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Financing Global Health 2023: The Future of Health Financing in the Post-Pandemic Era

Apeagyei A.E., Dieleman J.L., Leach-Kemon K., et al. Institute for Health Metrics and Evaluation (IHME) (2024) CC

IHME’s Financing Global Health report provides an overview of health spending around the world, with a special focus on investments in health in low- and middle-income countries. The report examines how this funding for health is changing each year and forecasts how it may change in the future. Fi... more

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Redefining Debt‑to‑Health, a triple‑win health financing instrument in global health

Hu Y., Wang Z., Zhou S., et al. Globalization and Health (2024) CC

As a recognized win–win-win approach to international debt relief, Debt-to-Health(D2H)has successfully translated debt repayments into investments in health-related projects. Although D2H has experienced modifications and periodic suspension, it has been playing an increasingly important role in r... more

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From lemming to leader: Moving beyond Gross Domestic Product (GDP) to bring health financing assistance into the 21st century

Nassiri-Ansari's T., Schwalbe N., Lehtimaki S. PLOS Global Public Health (2024) CC

Nearly 90 years after Simon Kuznets first introduced Gross Domestic Product (GDP) for the limited purpose of measuring economic growth (by measuring the monetary value of all local goods and services within a given period of time), calls continue to mount for decision-makers to stop using GDP and it... more

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Mapping the Literature on Development Assistance in Health: A Bibliometric Analysis

Karwa O., Jain R., Deo S. Observer Research Foundation (2024) CC

This paper presents a bibliometric analysis of the literature on private health aid and official health assistance between 2000 and 2022. It provides an overview of the sites and themes in the literature pertaining to development assistance in health, and collates the significant policy recommendati... more

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Banking on health: the surging pandemic of health financialization

Dentico N. Society for International Development (SID) (2023) CC

In the last three decades, health financialization has surged in several creative ways, yet this growing phenomenon remains surprisingly unknown, and neglected, in the global health arena. Financialization in the health domain could be described as the uncontrolled expansion of finance along vari... more

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The cost of inaction on health equity and its social determinants

Yerramilli P., Chopra M., Rasanathan K. BMJ Global Health (2024) CC

Rising levels of inflation, debt and macrofiscal tightening are putting expenditures on the social sectors including health under immense scrutiny. Already, there are worrying signs of reductions in social sector investments. However, even before the pandemic, evidence showed the significant returns... more

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Neglected Disease Research and Development: The Higher Cost of Lower Funding

G-Finder (2023) CC

Each year since 2007, G-FINDER has provided policy-makers, donors, researchers and industry with a comprehensive analysis of global investment into research and development of new products to prevent, diagnose, control or cure neglected diseases in low- and middle-income countries, making it the go... more

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Tomorrow’s Global Development Landscape: Mapping Trends and Reform Dynamics

Janus H., Keijzer N., Koch S. German Institute of Development and Sustainability (IDOS) (2024) CC

The key tools and governance approaches for international cooperation for sustainable development (hereafter, international cooperation) were set up in a markedly different time and age. International cooperation – with official development assistance (ODA) as the dominant means of implementa... more

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Navigating the 2024-2025 Replenishment Era: Strategies for the Global Fund's 8th Replenishment

Roll K., Benn C. Aidspan (2024) CC

The most packed schedule of cyclical replenishments in global health multilateral institutions has the potential to also clash with competing interests fuelled by a packed election calendar. But health imperatives are not a winner gets all scenario. The article provides a perspective on what needs t... more

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Development Finance at a Turning Point: Effects and Policy Recommendations

Berensmann K., Laudage Teles S., Sommer C., et al. German Institute of Development and Sustainability (IDOS) (2023) CC

Development finance is at a turning point, as the macroeconomic environment has changed profoundly and the financing gap for low- and middle-income countries has widened. The events that led to this new situation are the multiple crises that the global economy is facing, such as the climate crisis, ... more

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Public Financial Management: A Pathway to Universal Health Coverage in Low-and-Middle Income Countries

Barroy H., Yameogob P., Blecher M., et al. Health Systems & Reform (2024) CC

Achieving universal health coverage (UHC) is a politicalambition in many low- and middle-income countries(LMICs). Public funding has been recognized as funda-mental to the two dimensions of UHC: expanding healthservice coverage and increasing protection against health-related financial hardship. Rel... more

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Financing Global Health 2023: The Future of Health Financing in the Post-Pandemic Era - Malaria report

Institute for Health Metrics and Evaluation (IHME) - University of Washington (2024) C2

The document is part of the Financing Global Health 2023 series by the Institute for Health Metrics and Evaluation (IHME) and focuses specifically on malaria. It provides a concise overview of global and regional trends in malaria-related health spending, including development assistance, government... more

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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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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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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

Development assistance for health (DAH) plays a vital role in supporting health programmes in lowand middle-income countries. While DAH has historically focused on infectious diseases and maternal and child health, there is a lack of comprehensive analysis of DAH trends, strategic shifts and the... more

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The cost of austerity: The toll of IMF conditionalities on access to health in Zambia

Make Way, Wemos (2024) CC

Zambia is facing a severe economic crisis marked by high inflation, increasing poverty and a heavy debt burden that is straining both its fiscal stability and progress in health outcomes. By 2020, the country's external debt reached United States dollars (USD) 12.7 billion, representing 108% of the ... more

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How much bilateral and multilateral climate adaptation finance is targeting the health sector? A scoping review of official development assistance data between 2009– 2019

Alcayna T., O’Donnell D., Chandaria S. PLOS Global Public Health (2023) CC

Climate change is adversely affecting human health. Rapid and wide-scale adaptation is urgently needed given the negative impact climate change has across the socio-environmental determinants of health. The mobilisation of climate finance is critical to accelerate adaptation towards a climate resili... more

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Perceptions of healthcare finance and system quality among Nigerian healthcare workers

Josiah B.O., Enebeli E.C., Duncan B.A., et al. PLOS Global Public Health (2024) CC

Nigeria’s healthcare system faces significant challenges in financing and quality, impacting the delivery of services to its growing population. This study investigates healthcare workers’ perceptions of these challenges and their implications for healthcare policy and practice. A cross-sectiona... more

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How feasible is it to mobilize $31 billion a year for pandemic preparedness and response? An economic growth modelling analysis

Shahid M., Schäferhoff M., Brown G., et al. Globalization and Health (2024) CC

Covid-19 has reinforced health and economic cases for investing in pandemic preparedness and response (PPR). The World Bank and World Health Organization (WHO) propose that low- and middle-income governments and donor countries should invest $31.1 billion each year for PPR. We analyse, based on the... more

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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

The Council was established in late 2020 by Dr Tedros Adhanom Ghebreyesus (Director-General, WHO) to provide new economic thinking – reassessing how health and wellbeing are valued, produced and distributed across the economy. An all-female group of 10 distinguished economists and area experts, t... more