vaccination recommended

Coronavirus disease (COVID-19) training: Online training recommended

Continuidad de los servicios de salud esenciales: herramienta de evaluación de los centros recommended

Ensuring a safe environment for patients and staff in COVID-19 health-care facilities recommended

Infection prevention and control health-care facility response for COVID-19 recommended

Myths & COVID-19 Vaccinations recommended

COVID-19 vaccination: supply and logistics guidance: interim guidance, 12 February 2021
recommended

Vacinação contra a COVID-19: orientações relativas ao abastecimento e logística, 12 Fevereiro 2021
recommended

COVID-19 & Vaccination
recommended

Coronavirus disease (COVID-19) training: Online training
recommended

Continuidad de los servicios de salud esenciales: herramienta de evaluación de los centros
recommended

Ensuring a safe environment for patients and staff in COVID-19 health-care facilities
recommended

Infection prevention and control health-care facility response for COVID-19
recommended

Myths & COVID-19 Vaccinations
recommended