Tax capacity—the policy, institutional, and technical capabilities to collect tax revenue—is part of a deeper process of state building that is essential for achieving the sustainable development goals. This Staff Discussion Note shows that developing countries have made some progress in revenue... mobilization during the past decades, but that much more is needed. It finds that a staggering 9 percentage-point increase in the tax-to-GDP ratio is feasible through a combination of tax system reform and institutional capacity building. Achieving this calls for a holistic and institution-based approach that focuses on improving policy, administration, and legal implementation of core taxes. The note offers practical lessons and guidance, based on IMF capacity-building experience in this area.
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Pour atteindre les objectifs de sa stratégie et se
rapprocher de la cible de l’ODD 3 liée aux trois
maladies à l’horizon 2030, le Fonds mondial doit
réunir 18 milliards de dollars US pour sa huitième
reconstitution des ressources. Cette somme est
le minimum requis pour faire progresser... la lutte
contre le VIH, la tuberculose et le paludisme à
un rythme correspondant aux objectifs et pour
maintenir les investissements nécessaires dans les
systèmes de santé et communautaires.
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Damit wir die Meilensteine der Strategie des Globalen
Fonds für 2028 einhalten können und SDG 3 für uns weiter
erreichbar bleibt, benötigen wir 18 Milliarden US-Dollar,
um die nächste dreijährige Förderperiode des Globalen
Fonds finanzieren zu können.
With the COVID-19 pandemic and the ensuing energy and cost-of-living crises, many OECD countries have had to face significant economic and societal challenges over the last five years. The succession of crises has had important implications for health systems and the available resources allocated to... health. This policy brief examines the recent trends in health spending and discusses what is driving the latest spending trajectory.
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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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To realize Agenda 2030, aid agencies, private philanthropies, and their partners in the Global South need better data to monitor how official development finance (ODF) dollars advance the Sustainable Development Goals (SDGs) and avoid missing the mark. In this report, we summarize the results of a n...ovel effort to tag and analyze 2.7 million ODF projects between 2010-2021 using machine learning to understand their contributions to the SDG thematic areas at a goal
and target level. This time frame is instructive: it compares the last six years of the Millennium Development Goals era and the first six years of the new SDG age, from early optimism to later uncertainty about the resilience of the agenda to drive collective commitments amid unanticipated global shocks.
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Insufficient funding is hindering the achievement of malaria elimination targets in Africa, despite the pressing need for increased investment in malaria control. While Western donors attribute their inaction to financial constraints, the global health community has limited knowledge of China’s ex...panding role in malaria prevention. This knowledge gap arises from the fact that China does not consistently report its foreign development assistance activities to established aid transparency initiatives. Our work focuses on identifying Chinese-funded malaria control projects throughout Africa and linking them to official data on malaria prevalence. By doing so, we aim to shed light on China’s contributions to malaria control efforts, analysing their investments and assessing their impact. This would provide valuable insights into the development of effective financing mechanisms for future malaria control in Africa.
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The COVID-19 pandemic demonstrated that
the world was not well prepared to respond
to an infectious disease threat of this magnitude. Countries across all socioeconomic and development categories have struggled
to implement effective national responses. Substantial amounts of additional investmen...t are required to support the development of country capacities to prevent, detect and respond to both existing and emerging
infectious disease threats. Prior research efforts have estimated that between US$96 and $204billion is required, globally, to
advance country-level health security capacities, with US$63–131billion needed over a 3-year period. Given the substantial costs
of ongoing COVID-19 response, estimated to
be over US$12.5trillion through 2024, and an estimated 12.1–22.7million excess deaths, globally, due to COVID-19 as of January 2022,
the importance and potential return on investment of such upfront investments in capacity building are more evident than ever before.
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One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an approach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just h...ow much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the
years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a costeffective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness.
Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources.
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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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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...ous lines of healthcare provision. Health has been intentionally transformed into a commodity as private for-profit actors have been allowed freedom to operate - and ultimately play with people’s fundamental right to health - for their vested financial interests, nationally and internationally. Health financialization is thrivingly pursued today for example through the institutionalization of medical knowledge monopolies, the expansion of markets and of financial techniques applied to healthcare insurance schemes, the soaring digitalization of global health interventions and the booming data industry.
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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... on investments in health equity and its social determinants. Emerging data and trends show that these potential returns have increased during the COVID-19 pandemic - investments in social determinants can mitigate widespread reductions in human capital and the increasing likelihood of costly syndemics, while promoting access to healthcare innovations that have thus far been inequitably distributed. Therefore, we argue that, despite immediate fiscal pressures, this is exactly the time to invest in health equity and its broader social determinants, as the returns on such investments have never been greater.
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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...ld standard in tracking and reporting global funding for neglected disease R&D. This year’s report, the sixteenth overall, focuses on investments made in participants’ 2022 financial year (‘FY2022’) and, for the first time, adds comprehensive coverage of the product pipeline in each disease area.
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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...tion –
remains key, despite being generally considered as no
longer adequate for addressing today’s common and
collective challenges.
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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 ...country's gross domestic product (GDP). In 2020, Zambia sought assistance through the G20 Common Framework and the International Monetary Fund (IMF) Extended Credit Facility (ECF), securing a USD 1.7 billion loan over 5 years. IMF loans, however, come with austerity measures that prioritise fiscal discipline but could potentially exacerbate social inequalities. These measures, which include increasing consumer taxes on goods and services (value added taxes - VATs), electricity tariffs and fuel prices, disproportionately impact vulnerable populations, raising concerns about their long-term effects on essential services, especially accessible and good quality healthcare services.
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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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This article provides an in-depth analysis of the Global Fund's strategic initiatives in resource mobilization and recovery amid global economic fluctuations and geopolitical challenges. It highlights the Fund's successful conversion of pledges and innovative financing models that ensure sustainable... funding for combating HIV, tuberculosis, and malaria. The discussion extends to the Fund's rigorous recovery processes and advocacy efforts to bolster its visibility on international platforms. Additionally, it explores the impact of economic constraints on health funding and the potential of emerging markets and technologies. Performance metrics and health impact assessments underscore the Global Fund's critical role in advancing global health objectives. This analysis offers stakeholders valuable insights into the complexities of global health financing and the Global Fund's adaptive strategies in response.
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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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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.
Todos los países de la Región de las Américas en los que la malaria es endémica han asumido el reto de eliminar la enfermedad y de poner en marcha medidas para orientar sus programas y estrategias de salud en esa dirección. En este manual se explica cómo ejecutar las medidas con vistas a logra...r la eliminación de la malaria y prevenir su restablecimiento, mediante el aumento de la intensidad y la calidad de las medidas, la reorientación de las iniciativas, la reducción de los retrasos que favorecen la transmisión y un monitoreo adecuado que permita ajustar las intervenciones. En este sentido, se propone como primer paso estratificar el territorio —de modo que se puedan planificar y priorizar las intervenciones y grupos de población— para, a continuación, aplicar una medida de diagnóstico, tratamiento, investigación y respuesta como estrategia clave dirigida a hacer efectiva la eliminación de la enfermedad y a prevenir su restablecimiento en todos los estratos. Además, el documento trata de hacer operativo el concepto de vigilancia, como intervención promovida por la Organización Mundial de la Salud a través de la Estrategia Técnica Mundial contra la Malaria 2016-2030, y destaca la importancia de que las comunidades tengan acceso al diagnóstico y el tratamiento tempranos. Por último, en el manual también se incluyen aspectos de gestión y monitoreo que deben tenerse en cuenta para la eliminación de los focos de transmisión.
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