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1
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.
more
The motivations behind China’s allocation of health aid to Africa remain complex due to limited information on the details of health aid project activities. Insufficient knowledge about the purpose of China’s health aid hinders our understanding of China’s comprehensive role in supporting Afri
...
ca’s healthcare system. To address this gap, our study aimed to gain better insights into China’s health aid priorities and the factors driving these priorities across Africa. To achieve this, we utilized AidData’s Chinese Official Finance Dataset and adhered to the Organisation for Economic Co-operation and Development (OECD) guidelines.
more
Tracking development assistance for health from India to low- and middle-income countries, 2009–2020
Development assistance for health (DAH) is an important source of financing for health for many low-income and some middle-income countries. Most DAH has predominantly been contributed by high-income countries. However, in the context of economic progress and changing global priorities, DAH contribu
...
tions from countries of the Global South such as India have gained importance. In this paper, we estimate DAH contributed by India between 2009 and 2020.
more
Countries that are reforming their health systems to progress towards Universal Health Coverage (UHC) need to consider total resource requirements over the long term to plan for the implementation and sustainable financing of UHC. However, there is a lack of detailed conceptualization as to how the
...
current health financing mechanisms interplay across health system elements. Thus, we aimed to generate evidence on how to utilize resources from different sources of funds in Africa.
more
Strengthening resilient and sustainable systems for health (RSSH) is central to the Global Fund’s strategy, however questions persist about the Global Fund’s role in the health systems strengthening space, and the extent to which investments are designed to achieve strengthening objectives, or j
...
ust fill in gaps in the system. This paper reports on findings from the Prospective Country Evaluations (PCE), a multi-country multi-year evaluation of Global Fund support.
more
The COVID-19 pandemic disrupted health systems in 2020, but it is unclear how financial hardship due to out-of-pocket (OOP) health-care costs was affected. We analysed catastrophic health expenditure (CHE) in 2020 in
five countries with available household expenditure data: Belarus, Mexico, Peru, R
...
ussia, and Viet Nam. In Mexico and Peru, we also conducted an analysis of drivers of change in CHE in 2020 using publicly available data.
more
The global pandemic response has typically followed
cycles of panic followed by neglect. We are now, once
again, in a phase of neglect, leaving the world highly
vulnerable to massive loss of life and economic shocks
from natural or human-made epidemics and pandemics.
Quantifying the size of the
...
losses caused by large-scale
outbreaks is challenging because the epidemiological
and economic research in this field is still at an early
stage. Research on the 1918 influenza H1N1 pandemic
and recent epidemics and pandemics has shown a range
of estimated losses (panel).
more
In 2021, global life expectancy at birth was 74 years whereas in sub-Saharan Africa it was 66 years. Yet in that same year, $92 per person was spent on health in sub- Saharan Africa, which is roughly one fifth of what the next lowest geographic region—North Africa and Middle East—spent ($379). T
...
he challenges to healthy lives in sub-Saharan Africa are many while health spending remains low. This study uses gross domestic product, government, and health spending data to give a more complete picture of the patterns of future health spending in sub-Saharan Africa. We analyzed trends in growth in gross domestic product, government health spending, development assistance for health and the prioritization of health in national spending to compare countries within sub-Saharan Africa and globally.
more
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.
more
The relative priority received by issues
in global health agendas is subjected to impressionistic
claims in the absence of objective methods of assessment
of priority. To build an approach for conducting structured
assessments of comparative priority health issues receive,
we expand the public
...
arenas model (2021) and offer a
framework for future assessments of health issue priority
in global and national health agendas.
more
When we presented our analysis of Germany’s role in
global health in 2017 at an event in Berlin, Richard
Horton, the Editor-in-Chief of The Lancet, asked only
half-jokingly whether we could expect Germany to finally
shrug off the habitus of the “reluctant leader” and “step
up”. Back t
...
hen, the entire team of authors were hesitant
to use the term leadership as a broad label. We decided to
highlight areas where leadership could be observed, but
refrained from using it in the title of our previous study.
7 years later, after a devastating global pandemic, notable
political changes in Germany, and amid a substantially
changed global health landscape, we aim to analyse
Germany’s role in global health once more.
more
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
...
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.
more
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
...
esource mobilization in public health, particularly for low-and middle-income countries deep in debt.
more
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,
...
the COVID-19 crisis and the war in Ukraine. As a
result, interest rates have risen sharply over the past year and are not expected to decline anytime soon. High interest rates further restrict low- and middle-income countries’ access to international financial markets by making borrowing more expensive. At the same time, debt
levels in several countries are rising to levels that are almost impossible to repay. Poorer countries find themselves in a trap where financing the Sustainable Development Goals (SDGs) becomes a distant goal for them.
more
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
...
atedly, there is growing con-sensus in academic and applied policy circles that publicfinancial management (PFM)—the “systems engineering”of public financing—is a critical enabling factor for anyhealth system reform in support of UHC.
more
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
...
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.
more
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.
more
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
...
l survey was conducted with 600 healthcare professionals from eight states across Nigeria, representing a variety of healthcare occupations. Participants completed a questionnaire that assessed their perceptions of healthcare financing, quality of care, job satisfaction, and motivation using a 5-point Likert scale, closed- and open-ended questions. Descriptive statistics, Chi-squared test, and regression analysis were used to analyze the data. The findings revealed that healthcare workers were generally not satisfied with the current state of healthcare financing and system quality in Nigeria. Poor funding, inadequate infrastructure, insufficient staffing, and limited access to essential resources were identified as major challenges.
more
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
...
projected economic growth of countries between 2022 and 2027, how likely it is that low- and middle-income country governments and donors can mobilize the estimated funding.
more
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.
more
