Operationalising health in the humanitarian-development-peace nexus (HDPN) in Africa: a new framework for building resilience in countries with fragile, conflict and violence-affected settings.

Humanitarian needs are escalating globally, with around 300 million people requiring assistance-over half in Africa. These crises are increasingly driven by conflict, climate-related disasters and emergencies and economic instability, all severely impacting public health and disrupting health systems. A new approach is essential to address root causes of humanitarian crises and develop durable solutions. In response to this need, the WHO developed a framework for health in the humanitarian-development-peace nexus (HDPN) in Africa. This framework was informed by literature reviews and consultations with key stakeholders across UN and wider humanitarian sector (including the African Union bodies, WHO offices and relevant non-governmental organisations). The framework presents a structured method for countries to integrate health across the HDPN, emphasising policy alignment, the need for sustainable financing, strong monitoring systems and adaptable governance. It defines clear roles for WHO, the African Union Commission, regional economic communities and authorities in countries as applicable. Key areas for operationalising the framework include health sector development planning, budgeting, financing, intersectoral coordination, services delivery and monitoring and evaluation. It also recommends integrated strategic actions focusing on health across humanitarian, development and peacebuilding efforts, emphasising synergy and co-benefits from this nexus approach. With a growing number of countries facing humanitarian crises, fragility and conflict, urgent implementation of this framework is vital to build resilience and improve health outcomes across Africa and beyond.