article · Journal of International Health Sciences and Management
The COVID-19 pandemic revealed severe vulnerabilities in funding for pandemic prevention, preparedness, and response across sub-Saharan Africa. Countries in the region face substantial health burdens alongside limited domestic fiscal capacity and heavy reliance on external assistance. A scoping review of twenty-seven sources published between 2020 and 2025 examined funding mechanisms across national, regional, and global levels. These mechanisms include the new Pandemic Fund, the concluded Pandemic Emergency Financing Facility, Africa CDC programmes, the African Risk Capacity, pooled vaccine procurement, and domestic budgets. However, national funding remains constrained by mounting debt service obligations and unmet targets from the Abuja Declaration. Severe equity concerns persist, especially regarding vaccine distribution. Overall, the proliferation of new institutions has failed to produce predictable or sustainable funding, leaving the financing architecture fragmented and heavily donor-dependent.
Sub-Saharan Africa remains vulnerable to future health emergencies due to unresolved weaknesses in health financing. Mapping the current funding landscape highlights major structural bottlenecks, such as high debt burdens and extreme dependence on external aid. These insights are essential for international donors, regional health bodies, and national governments seeking to establish equitable, dependable, and coordinated investments in health security.
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Background: The COVID-19 pandemic exposed the fragility of financing for pandemic prevention, preparedness and response (PPR) in sub-Saharan Africa, where a high disease burden coincides with constrained fiscal space and heavy dependence on external assistance.Aim: To map the post-COVID landscape of PPR financing relevant to sub-Saharan Africa and to characterise its equity dimensions, gaps and limitations.Methods: A scoping review was conducted following the Arksey and O’Malley framework, the Joanna Briggs Institute guidance and the PRISMA-ScR reporting standard. Four databases and grey literature were searched for sources published between 2020 and 2025, and eligible sources were charted and synthesised thematically.Results: Twenty-seven sources were included. Financing mechanisms operated at global, regional and national levels, ranging from the new Pandemic Fund and the closed Pandemic Emergency Financing Facility to Africa CDC initiatives, the African Risk Capacity, pooled vaccine procurement, and domestic budgets constrained by the unmet Abuja target and rising debt service. Equity concerns were prominent, exemplified by COVID-19 vaccine inequity, and the architecture was found to be fragmented, donor-dependent and unpredictable.Conclusion: The post-COVID period produced more financing institutions but not more predictable or sustainable financing for the region. The review provides a consolidated map of PPR financing for sub-Saharan Africa to inform policy and research.
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DOI: 10.48121/jihsam.1964958
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