WHO issues guidance to address drastic global health financing cuts – World Health Organization (WHO)

Report on Global Health Financing Crisis and Alignment with Sustainable Development Goals

Executive Summary

The World Health Organization (WHO) has issued new guidance in response to a severe global health financing emergency. A projected 30% to 40% reduction in external health aid by 2025 threatens to disrupt essential health services in low- and middle-income countries (LMICs), posing a significant risk to the achievement of the Sustainable Development Goals (SDGs). The guidance provides a policy framework for nations to mitigate the immediate impacts and transition towards sustainable, domestically-funded health systems, a critical step for advancing SDG 3 (Good Health and Well-being) and SDG 17 (Partnerships for the Goals).

Direct Threats to SDG 3: Good Health and Well-being

The impending funding cuts directly undermine progress on multiple targets within SDG 3. A March 2025 WHO survey of 108 LMICs indicates that these reductions have already curtailed critical services by up to 70% in some nations. The primary areas of concern include:

• Universal Health Coverage (Target 3.8): The foundation of UHC is threatened as access to essential services is compromised.
• Maternal and Child Health (Targets 3.1 & 3.2): Reductions in funding for maternal care and vaccination programs jeopardize hard-won gains in reducing mortality rates.
• Communicable Diseases and Emergency Preparedness (Target 3.3 & 3.d): Cuts to disease surveillance and health emergency response systems weaken global health security.
• Health Workforce (Target 3.c): Over 50 countries report job losses among health workers and major disruptions to training programs, hindering the development and retention of a skilled health workforce.

Broader Implications for Sustainable Development

The health financing crisis extends beyond SDG 3, with significant implications for the broader 2030 Agenda. The compounding effects of rising debt, inflation, and high out-of-pocket health spending exacerbate existing vulnerabilities.

• SDG 1 (No Poverty): Reduced public funding increases the risk of catastrophic health expenditure, a major driver of poverty.
• SDG 10 (Reduced Inequalities): The crisis disproportionately impacts the most vulnerable populations, widening health and economic disparities between and within countries.
• SDG 8 (Decent Work and Economic Growth): The guidance reframes health spending not as a cost but as a crucial investment in social stability and economic resilience, which is undermined by funding cuts and health sector job losses.

WHO Policy Recommendations for Mitigating SDG Setbacks

The WHO guidance outlines a suite of policy options designed to protect progress on the SDGs by fostering resilience and sustainability. Key recommendations include:

1. Prioritize health services for the poorest and most vulnerable populations, upholding the core SDG principle of “leaving no one behind.”
2. Protect national health budgets as a political and fiscal priority to safeguard essential services and maintain momentum towards UHC (SDG 3.8).
3. Improve efficiency through strategic purchasing, better procurement, and reduced overheads to maximize the health impact of every dollar spent.
4. Integrate externally-funded, disease-specific programs into comprehensive Primary Health Care (PHC) models to ensure service continuity and sustainability.
5. Utilize health technology assessments to prioritize services and products that offer the greatest health impact, ensuring efficient resource allocation.

Country-Level Actions Towards SDG 17: Strengthening Domestic Resources

Several countries are already implementing policies that align with the WHO’s guidance, demonstrating leadership in the transition towards self-reliance and strengthening domestic resource mobilization (SDG Target 17.1).

• Kenya, Nigeria, and South Africa: Have allocated or are seeking approval for additional domestic budget funds for health to offset aid shortfalls.
• Ghana: Lifted the cap on an excise tax earmarked for its national health insurance agency, resulting in a 60% budget increase and strengthening its domestic financing mechanisms.
• Uganda: Has outlined a clear policy agenda for the integration of health services and programs, aiming to improve efficiency and sustain service delivery with domestic capacity.

Conclusion: A Shift Towards Sustainable Health Systems

The global health financing crisis presents an opportunity for a paradigm shift away from aid dependency towards sustainable, self-reliant health systems. This transition is fundamental to achieving UHC and the broader 2030 Agenda. The WHO’s commitment, supported by initiatives like the forthcoming UHC Knowledge Hub, aims to facilitate this shift through technical support and peer learning, reinforcing the global partnership for sustainable development (SDG 17).

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to the following Sustainable Development Goals (SDGs):

• SDG 3: Good Health and Well-being

  This is the central theme of the article. It discusses the disruption of essential health services, including maternal care, vaccination, and disease surveillance, due to funding cuts. The guidance from the WHO aims to ensure the delivery of health services, strengthen health systems, and achieve universal health coverage (UHC), all of which are core components of SDG 3.

• SDG 1: No Poverty

  The article connects health financing to poverty by highlighting the impact on the “poorest” and the problem of “high out-of-pocket spending.” The guidance to prioritize services for the most vulnerable and protect them from financial shocks directly relates to poverty reduction and social protection, which are key elements of SDG 1.

• SDG 17: Partnerships for the Goals

  The article’s focus on the reduction of “external health aid” and the need for countries to transition towards “sustainable self-reliance, based on domestic resources” is a core issue of SDG 17. It discusses financial resource mobilization, aid dependency, and global partnerships like the UHC Knowledge Hub, which are all central to the implementation of this goal.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article, several specific SDG targets can be identified:

• SDG 3: Good Health and Well-being

  • Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article explicitly mentions the WHO’s commitment to “universal health coverage” and the disruption to “essential health services” like maternal care and vaccination. It also addresses financial risk by discussing “high out-of-pocket spending.”
  • Target 3.c: Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries. The article directly addresses this target by reporting “job losses among health and care workers, along with major disruptions to health worker training programmes” due to funding cuts.
  • Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks. The disruption of services for “health emergency preparedness and response, and disease surveillance” mentioned in the article is directly related to this target.

• SDG 1: No Poverty

  • Target 1.3: Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable. The recommendation to “prioritize the health services accessed by the poorest” and cushion them from the impact of funding cuts aligns with the goal of providing social protection for the most vulnerable populations.

• SDG 17: Partnerships for the Goals

  • Target 17.1: Strengthen domestic resource mobilization, including through international support to developing countries, to improve domestic capacity for tax and other revenue collection. The article’s central message is for countries to “transition away from aid dependency towards sustainable self-reliance, based on domestic resources.” The examples of Ghana lifting the cap on excise tax and Nigeria increasing its health budget are direct examples of domestic resource mobilization.
  • Target 17.2: Developed countries to implement fully their official development assistance commitments. The article’s premise is the “sudden and severe cuts to external funding” and the projection that “External health aid is projected to drop by 30% to 40%,” which directly concerns the fulfillment of ODA commitments.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

The article implies several indicators that can be used to measure progress:

• Indicators for SDG 3

  • Indicator 3.8.1 (Coverage of essential health services): The article’s mention of funding cuts reducing “critical services – including maternal care, vaccination, health emergency preparedness and response, and disease surveillance – by up to 70%” implies that the coverage of these essential services is a key metric for measuring the impact of financing shocks.
  • Indicator 3.8.2 (Proportion of population with large household expenditures on health): The reference to “high out-of-pocket spending” as a persistent challenge implies this indicator, which measures the financial burden of healthcare on households.
  • Indicator 3.c.1 (Health worker density and distribution): The report of “job losses among health and care workers” directly relates to this indicator, which tracks the availability of the health workforce.

• Indicators for SDG 17

  • Indicator 17.1.1 (Total government revenue as a proportion of GDP, by source): The actions taken by Ghana (lifting the cap on excise tax) and Nigeria (allocating additional budget funds) are measures of domestic resource mobilization, which can be tracked by monitoring government revenue sources as a proportion of GDP.
  • Indicator 17.2.1 (Net official development assistance as a proportion of GNI): The article’s core data point that “External health aid is projected to drop by 30% to 40%” is a direct reference to the flow of Official Development Assistance (ODA), which this indicator measures.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

Source: nationaltribune.com.au