Sub-Saharan Africa is still grappling with a heavy disease burden, mainly from HIV/AIDS, tuberculosis, and malaria. As external funding dwindles, it's crucial to allocate domestic public health spending wisely. This study looked at whether directing funds towards major diseases and high-burden areas improves health outcomes across 43 African countries between 2003 and 2022. The results show a strong link between public health spending and health outcomes. However, the relationship is a bit puzzling - it's stronger in areas with high disease burdens. This suggests that public health spending is mainly used to treat existing problems rather than prevent them. The study also found that other factors like economic growth, inequality, and governance play a big role in determining health outcome