Reforming Debt Sustainability To Support Health Financing In Africa

This report examines the relationship between debt sustainability in Africa and the continent’s ability to finance health systems at scale. It argues that prevailing Debt Sustainability Analysis frameworks are not fit for purpose because they systematically undervalue health investment in Africa, treating health spending primarily as a fiscal cost rather than a growth-enhancing investment. As a result, borrowing limits are set conservatively, constraining public investment in health even where economic returns are high.