The signing of the United Nations millennium development goals created a platform for the injection of billions of dollars of donor funds into countries with great need. As it were, this funding is meant to accelerate the achievement of these goals by the year 2015 considering that amongst others, they will help in improving healthcare delivery and strengthen health systems. Of particular concern is the situation in sub-Saharan Africa. So far, the impact of donor support in the region has being fairly remarkable with funding to combat major health problems reaching unprecedented levels in recent times with improvements on certain fronts. However, reports have it that besides other issues in many instances funds are allocated only to disease specific projects (“vertical programming”) rather than to broad based investments (“horizontal programming”). Furthermore, the problem of corruption and mismanagement of these funds in many of the recipient countries are bothering issues warranting urgent solutions. As these issues do come to bear, it is critical to state that donor support is only a part of the development picture. There is now the need for sustainable policies for gradually exiting from donor funding for health, without which these countries dependant on humanitarian actors, will continue to cripple their ability to be self-sufficient and self reliant, and should these agencies cease to continue or run out of funding the consequences for the region are dire.

sub-Saharan Africa, donor support, health systems, sustainability