Getting to Zero
Sustainable Financing of National HIV Responses
The document “Malaria Elimination Programme Review, India 2022”, published by the WHO Country Office for India, provides an in-depth assessment of India’s progress toward malaria elimination. It evaluates the structure, implementation, and effectiveness of national and subnational malaria prog...rams, focusing on surveillance, diagnosis, treatment, vector control, and community engagement. The review identifies strengths, challenges, and areas for improvement, offering evidence-based recommendations to accelerate India's efforts to eliminate malaria by 2030.
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To deliver on the Global Fund Strategy milestones
for 2028 and ensure we keep the SDG 3 target
within reach, we need to raise US$18 billion to
fund the Global Fund’s next three-year grant cycle.
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...le and equitable manner. With global cooperation and adequate fiscal reforms, Mozambique can secure quality healthcare for its population and move toward a more self-reliant and healthy future.
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In contrast to bilateral aid, aid disbursed from
multilateral institutions increased significantly at the onset
of the COVID-19 pandemic. Yet, at a time when a coherent
and effective multilateral response is needed most, the
COVID-19 pandemic revealed a shifting landscape of donor
agencies that... struggle with basic functions, such as crossnational coordination. While multilaterals are uniquely
positioned to transcend national priorities and respond
to pandemics, functionally we find official development
assistance (ODA) from these entities may increasingly
mimic the attributes of bilateral aid. We explore three
important, but not comprehensive, attributes of aid leading
up to and during the COVID-19 pandemic: (1) earmarking,
(2) donor concentration and (3) aid modality.
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Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, termed progress and ambitious, aimed at strengthening co...mprehensive health service delivery to achieve SDG 3 and universal health coverage in low-income and middle-income countries (Stenberg et al., 2017). Out of the 47 countries in the WHO African region only eight, on average, met the recommended threshold of spending a minimum of US$ 249 per capita on health during the period from 2012 to 2020. In 2020, this achievement was observed in only five countries while the remaining countries spent less than US$ 249 per capita, with health expenditures ranging from US$ 16.4 to US$ 236.6, highlighting significant disparities across the region.
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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...nancing Global Health examines where money for health originates and what health issues it funds.
This year, Financing Global Health 2023 looks at how interest payments on loans that many countries took out during the COVID-19 pandemic to keep their economies afloat and their people protected are now straining health budgets. It also details how development partners’ investments in health in low- and middle-income countries – development assistance for health – have changed since reaching historic levels during the COVID-19 pandemic, dropping by $19.4 billion between 2021 and 2023, from $84.0 billion to $64.6 billion.
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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
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space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
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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...ir impact on health systems
and outcomes. This study aims to provide a comprehensive
review of DAH from 1990 to 2022, examining its evolution
and funding allocation shifts.
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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...h and development, driven by a constrained financing environment and desire to promote more countryownership of programs and services, there are specific questions facing PEPFAR’s future. A National Academy report from 2017, for example, recommended that PEPFAR look toward phasing down its spending and supporting countries in their transition from bilateral aid to domestic financing for HIV. At a
Senate hearing last year, PEPFAR was asked how it was working to increase domestic resources and under what conditions would it need less resources to accomplish its goals. Recent challenges in securing a five-year reauthorization of the program have only served to heighten the focus on
sustainability and domestic resource mobilization. How PEPFAR does this, however, remains an ongoing question.
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This paper examines the implications of the IMF’s April 2024 macro-fiscal forecast updates on government health expenditure (GHE) across 170 economies through 2029, covering nearly all years remaining to achieve the Sustainable Development Goals (SDGs). The findings reveal wide disparities in gove...rnments' capacities to increase health spending, with differences not only observed across income groups but also within them. Primary concerns focus to two groups of low- and lower middleincome
countries: the first group is projected to experience a contraction in real per capita GHE from 2019 and 2029, threatening to reverse progress toward the health SDG targets, while the other group faces stagnation in real per capita GHE, greatly limiting advancement. The insights presented are crucial for health policymakers and their external partners to respond to evolving macro-fiscal circumstances and stabilize investment growth in health. While increasing the priority of health in spending is a key policy option, it will not be sufficient on its own. Effective responses also
require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDGs.
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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 ...the concept is defined and operationalized by agencies and how such policies relate to overall health spending patterns.
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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.
Only 10 per cent of households have electricity. Less than one half (46 per cent) of the households use basic sanitation facilities. Three in every four of the household population had basic drinking water services. More than one third of under-5 Malawian children (boys 39 per cent than girls 32 per... cent) suffer from stunting with related health issues that can include cognitive impairment.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal...th information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is ...poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
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The document outlines essential steps and provides guidance to countries on the adoption and deployment of c-IPTp so that it is integrated into the existing health system. It draws upon best practices and lessons learned from pilot implementation experiences in eight African countries and targets st...akeholders at the national level that are involved in the provision of maternal and child services, including national and local policymakers and implementers of malaria, maternal health, child health, reproductive health and community health programmes, and nongovernmental and other organizations.
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Le guide décrit les étapes essentielles et donne des orientations aux pays pour l’adoption et le déploiement du c-TPIg de manière à l’intégrer dans le système de santé existant. Il s’appuie sur les meilleures pratiques et les enseignements tirés des expériences pilotes dans 8 pays af...ricains et vise toutes les acteurs impliqués dans la prestation des services pour la mère et l’enfant - responsables politiques nationaux et locaux et acteurs de mise en œuvre des programmes de lutte contre le paludisme, de la santé maternelle, de la santé de l’enfant, de la santé reproductive, des programmes de santé communautaires - ainsi que les organisations non gouvernementales et d’autres organismes. Les pays décidant d’introduire le c-TPIg sont invités à adapter ces orientations à leurs contextes nationaux et locaux.
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