Achieving timely prevention, detection, and response to infectious disease threats, while maintaining equitable access to essential services—depends on robust, well-governed health systems. In Africa’s diverse contexts, strengthening these systems requires integrated policy frameworks, adaptive management practices, and innovative technologies that address gaps in surveillance, workforce capacity, supply chains, and community engagement.

This Article Collection examines multidisciplinary strategies to enhance health system resilience and epidemic preparedness across the continent. We focus on:

- Policy and Governance: Crafting adaptive national and subnational policies, financing models, and regulatory environments that incentivize rapid outbreak response and sustain routine care.

- Health System Management: Optimizing human resources for health, supply-chain logistics, and facility-level coordination to maintain continuity of care during emergencies.

- Digital Health & Informatics: Deploying electronic surveillance platforms, mobile health (mHealth) tools, and data-analytics dashboards for real-time monitoring, early warning, and evidence-based decision-making.

- Surveillance & Laboratory Networks: Expanding laboratory capacity, sample-transport systems, and integrated One Health approaches to detect zoonoses and emerging pathogens.

- Community Engagement & Risk Communication: Leveraging regional partnerships, local governance, and culturally tailored messaging to build trust and promote preventive behaviors.

- Operational Research & Evaluation: Implementing outbreak simulations, performance metrics, and rapid-cycle evaluations to refine interventions and inform scalable best practices.

We welcome submissions that generate practical, scalable solutions for African health systems. By uniting insights from policymakers, health managers, informaticians, and frontline practitioners, this Collection aims to inform evidence-driven investments, strengthen preparedness capacities, and improve health outcomes across the continent.

It is generally acknowledged that recent improvements in health outcomes in Africa have been attributed to the increase in development assistance for health, especially over the past three decades. With development assistance for health in Sub-Saharan Africa on the decline, increased domestic resource mobilization for health will be needed to sustain progress or even avoid disruptions, given recent and likely future declines in external support.

There is also a general recognition that bridging the funding gap in the face of declining donor aid funding will depend crucially on governments in Africa increasing domestic funding and planning transitions towards greater domestic health spending. Arguably, recent events in the global health financing architecture have only added impetus to a situation that has been unfolding for several years. Despite high-level political and policy statements, domestic financing remains very low in many African countries.

Thus, one question that confronts national health authorities and health financing policy experts is, are there plausible scenarios over the short and medium term to transition towards increased domestic financing in anticipation of declining development assistance for health, with minimal disruptions to the progress made so far? Rather than focusing on aspirational targets, such as the share of total government spending allocated to the health sector, it is essential to examine how well countries are performing, given their level of income and other spending drivers. Bringing new evidence on the potential of African countries to increase domestic resources for health into one collection would greatly add value to the debate.

This collection will feature empirical papers that will hopefully examine the extent to which countries can increase domestic resources for health. The scope of empirical papers covers the following pertinent dimensions of health financing, including revenue mobilization, risk pooling, and strategic purchasing:

(a) Quantifying the potential for domestic resource mobilization for health

(b) Modelling future health spending and costs in the short to medium term, incorporating scenarios about anticipated changes in external health financing.

(c) Estimating the efficiency or effectiveness of health spending.

(d) Evaluating the impact of strategic purchasing on health system performance

(e) Description and evaluation of levels and patterns of development assistance for health in sub-Saharan Africa.

(f) Evaluation of effective strategies that countries are implementing to increase domestic financing for health.