Securing the future of health in Africa through sustainable financing

Addis Ababa-Around 385 million people in the African region are pushed into or deeper into poverty each year due to out-of-pocket expenditure on health. At the same time, governments are facing growing national financial pressures as public spending stagnates, debt burden increases and external assistance declines.

Health ministers gathering in Addis Ababa for the Seventy-sixth session of the World Health Organization (WHO) Regional Committee for Africa today endorsed a new strategy that sets out a roadmap for sustainable health financing over the next decade to help countries build more resilient and self-reliant health systems.

The Strategy for Financing the Future of Health in the WHO African Region (2026-2035) responds to one of the Region's most pressing challenges: ensuring that everyone can continue to access quality health services without financial hardship, even as countries navigate changing economic realities. The strategy promotes stronger domestic resource mobilization, more efficient use of available resources and financing systems that are better prepared to withstand future shocks.

Over the past two decades, countries across the region have introduced important health financing reforms. Yet progress remains uneven. Direct payments by households still account for an average of 35% of current health expenditure, well above the WHO benchmark of 20%, while many countries remain heavily dependent on external financing at a time when development assistance is projected to decline significantly. In many low-income countries, debt servicing now exceeds government spending on health, placing additional pressure on already stretched health systems.

"Health is one of the best investments a country can make. But financing health sustainably requires more than increasing resources, it requires making smarter, fairer and more resilient investments that protect people from financial hardship while strengthening health systems. This strategy reflects our shared commitment to ensuring that every investment in health delivers greater value for the people of Africa," said Dr Mohamed Janabi, WHO Regional Director for Africa.

The strategy outlines seven priority areas for action, including strengthening health financing governance, increasing domestic resource mobilization, improving the pooling of health funds, making purchasing of health services more strategic, modernizing public financial management and strengthening financing for essential public health functions. Together, these reforms aim to improve efficiency, expand financial protection and ensure that limited resources generate greater health impact.

By 2035, the strategy aims for 56% of Member States to demonstrate sustained increases in government spending on health, 56% to improve financial protection for their populations, and 75% to have up-to-date national health financing strategies that support effective resource mobilization and use. It also seeks sustained regional progress in reducing the number of people pushed into poverty because of health spending.

Financing health is about far more than budgets. It is about ensuring that families can seek care without fear of financial hardship, that health systems remain resilient during times of crisis, and that countries have the resources needed to protect and improve the health of their populations. Through this strategy, African countries have committed to building financing systems that are more sustainable, equitable and resilient for generations to come.