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2224

HEALTH SYSTEMS FINANCING The path to universal coverage

World Health Organization (2010) C_WHO

Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute both to a better quality of life and also to global peace a... more

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The future of health in Mozambique: Collaborative efforts for sustainable financing

N’weti, Wemos (2024) CC

As part of the project ‘Equitable health financing for a strong health system in Mozambique’, N’weti and Wemos developed this policy brief with actionable policy recommendations for the Mozambican government and international organizations on how to increase resources for health in a sustainab... more

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PEPFAR: Exploring Co-Financing as a Tool for Domestic Resource Mobilization

Kates J. Kaiser Family Foundation (KFF) (2024) CC

There is growing pressure on PEPFAR, the U.S. global HIV program, to increase its planning for sustainability, including through domestic resource mobilization and, ultimately, transitioning financing at least in part to recipient countries. While this is connected to a broader push in global healt... more

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Why Is There So Little Contractually Contingent Financing?

Dissanayake R. Center for Global Development (2024) CC

Most foreign aid comes in one of two forms: either we pay a person or an institution today in exchange for delivering some beneficial activity in the future, or we observe something bad happen to them and then give them support to recover from it. This kind of aid is simple to design and deliver, b... more

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Developing a National Health Financing Strategy: A Reference Guide

Joseph Kutzin, Sophie Witter, Matthew Jowett et al. World Health Organization (WHO) (2017) C_WHO

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Public financial management for effective response to health emergencies

World Health Organization WHO (2022) C_WHO

The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r... more

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Political economy analysis for health financing: A ‘how to’ guide

World Health Organization (WHO) (2024) CC

This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within health financing, and... more

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High-Performance Health Financing for Universal Health Coverage

The World Bank The World Bank (2019) CC

The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20... more

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Innovative financing for HIV response in sub–Saharan Africa

Atun, R.; Silva, S.; Ncube, M.; Vassall, A. Journal of global health (2016) CC

In 2015 around 15 million people living with HIV were receiving antiretroviral treatment (ART) in sub–Saharan Africa. Sustained provision of ART, though both prudent and necessary, creates substantial long–term fiscal obligations for countries affected by HIV/ AIDS. As donor assistance for healt... more

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Improving Financial Access to Maternal, Newborn and Child Health Services for the Poor in Nigeria

Cynthia Green (2012) C1

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Estimating Financing to the Sustainable Development Goals: Methodology Note for V2.0.

Turner, Jennifer, and Bryan Burgess AidData at William & Mary (2019) CC

Unfortunately, current data available on SDG financing are not sufficient to quantify the distribution of financing for the SDGs. AidData’s methodology for measuring financing to the SDGs attempts to fill this gap by analyzing development project documentation to estimate project-level contributi... more

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Health financing for the COVID-19 response: Process guide for national budgetary dialogue. ACT-A Health Systems Connector

World Health Organization (WHO), World Bank, Global Financing Facility (GFF) et al. World Health Organization (WHO) (2021) CC

Annual and medium-term budget preparation processes are the platforms through which specific plans are transformed into actual resource allocation decisions. The aim of this Process Guide is to support key stakeholders involved in these processes (such as the Cabinet, Ministries of Finance and Healt... more

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HIV financing status in selected countries of the Western Pacific Region (2009-2015)

World Health Organization (Western Pacific Region) (2016) C_WHO

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Africa’s Health Financing in a New Era

Africa Centres for Disease Control and Prevention (Africa CDC) (2025) CC

Africa’s health sector is facing an unprecedented financing crisis, driven by a sharp decline of 70% in Official Development Assistance (ODA) from 2021 to 2025 and deep-rooted structural vulnerabilities. This collapse is placing immense pressure on Africa’s already fragile health systems as ODA ...is seen as the backbone of critical health programs: pandemic preparedness, maternal and child health services, disease control programs are all at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage. Compounding this is Africa’s spiraling debt, with countries expected to service USD 81 billion by 2025—surpassing anticipated external financing inflows—further eroding fiscal space for health investments. Level of domestic resources is low. TThe Abuja Declaration of 2001, a pivotal commitment made by African Union (AU) member states, aimed to reverse this trend by pledging to allocate at least 15% of national budgets to the health sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10% benchmark, with some allocating as little as 5–7% of their national budgets to health. In addition, only 16 (29%) of African countries currently have updated versions of National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP). These two documents play a critical role in driving internal resource mobilisation. At the same time, public health emergencies are surging, rising 41%—from 152 in 2022 to 213 in 2024—exposing severe under-resourcing of health infrastructure and workforce. Recurring outbreaks (Mpox, Ebola, cholera, measles, Marburg…) alongside effects of climate change and humanitarian crises in Eastern DRC, the Sahel, and Sudan, are overwhelming systems stretched by chronic underfunding. The situation is worsened by Africa’s heavy dependency with over 90% of vaccines, medicines, and diagnostics being externally sourced—leaving countries vulnerable to global supply chain shocks. Health worker shortages persist, with only 2.3 professionals per 1,000 people (below the WHO’s recommended 4.45), and fewer than 30% of systems are digitized, undermining disease surveillance and early warning. Without decisive action, Africa CDC projects the continent could reverse two decades of health progress, face 2 to 4 million additional preventable deaths annually, and a heightened risk of a pandemic emerging from within. Furthermore, 39 million more Africans could be pushed into poverty by 2030 due to intertwined health and economic shocks. This is not just a sectoral crisis—it is an existential threat to Africa’s political, social, and economic resilience, and global stability. In response, African leaders, under Africa CDC’s stewardship, are advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance. more

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Health Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health financing. The report points out the need to improve public financial management within th... more

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Conditioned Domestic “Co-financing” Policies in Global Health

Sparkes S., Yungrattanachai M., Fan V., et al. Center for Global Development (2024) CC

Conditioned domestic financing policy, referring to the domestic financing of health projects, programs, and national responses conditioned by global health funding agencies and recipient country governments, is one mechanism to promote sustainability and country ownership. We aim to understand how ... more

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Afghanistan Reconstruction Trust Fund (ARTF) - Administrator’s Report on Financial Status as of March 20, 2019

Afghanistan Reconstruction Trust Fund (ARTF) Afghanistan Reconstruction Trust Fund (ARTF) (2019) CC

Administrator’s Report on Financial Status as of March 20, 2019 of the Afghanistan Reconstruction Trust Fund (ARTF): Total donor indicated and actual (paid-in) contributions for the core ARTF for FY1398 amount to US$351.94 million, of which US$240.47 million (68%) are without preference and US$111... more

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SDG Costing & Financing for Low-Income Developing Countries

Sachs, J.; G. McCord; N. Maennling et al. UN Sustainable Development Solutions Network (SDSN) (2019) CC

The Sustainable Development Goals (SDGs) call for major societal transformations that will require significant fiscal outlays as well as private investments. The fiscal outlays cover public investments, the public provision of social services, and social protection for vulnerable populations. The ke... more

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The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal ... more

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Results Based Financing: Engaging Communities to Strengthen Systems in Fragile Contexts

Hetty Burgman and Piet Vroeg Cordaid (2015) C2