*1.4.3 Health financing*

In 2018 and 2019, Africa's economic growth was at 3.4% and was expected to rise to 3.9% and 4.1% in 2020 and 2021 respectively [28]. Amid the COVID-19 pandemic of 2020, the dynamics changed resulting in contraction of economies globally with expected 1.7% to 3.4% contraction of Africa's economy [29].

The 2001 Abuja Declaration recommended allocation of 15% of the annual national budget to the health sector; achieving this has been challenging [30]. In 2012, 6 countries met the target; and this reduced to 4 in 2014. Currently, the preferred indicator for health financing is the percentage gross domestic product (% GDP). To achieve universal health coverage (UHC), the World Health 2010 Report suggested that a national government has to spend at least 4–5% of GDP on *Organ Donation and Transplantation in Sub-Saharan Africa: Opportunities and Challenges DOI: http://dx.doi.org/10.5772/intechopen.94986*

**Figure 3.** *Map of Africa showing UN sub-regions.*

health [31]. Whilst per capita expenditure on health in America and Europe were over \$1800 in 2014, the per capita expenditure on health in Africa averaged only \$51.6 [32]. Further analysis shows that over the same period, in Africa, general government health expenditure was less than 50% of the total health expenditure while other sources such as out of pocket (OOP) payments and external sources (from funders) accounted for over 50% [32]. In general, transplantation service largely depends on robust and adequate finances hence the programme thrives in HICs and UMICs.
