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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 Sector Financing Strategy (HSFS) 2025 – 2034

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China’s hidden role in malaria control and elimination in Africa

Odhiambo J.N., Dolan C., Malik A.A., et al. BMJ Global Health (2023) CC

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... more

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Financing global health security: estimating the costs of pandemic preparedness in Global Fund eligible countries

Eaneff S., Boyce M.R., Graeden E., et al. BMJ Global Health (2022) CC

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... more

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WHO African Region Health Expenditure Atlas 2023

WHO African Region (2024) CC

Over the past decade, countries in the African region experienced slow progress in mobilizing resources for health while facing continued challenges. In their revised estimates published in 2017, Stenberg et al., developed two costs scenarios, termed progress and ambitious, aimed at strengthening co... more

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Mapping the Literature on Development Assistance in Health: A Bibliometric Analysis

Karwa O., Jain R., Deo S. Observer Research Foundation (2024) CC

This paper presents a bibliometric analysis of the literature on private health aid and official health assistance between 2000 and 2022. It provides an overview of the sites and themes in the literature pertaining to development assistance in health, and collates the significant policy recommendati... more

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Banking on health: the surging pandemic of health financialization

Dentico N. Society for International Development (SID) (2023) CC

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... more

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Neglected Disease Research and Development: The Higher Cost of Lower Funding

G-Finder (2023) CC

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... more

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Estrategia operativa 2024-2030 del Programa Mundial sobre Malaria‎

World Health Organisation (WHO) (2024) C_WHO

En su condición de departamento técnico de la OMS para el paludismo, al Programa Mundial sobre Malaria le corresponde una importante función de liderazgo de la respuesta mundial. Por medio de sus acciones directas y su red, tiene la capacidad de conformar el ecosistema de la respuesta al paludism... more

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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 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

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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 assistance have been registered. To create fiscal ... more

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Evolution and effectiveness of bilateral and multilateral development assistance for health: a mixed-methods review of trends and strategic shifts (1990–2022)

Xie S., Du S., Huang Y., et al. BMJ Global Health (2025) CC

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... more

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Health for All – transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Health for All

World Health Organization (WHO) (2023) CC

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... more

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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 financing. The report points out the need to improve public financial management within th... more

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Government Health Spending Outlook - Projections Through 2029: Diverging Fiscal Pressures, Uneven Constraints

The International Bank for Reconstruction and Development The World Bank (2024) CC

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... more

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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 governments, is one mechanism to promote sustainability and country ownership. We aim to understand how ... more

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Health Taxes: A Compelling Policy for the Crises of Today

The Task Force on Fiscal Policy for Health Report 2024 Bloomberg (2024) CC

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... more

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A healthy return: Investment case for a sustainably financed WHO

World Health Organization (WHO) (2022) CC

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.

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The Evolution of the ODA Accounting Rules

Casadevall-Bellés S., Calleja R. Center for Global Development (2024) CC

Frequent efforts to revise the official development assistance (ODA) accounting rules have raised important questions about the integrity and relevance of what currently “counts” as ODA spending. In this note, we outline a brief history of the evolution of the ODA accounting rules to date, highl... more

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Manual para la estratificación según el riesgo de malaria y la eliminación de focos de transmisión

Pan American Health Organization (PAHO) (2022) C_WHO

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... more

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Manual for Stratifying Malaria Risk and the Elimination of Foci

Pan American Health Organization (PAHO) (2022) C_WHO

All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it... more