the aid library

Health Financing Progress Matrix assessment, Zambia 2024

World Health Organisation (WHO) (2024) C_WHO

This report summarizes the findings of the Health Financing Progress Matrix assessment for Zambia. Recognizing the remarkable progress towards UHC made by the country over the past twenty years, the report also highlights weaknesses in the current h ... more

Innovative financing instruments for global health 2002–15: a systematic analysis

Atun, R.; Silva, S.; Knaul, F.M. Lancet Global Health (2017) CC

Development assistance for health (DAH), the value of which peaked in 2013 and fell in 2015, is unlikely to rise substantially in the near future, increasing reliance on domestic and innovative financing sources to sustain health programmes in low-i ... more

HEALTH SYSTEMS FINANCING The path to universal coverage

World Health Organization (2010) C_WHO

Promoting and protecting health is essential to human welfare and sustained economic and social development. This was recognized more than 30 years ago by the Alma-Ata Declaration signatories, who noted that Health for All would contribute both to a better quality of life and also to global peace a ... more

Health Financing in Ukraine: Resilience in the context of war

World Health Organization (WHO) (2022) C_WHO

This technical note provides tailored advice on further adjustments in health financing policy in the context of war based on principles of universal health coverage, solidarity and equity. It summarizes international evidence and accounts for spec ... more

Guidance paper - Assessing country health financing systems: the health financing progress matrix

Jowett, M.; J. Kutzin; S. Kwon et al. World Health Organization (WHO) (2020) CC

This paper outlines the background to and design of the Health Financing Progress Matrix (HFPM), WHO’s standardized qualitative approach to assessing country health financing systems. Primarily qu ... more

Mobilizing Financing for Universal Health Coverage in Brazil

Bascolo, E. World Health Organization WHO; PAHO (2022) C_WHO

Presentation Ernesto Bascolo, Advisor on Health Governance, Leadership, Policy and Planning. Pan American Health Organization/World Health Organization (PAHO/WHO) In: 20 - 24 June 2022, Brazil. "Conversaciones Técnicas Preliminares sobre la Adhesión de Brasil a OCDE"

The cost of the reemergence of monkeypox: An overview of health financing in Africa

Sokunbi T.O., Akinbi E.O. Health Policy OPEN (2024) CC

This study aims to provide an overview of health financing in Africa and to examine the impact of the reemergence of mpox on health financing in the region.

The future of health in Mozambique: Collaborative efforts for sustainable financing

N’weti, Wemos (2024) CC

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 ... more

Towards Mapping the Fiscal Space: Health Sector Financing Strategy in Mozambique

N’weti, Wemos (2024) CC

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 S ... more

Redefining Debt‑to‑Health, a triple‑win health financing instrument in global health

Hu Y., Wang Z., Zhou S., et al. Globalization and Health (2024) CC

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 ... more

From lemming to leader: Moving beyond Gross Domestic Product (GDP) to bring health financing assistance into the 21st century

Nassiri-Ansari's T., Schwalbe N., Lehtimaki S. PLOS Global Public Health (2024) CC

Nearly 90 years after Simon Kuznets first introduced Gross Domestic Product (GDP) for the limited purpose of measuring economic growth (by measuring the monetary value of all local goods and services within a given period of time), calls continue to mount for decision-makers to stop using GDP and it ... 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 vulnerabilities. This collapse is placing immense pressure o ... n 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

The nature and contribution of innovative health financing mechanisms in the World Health Organization African region: A scoping review

Nabyonga-Orem J., Christmals C.D., Addai K.F. et al. Journal of Global Health (2023) CC

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 ... more

Global Health Financing in Turbulent Times: A Detailed Analysis of The Global Fund's Resource Mobilization and Recovery Efforts

Kiai G.N. Aidspan (2024) CC

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 ... more

Health Financing Progress Matrix assessment, Kenya 2023: summary of findings and recommendations

Kenya Ministry of Health, World Health Organization (WHO) (2024) CC

This comprehensive HPFM report thoroughly explores Kenya’s health financing landscape. It provides an in-depth analysis of the current state of affairs and sheds light on required strategic changes in health ... more

PEPFAR: Exploring Co-Financing as a Tool for Domestic Resource Mobilization

Kates J. Kaiser Family Foundation (KFF) (2024) CC

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 ... 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. This kind of aid is simple to design and deliver, b ... more