(Published with Decision No. 3003/QðBYT dated 19/8/2009 of the Minister of Health)
PLoS ONE 18(5): e0285031. https://doi.org/10.1371/journal.pone.0285031
The study aims to integrate HPV vaccination into routine care in adolescent HIV clinics. To achieve success, we will co-design a package of implementation strategies using a previously successful implementation research approach... developed for cervical cancer prevention in LMICs: the Integrative Systems Praxis for Implementation Research (INSPIRE). INSPIRE is a novel, comprehensive approach to develop, implement, and evaluate implementation science efforts
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While motivational factors vary, opportunities for career advancement, stimulating and challenging tasks, opportunities for promotion, and co-worker recognition are core factors that can engender retention of rural health workers. Interventions are required to enhance rural health worker motivation ...and retention, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. Strategies around retention need to be addressed as these would better enable rural primary health workers to cope with the challenging conditions they work in rural areas.
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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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Overall, harmonisation and innovation should be the
focus of the future direction of DAH and the creation of
a healthy global community. The world needs all hands
on deck if it were to move towards achieving the SDGs,
addressing global health inequalities and improving the
welfare of the global... population, while ensuring that no
one is left behind.
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We investigate whether and to what extent Chinese development finance affects infant mortality, combining 92 demographic and health surveys (DHS) for a maximum of 53 countries and almost 55,000 sub-national locations over the 2002-2014 period. We address causality by instrumenting aid with a set of ...interacted variables. Variation over
time results from indicators that measure the availability of funding in a given year. Cross-sectional variation results from a sub-national region’s “probability to receive aid.” Controlled for this probability in tandem with fixed effects for country-years and provinces, the interactions of these variables form powerful and excludable instruments. Our results show that Chinese aid increases infant mortality at sub-national scales, but decreases mortality at the countrylevel. In several tests, we show that this stark contrast likely results from aid being fungible within recipient countries.
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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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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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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.
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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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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 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.
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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
...
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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For this report, the Task Force commissioned
additional background papers on health taxes to
update the evidence, assess short-term revenue
potential, and understand the role of health taxes
in the current era of multiple crises. We find that
health taxes continue to be underutilized despite th...e
powerful impact they have in reducing preventable
death and disease — a particularly glaring act of
neglect in a world that has experienced a massive
pandemic.
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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 for pandemic financing that spans the entire pandemic cycle..., emphasizing the need for timely, adequate, and effective financial resources. The framework is designed to support
policymakers in both low- and middle-income countries (LMICs) and high-income nations, providing a guide to appropriate financing tools for each stage of a pandemic, from prevention and preparedness to response and recovery. Key economic concepts such as global public goods, time preference, and incentives are explored to underscore the complexities of pandemic financing.
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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.
In 2019, the Task Force on Fiscal Policy for Health concluded that taxes on tobacco, alcohol, and sugar-sweetened beverages were a highly effective but greatly underused policy tool to reduce consumption, save lives, and raise domestic resources. The Task Force estimated that if all countries increa...sed their excise taxes to raise prices by 50 percent, over 50 million premature deaths could be averted worldwide over the next 50 years while
raising over USD 20 trillion of additional revenue. Since the Task Force first convened, the world has faced a “polycrisis,” including a global pandemic, an economic recession, and the outbreak of wars in Europe and the Middle East. Against this backdrop, the world has also experienced prolonged health and fiscal crises. Health systems, weakened by the COVID-19 pandemic, lack sufficient financing to rebuild and respond to the surging noncommunicable diseases epidemic caused by uncontrolled risk factors such as tobacco, alcohol, and sugar consumption. Opportunities to raise domestic resources are limited and debt burdens have squeezed budgets. The period from 2019 to 2027 risks becoming a “lost decade” for health and social policies, with 110 countries facing little prospect of any
ability to raise government revenues beyond current levels. In this paper, we describe the current health and fiscal crises and review the contribution that health taxes could make in turning around this dire situation. We conclude that taxes on tobacco, alcohol, and
sugar-sweetened beverages are an ideal policy solution—good for the budget and good for health. These taxes are relatively quick to implement, and, unlike other taxes, do not put economic growth at risk—a vital benefit in the current era.
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This Guide is part of WHO’s overall programme of work on Political Economy of Health Financing Reform: Analysis and Strategy to Support UHC. The impetus for this work came from demands for more concrete evidence, recognition and integration of political economy issues within
health financing, and... overall system, reform design and implementation processes. This Guide is complementary to WHO’s Health Financing Progress Matrix assessment, as well as Health Financing Strategy development guidance. In this way, it promotes an embedded political
economy analysis approach that can be used in conjunction with other health financing assessments and guidance. The political economy framework can also be extended and easily adapted to broader health policy reforms.
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Questions concerning the relevance and reform of official development assistance (ODA), and how ODA and broader development finance could—or should—change to better reflect shifting demands are not new, with academics and policymakers suggesting a range of options for reform. In this background ...note, we briefly review the major reform proposals from 2009 onwards, highlighting the key issues underlying approaches to ODA reforms, and the main “types” of proposals typically put forward.
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