With 22% of the global disease burden, Africa accounts for only 1% of global health spending. Health spending on the continent amounts to just USD 85 per capita, while out-of-pocket payments by households account for around 35% of current health expenditure. Against a backdrop marked by COVID-19, debt and declining international aid, sustainable health financing has therefore become a priority for the continent.
Health financing has become one of the major challenges to Africa’s development. Epidemics, debt and declining international aid have worsened the situation. Africa accounts for 22% of the global disease burden, but only 1% of global health spending. Health spending amounts to around USD 85 per capita, while fewer than 40% of countries meet the $86 threshold recommended by the WHO.
“Sustainable health financing is an economic priority. Africa must invest in its health. Viewing health as an expense is no longer sustainable.”
Mahmoud Ali Youssouf, Chairperson of the African Union Commission – Djibouti
The issue of health financing on the continent also concerns the stability and distribution of resources. In 2023, out-of-pocket payments accounted for an average of 35% of current health expenditure in the WHO African Region. This situation places households under strain: in 2022, nearly 385 million people were pushed into poverty or deeper poverty because of these expenses.
“In Morocco, we have taken a clear decision to place human capital at the heart of the model and to make health a turning point in the Kingdom’s ambition. This conviction has been translated into a strong and sustained financial commitment.”Nadia Fettah Alaoui, Minister of Economy and Finance – Morocco
The African Union has long sought to strengthen health financing. In April 2001, African leaders adopted the Abuja Declaration, which set, among other goals, the target of allocating at least 15% of national budgets to health. However, more than twenty years later, this commitment remains difficult to achieve. According to Africa CDC, only three countries; Rwanda, Botswana and Cabo Verde, had consistently reached or exceeded this threshold in 2025.
“We heard the President mention that Africa spends more than €140 billion on health, but only 41% of this amount is financed directly by governments. How can we help governments address this issue? Because the 60% that is not financed by governments is financed by families or international partners.”
Aboubakri Diaw, Head of the United Nations Economic Mission for Africa – Senegal
In this regard, Africa CDC launched a new strategy in April 2025 aimed at improving health financing across the continent. Covering the 2026–2030 period, it aims for 20 countries to cover at least 50% of their health expenditure through sustainable domestic resources, with a dashboard to track progress and strengthen transparency.
