Health Financing
Shifting health systems from donor dependence toward domestic budgets and African-owned financing frameworks that hold past the donor cycle.
Domestic revenue. African ownership.
Africa's health systems are structurally exposed — aid flows cover gaps that domestic budgets have not been designed to close. When donors shift priorities, service delivery collapses. We work on the financing architecture itself: compacts with measurable targets, knowledge tools and domestication of budget commitments governments have already made.
This approach is relevant to gender-responsive health services, immunisation and primary care equity and to fiscal sustainability arguments in the socio-economic pillar.
Three instruments.
Compacts set targets, the database maps what works and domestication converts commitments into appropriations.
Multi-Country Financing Compacts
Structured agreements between groups of governments with specific domestic health budget targets, reporting schedules and peer accountability mechanisms.
- Measurable domestic budget commitments with defined review periods
- Peer accountability across signatory countries — not donor-to-recipient reporting
- Technical support for countries to model revenue headroom and financing options
Health Financing Exemplars Database
A country-level knowledge tool mapping which financing instruments have produced domestic budget gains — disaggregated by country income band, health system type and instrument category.
- Searchable by country, instrument and health system characteristic
- Evidence base for national financing proposals and parliamentary arguments
- Updated after each major AU health financing review cycle
Budget Commitment Domestication
Converting signed continental commitments into line-item budget appropriations through ministry of finance and parliamentary budget committee engagement.
- Abuja Declaration 15% target: country-by-country gap analysis and domestication tracking
- Addis Ababa Immunisation Agenda: costing support and appropriation scheduling
- Budget literacy workshops for parliamentary health and finance committees
Applied across all three pillars.
The tools and institutions differ by pillar — the logic of working inside legislative moments is constant.
Gender Equality
Gender-responsive health budgets
Ensuring domestic health allocations explicitly fund reproductive health services and maternal care — not only headline budget totals.
Health Equity
Domestic immunisation and primary care funding
Replacing donor-funded immunisation programmes with domestically financed equivalents, using the Addis Ababa Agenda as the accountability reference.
Socio-Economic Justice
Fiscal sustainability arguments
Connecting health financing reform to broader domestic resource mobilisation arguments in the socio-economic pillar — taxation, domestic bond markets and public expenditure efficiency.
See the full programme approach
Health financing works alongside policy advocacy and active citizenry across all three thematic pillars.
