The shrinking of international donor funding is causing significant changes in African healthcare. Nigeria and Mozambique demonstrate that it is possible to safeguard healthcare provision when external financing decreases. They do this through greater government involvement, integrated services, and more effective use of existing resources.
For many years, numerous health programmes depended on donor-funded projects focused on specific diseases. Such projects usually set up separate systems for malaria, HIV, tuberculosis, immunisation and other areas. It has been the funding reductions that have revealed the financial and operational risks involved in that approach.