the aid library

Financing the Pandemic Cycle: Prevention, Preparedness, Response, and Recovery and Reconstruction

Fan V. Y., Kim S., Pineda D., et al. Center for Global Development (2024) CC

The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This chapter presents a comprehensive framework ... more

Conditioned Domestic “Co-financing” Policies in Global Health

Sparkes S., Yungrattanachai M., Fan V., et al. Center for Global Development (2024) CC

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 go ... more

Why Is There So Little Contractually Contingent Financing?

Dissanayake R. Center for Global Development (2024) CC

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. T ... more

Projected Health Financing Transitions: Timeline and Magnitude

Rachel Silverman Center for Global Development (2018) C2

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 globa ... more

Financing Global Health 2014: Shifts in Funding as the MDG Era Closes

Institute for Health Metrics and Evaluation (2015) CC

Financing Global Health 2014 is the sixth edition of this annually produced report on global health financing. As in previous years, this report captures trends in ... more

Sustaining Effective Coverage for HIV, Tuberculosis, and Malaria in the Context of Transition in Tanzania

Fleisher, Lisa; Mehtsun, Sinit; Arias, Daniel Results for Development (R4D) (2017) C1

R4D conducted a thorough desk review and qualitative fiscal space analysis, 19 interviews about financing for the three diseases and the extent of alignment between public financial management syste ... more

Financing Global Health 2017: Funding Universal Health Coverage and the Unfinished HIV/AIDS Agenda

Institute for Health Metrics and Evaluation (IHME) Institute for Health Metrics and Evaluation (IHME) (2018) C2

In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development ... more

Sustaining Effective Coverage for HIV, Tuberculosis, and Malaria in the Context of Transition in Kenya

Chaitkin, Michael; O’Connell, Meghan Results for Development (R4D) (2017) C1

The report explores strategies for sustaining the country’s responses to the three diseases and eventually transitioning away from external funding and programmatic support. It takes stock of Kenya’s health ... more

Financing Global Health 2018: Countries and Programs in Transition

Institute for Health Metrics and Evaluation (IHME) Institute for Health Metrics and Evaluation (IHME) (2019) C2

This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of d ... more

Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015

Global Burden of Disease Health Financing Collaborator Network Lancet (2018) CC

Background: Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution o ... more

Financing Global Health 2013: Transition in an Age of Austerity

Institute for Health Metrics and Evaluation (2014) CC

Financing Global Health 2013: Transition in an Age of Austerity, IHME’s fifth annual report on global health expenditure, depicts financing trends that underline the resilience of ... 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 ... more

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 vulnerabi ... lities. 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

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Global Burden of Disease 2021 Health Financing Collaborator Network The Lancet Glob Health (2023) C2

The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-i ... more

Equity and adequacy of international donor assistance for global malaria control: an analysis of populations at risk and external funding commitments

Snow, RW.; Okiro, EO.; Gething, PW.; Atun, R.; Hayc, SI. The Lancet (2010) CC

Financing for malaria control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to id ... more

Financing Maternal and Child Health—What Are the Limitations in Estimating Donor Flows and Resource Needs?

Schäferhoff, M.; Schrade, C.; Yamey G. PLOS Med (2010) CC

Marco Schäferhoff and colleagues critique funding estimates for the maternal and child health Millennium Development Goals, and make recommendations for ... more

Potential for additional government spending on HIV/AIDS in 137 low-income and middle-income countries: an economic modelling study

Haakenstad, A.; Moses, M.W.; Tao, T.; et al. (2019) CC

Between 2012 and 2016, development assistance for HIV/AIDS decreased by 20·0%; domestic financing is therefore critical to sustaining the response ... 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 ... more