HQ Team
April 4, 2025: Africa’s health sector faces an ‘unprecedented’ financing crisis, driven by a sharp fall of 70% in official development assistance (ODA) — a barometer for international aid flow, according to a concept paper from the Africa Centres for Disease Control and Prevention.
The decrease in aid from 2021-2024 “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,” it stated.
Without decisive action, Africa CDC forecasts the continent could reverse two decades of health progress, and face between two to four million additional preventable deaths annually.
It also projects 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.”
Spiralling debt
Africa’s spiralling debt, with countries expected to service $81 billion by 2025—surpassing anticipated external financing inflows— is further eroding fiscal space for health investments.
The Abuja Declaration of 2001, a commitment made by African Union member states, aimed to reverse this trend by allocating 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.
More than 30 African Union member states remain well below the 10% benchmark, with some allocating as little as between five and seven per cent of their national budgets to health. The Union is a continental body consisting of the 55 member states that make up the countries of the African Continent.
In addition, only 16 (29%) of African countries currently have updated versions of the National Health Development Plan supported by a National Health Financing Plan. These two documents play a critical role in driving internal resource mobilisation.
Surge in public health emergencies
Public health emergencies are surging too. These emergencies rose 41% — from 152 in 2022 to 213 in 2024— exposing severe under-resourcing of health infrastructure and workforce.
Recurring outbreaks such as Mpox, Ebola, cholera, measles and 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.
Three-pillar strategy
African leaders alongwith Africa CDC’s, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.
The Lusaka Agenda, led by Africa CDC, promotes ODA alignment with national priorities aiming to raise that from 50% to 80% by 2028 and unlock $3.4 billion annually for health systems.
The second pillar relies on innovative financing mechanisms to bridge urgent gaps. Africa CDC wants solidarity levies—such as taxes on airline tickets, imports, alcohol, tobacco, and mobile services—and diaspora funds leveraging Africa’s $95 billion in annual remittances.
Public-private partnerships, connectivity, digital health, and local manufacturing, offer additional opportunities, according to the concept paper.
