Post-COVID pandemic preparedness and response financing in sub-Saharan Africa: a scoping review

Abstract

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.

Keywords

• pandemic preparedness
• health policy
• global health
• sub-saharan Africa
• scoping review

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