The Global Health Expenditure Report delves into the intricate landscape of global economies and health systems. This year, it focuses on health spending in 2022, the third year of the COVID-19 pandemic. It shows how countries around the world responded to the health and economic shocks of the pande...mic from a financial perspective. It also considers what the future may hold as countries emerge from the pandemic. Although it is still too early to gauge whether the COVID-19 pandemic has altered long-term trends in health spending, spending appears to have peaked and is now at or below its long-term rising trend in most country income groups. Additionally, to mark the 25th anniversary of the World Health Organization’s (WHO) Health Expenditure Tracking Program, the report reviews the program’s achievements and envisions a path forward. As the program’s lead technical agency, WHO is committed to working closely with partners to support countries in tracking health spending and sustaining the Global Health Expenditure Database and the Global Health Expenditure Report as global public goods.
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The role of evidence in the journey towards universal health coverage is paramount. Financial risk protection monitoring, the major focus of this report, informs where the WHO African Region stands in reducing the financial hardship people face due to health expenses. This report details the status ...of financial risk protection and related trends, the drivers of out-of-pocket (OOP) payments and the impact of the COVID-19 pandemic on financial risk protection. As such, it provides evidence coutries can draw on to develop health financing systems and reforms that mitigate financial barriers to accessing health services. Through analysis of country data, cross-country learning and drawing on the published literature, this report proposes recommendations that countries may adapt to their contexts.
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This paper was commissioned by N´weti and Wemos as part
of the project “Equitable health financing for a strong health
system in Mozambique”. Its purpose is to contribute to the
debate of the Mozambican Ministry of Health’s draft Health
Sector Financing Strategy (HSFS) 2025 – 2034
We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We address causality by instrumenting aid with a set of ...interacted variables. Variation over
time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region’s “probability to receive aid.” Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the countrylevel. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.
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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.
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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...he Council has focused on reimagining how to put Health for All at the heart of government decision-making and private sector collaboration at regional, national and international levels.
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For this report, the Task Force commissioned
additional background papers on health taxes to
update the evidence, assess short-term revenue
potential, and understand the role of health taxes
in the current era of multiple crises. We find that
health taxes continue to be underutilized despite th...e
powerful impact they have in reducing preventable
death and disease — a particularly glaring act of
neglect in a world that has experienced a massive
pandemic.
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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...ut in the former case has limits in how sharply it incentivizes success and effort from a range of actors and in the latter case leads to the inefficient and undignified “begging bowl” approach to humanitarian financing. In what follows, I identify a broad family of alternative approaches, which
can loosely be grouped together as “contractually contingent financing,” and explain why they are still relatively underused.
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There has never been a more critical moment to invest in WHO, and strengthen the unique role it plays in global health. Now is the time to sustainably finance WHO and invest in a healthy return for all.
Le Plan d’action pour l’élimination du paludisme 2021-2025 a été élaboré en consultation avec les pays et les partenaires régionaux comme cadre de référence pour orienter les efforts nationaux et les contributions des donateurs et partenaires dans le but d’éliminer la maladie dans la ...Région des Amériques. Le plan souscrit aux objectifs et aux piliers de la Stratégie technique mondiale de lutte contre le paludisme 2016-2030 adoptée par l’OMS, et présente également des éléments clés pour relever les défis spécifiques à la Région.
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The Plan of Action for Malaria Elimination 2021-2025 has been developed in consultation with countries and regional partners as a framework of reference to guide the efforts of countries and the contributions of donors and partners towards elimination of the disease in the Americas. The Plan subscri...bes to the goals and pillars of the WHO Global Technical Strategy against Malaria 2016-2030 (GTS), while presenting key elements to address the specific challenges of the Region. The document seeks to guide national plans and promote an inter-programmatic- intersectoral approach, and joint efforts between countries and partners. The Plan is also the reference framework for PAHO technical cooperation in malaria in the period 2021-2025. The goals to be achieved require changes in action against malaria that must occur at the operations level and for which regulatory and policy adjustments are required from the national levels. Thus, the Plan promotes a systematic action of detection, diagnosis and response, which must be massively implemented and monitored programmatically. A main element of change is action aimed at recognizing the need to address key malaria foci in each country with specific, information-based operational solutions. The Plan of Action seeks to promote these changes in malaria programs in the countries and through the interactions among all actors. The model proposed in this plan is based on a cross-functional dialogue and interconnections across the lines of action (SL). Strategic lines 1, 2 and 3, which correspond to the three pillars of the WHO/GTS, complement each other, and are not designed to function independently. The idea of the consolidated supportive elements - strengthened health systems, strategic planning, financing, partnerships, advocacy, and operational research (SL 4) is to provide the platform, operational structures and alliances for the more specific malaria interventions presented in strategic lines 1, 2 and 3.
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O Plano de ação para a eliminação da malária 2021-2025 foi desenvolvido em consulta com países e parceiros regionais como um marco de referência para orientar os esforços dos países e as contribuições de doadores e parceiros em prol da eliminação desta doença nas Américas. O plano sub...screve às metas e aos pilares da Estratégia técnica mundial para o paludismo 2016-2030, da Organização Mundial da Saúde, ao mesmo tempo em que apresenta elementos essenciais para enfrentar os desafios específicos da região.
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El Plan de acción para la eliminación de la malaria 2021-2025 ha sido elaborado en consulta con los países y asociados regionales como un marco de referencia para orientar las acciones de los países y las contribuciones de los donantes y de los asociados hacia la eliminación de la enfermedad en... la Región de las Américas. El plan está en consonancia con los objetivos y pilares de la Estrategia técnica mundial contra la malaria 2016-2030 de la OMS, al tiempo que presenta elementos clave para afrontar los desafíos específicos de la Región.
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Esta nota técnica busca guiar a los programas nacionales de malaria y a las organizaciones implicadas en el apoyo de los esfuerzos para la eliminación de la malaria en la Región de las Américas, a fin de que intensifiquen las acciones políticas/estratégicas e implementen los cambios operativos... necesarios para acelerar la eliminación de P. falciparum como parte de las estrategias nacionales para la eliminación de la malaria. Con tal finalidad, orienta las acciones que deben llevarse a cabo para acelerar la eliminación de P. falciparum en zonas próximas a su eliminación, sin comprometer los esfuerzos unificados de eliminación del paludismo (P. vivax - P. falciparum) y contribuyendo al objetivo final del país de eliminar el paludismo en su conjunto. La aceleración de la eliminación de P. falciparum procura mitigar el riesgo de aparición y propagación de la resistencia a la artemisinina y de la resistencia a los fármacos asociados; acelerar la reducción del número total de casos de paludismo en zonas con una proporción importante de P falciparum; acelerar la eliminación de la malaria (P. vivax y P. falciparum) teniendo en cuenta que P. falciparum es uno de los desencadenantes de las recaídas de P. vivax; desarrollar capacidades en intervenciones para acelerar la eliminación de la malaria a partir de la experiencia de eliminación de P. falciparum, reduciendo el tiempo para alcanzar la eliminación de la malaria; y empoderar a diferentes actores, autoridades de alto nivel, donantes, municipios y otras entidades para la eliminación de la malaria con inspiración en los logros de la eliminación del P. falciparum.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge of eliminating malaria and have focused their health programs and strategies on that goal. The risk of emergence of artemisinin resistance in the Americas, the characteristics of P. falciparum parasite, and the e...pidemiological evidence of subnational territories experiencing reintroduction of P. falciparum urge for a call to push for P. falciparum elimination as an intermediate goal of the elimination of all malaria human species. Derived from the elimination of P. falciparum, other important results are expected, such as the empowerment of different actors and entities for the elimination of malaria inspired by the achievements of the elimination of P. falciparum, using early victories as a catalyst. This technical note provides guidance on actions to accelerate P. falciparum elimination in areas close to achieving this goal without compromising unified malaria elimination efforts (P. vivax - P. falciparum), while contributing to the country's ultimate goal of eliminating malaria overall. The acceleration of P. falciparum elimination has several goals: mitigating the risk that resistance to artemisinin and associated drugs will emerge and spread; accelerating the reduction in the total number of malaria cases in areas with a significant proportion of P. falciparum; accelerating malaria elimination (both P. vivax and P. falciparum), considering that P. falciparum is one of the triggers of P. vivax relapses; developing capacities in interventions to accelerate malaria elimination by building on the experience of P. falciparum elimination; and empowering different actors, including high-level authorities, donors, municipalities, and other entities involved in malaria elimination, by inspiring them with the achievements of P. falciparum elimination.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover...nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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The guidelines are primarily intended for health-care professionals working in first- or second-level health-care facilities, including emergency, inpatient and outpatient services. They are also directed at policy-makers, health-care planners and programme managers, academic institutions, non-gover...nmental and civil society organizations to inform capacity-building, teaching and research agendas.
Web annex A provides the quantitative evidence reports, Web annex B summarizes the qualitative and economic evidence and Web annex C presents the Evidence-to-Decision frameworks.
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Control of pollution from antibiotic manufacturing is a key part of safeguarding the longevity of antibiotics for all. Pollution contributes to antibiotic resistance and potentially undermines the effectiveness of medicines. High levels of antibiotics in water bodies downstream of manufacturing site...s have been widely documented. Currently, antibiotic pollution from manufacturing is largely unregulated and quality assurance criteria typically do not address environmental emissions.
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