Health Financing

Building resilient health systems that can provide needed services to people requires strong financing and governance capacities of national authorities. WHO supports Member States to design, implement and monitor health financing policies to reduce the number of people suffering financial hardship when accessing essential health care services. WHO also supports countries in the development, implementation, monitoring and review of their national policies, legal frameworks and plans, in an inclusive participatory manner, as tools for strengthening health governance.

The African Region has not met its commitment to reduce financial hardship for people seeking health care: 152 million people (13.7%) are pushed into poverty because of health spending. Public financing for health has tripled since 2000 but remains below the requirement to provide a package of essential services, while external funding as a share of current health expenditures remains unchanged (from 23% in 2012 to 24% in 2022), underlining the continuous reliance of countries in the Region on external funding. This has threatened national health systems in the wake of the external aid reductions in 2025. Health systems in the Region also still suffer from inefficiency, which compounds the limited resources: up to one in every five dollars spent on health is lost due to inefficiency.

Health governance in the WHO African Region is evolving to meet the demands of Universal Health Coverage (UHC), the Sustainable Development Goals (SDGs) and regional health security. The Region has made strides in policy development, institutional reforms and multisectoral collaboration, but persistent challenges, exacerbated by financial constraints and health emergencies, continue to test the resilience of governance systems. Most countries have updated national health policies and strategies; however, these have not served to bring coordinated investments into health systems among stakeholders. Despite efforts at decentralization of health services in a growing number of countries, the governance structures and decision space at subnational level remain inadequate.