Finance for health
We all want to receive the health services we need. No matter who you are, where you come from, or what your financial status is. But many countries – especially low- and middle-income countries – don’t have enough public resources to meet everyone’s health needs. Their health service delivery relies heavily on people’s out-of-pocket spending and external funding.
Wemos aims to increase the quality and quantity of external and domestic funding for health in low- and middle-income countries. We collaborate with civil society partners in these countries and with global networks to ensure that global policies respond to the needs of the countries. We aim to convince global health donors and other global actors who influence public health budgets to improve their mutual coordination and their alignment with country priorities. Because that advances universal and equitable access to health services that leave no one behind.
Several global health funds aim to strengthen systems for health at country, regional and/or global level. For example, the Global Financing Facility, the Global Fund, Gavi, and the Pandemic Fund. Collectively, they provide a source of finance for health that is currently indispensable for low- and middle-income countries. However, if external funding is not well-aligned with national plans and systems, it can challenge national leadership, cause fragmentation and disrupt policy implementation in recipient countries.
To prevent this, global funding for health needs to be channeled via a harmonized and transparent system that facilitates democratic accountability and ownership at country level. Moreover, it should be predictable and not have undue restrictions, such as limiting its use for recurrent expenditures like health worker salaries.
Making the Global Financing Facility more effective and equitable in Ethiopia (policy brief)
Policy brief by CORHA and Wemos with recommendations on how to make the Global Financing Facility (GFF)'s investment in Ethiopia more effective towards a strong health system and health equity.
Together for stronger health systems (policy brief)
Joint policy brief by Cordaid, N'weti and Wemos analyzing the collaborative strategies of Global Fund, Gavi and GFF in DR Congo, Mozambique and Rwanda.
The progress of the Global Financing Facility (GFF) in Uganda
Tracking the progress and implications of the Global Financing Facility (in this case results - based financing) in the healthcare sector in Uganda. By CEHURD, Uganda Debt Network and Wemos
Many low- and middle-income countries struggle to raise sufficient public funds to achieve universal health coverage and depend on development finance to fill gaps. However, development finance has increasingly been focused on private-for-profit solutions, for instance by de-risking private investments and subsidizing public-private partnerships. In the health sector, this approach risks commercialization of health services, exacerbating inequalities in access to health services instead of closing inequality gaps. For example, it can lead to more pay-for-service systems, creating financial barriers for people with low incomes.
Universal and equitable public healthcare systems require public financing. And public resources for health should be used wisely, avoiding diversion into commercial solutions that do more harm than good. We ask global health actors to be critical when it comes to private sector solutions, and to support public health systems in the first place. Also, we aim to raise awareness of alternatives for increasing those scarce public resources.
IFC Health Projects Tracker
A database with an organised and comprehensive overview of all health-related projects in which the World Bank's International Finance Corporation (IFC) is involved as an investor or advisor since 2017.
The Africa Medical Equipment Facility in Kenya
Does this new blended finance facility contribute to equitable access to healthcare services?
Improving healthcare, but for whom?
Inventory study on the International Finance Corporation’s investments in healthcare
Health security and equity: a public priority
Position paper on the IDA20 policy framework from a health perspective
Position paper on the promotion of Public-Private Partnerships in healthcare
Although development assistance fills important financing gaps, it pales in comparison with structural drains on the public purse in many countries. The outflow of finances from low- and middle-income countries through unfair global tax rules, illicit financial flows, and debt servicing is almost double the inflow of official development assistance. Ultimately, a profound change is needed in the global financial and health architecture and the ways in which financial resources are raised and allocated. We need reforms to reverse the net flow of resources from low- and middle-income countries to high-income countries, not only enlarging countries’ public purse, but also increasing national sovereignty and self-sufficiency.
Wemos strives to connect the work of economic justice movements to the global health financing discussion. We aim for global health actors to become vocal on these issues, acknowledge the need for and support calls for reforms of the international financial architecture to expand the public purse of low- and middle-income countries.
History RePPPeated II
Why Public-Private Partnerships are not the solution
The End Austerity report
A Global Report on Budget Cuts and Harmful Social Reforms in 2022-25. With contributions by Wemos.
The Covid-19 pandemic has shown that prevention, preparedness, response and recovery from the impact of infectious disease require unified pro-public action. After all, ‘no one is safe until everyone is safe’. Health systems – underfunded in many countries – were ill-prepared to cope with a pandemic, and are still suffering from the impact of Covid-19. The global funding challenge is vast, and responses so far grossly insufficient.
In line with our vision on equitable finance for health, Wemos advocates for this funding to be mobilised progressively (according to the ability to pay), allocated according to needs, and governed democratically. Considering the already large funding gaps for health, funding for pandemic PPR should not go to the detriment of existing funding flows for global health. In addition. pandemic PPR is a global responsibility that benefits all countries, and hence should not be funded from Official Development Assistance. On the basis of these principles, we analyse the different proposals and advocate for solutions that are equitable, inclusive and sustainable.
Negotiating text of the Pandemic Accord: promising for access to medicines, concerning on adequate financing
On 30th October 2023, the Intergovernmental Negotiating Body (INB), responsible for drafting and negotiating a WHO Pandemic Accord, released the latest proposal for the negotiating text. Wemos has a mixed assessment regarding health workforce, access to medicines and financing. In this article, we outline our recommendations that WHO member states should consider in the next negotiations.
Call on governments: focus Pandemic Accord on strengthening health systems
Wemos calls on all national governments to seize the establishment of the Pandemic Accord as an opportunity to strengthen health systems worldwide.
Make pooling work to end pandemics
A qualitative analysis of the Covid-19 Technology Access Pool.
Video: Make pooling work for Covid-19 vaccines
Video on the importance of sharing intellectual property, knowledge and data for scaling up production of Covid-19 vaccines.
Most low- and middle-income countries face severe health workforce shortages. Not enough health workers are trained, and for those who are, there are no steady jobs because there is no funding for their salaries. As a consequence, those health workers who are employed are overburdened and unable to give proper attention and care. While donors and governments agree that expanding the health workforce is urgent, domestic funding often runs short and external funding is too volatile or comes with restrictions that prohibits its use for recurring expenditures like salaries.
In the short to medium term, we advocate continued co-investment and improved quality of funding – predictable, long-term budget-support – from global health actors in low-and middle-income countries’ health workforce. This can boost the quantity and quality of health workers and provide the best conditions for their retention. Within the European Union, we advocate that Member States invest in training, job satisfaction and professional development of health workers, to increase their numbers and improve retention. In some cases, this can be done using existing EU funding instruments. Ultimately, all countries should raise their domestic resources in line with global targets, invest in long-term planning and forecasting, and in the recruitment, development, training, retention and management of their health workforce. For low- and middle-income countries, this will require an overall expansion of their public budgets (see also our section on reforms of the international financial architecture).
Action Brief 3: Enhancing domestic and international financing for investments in the health and care workforce
Wemos, Last Mile Health and Public Services International have compiled an action point list of priorities for civil society organizations to support investments in human resources for health. The document was prepared ahead of the WHO Fifth Global Forum on Human Resources for Health, which took place between April 3 and 5, 2023.
Missed opportunities in Rome on global health
During the Global Health Summit (21 May 2021), the G20 and the European Commission co-signed the Rome Declaration. We applaud their recommitment to strengthening health systems, but also identify missed opportunities.
Call by 143 organisations: support health worker recruitment in poor countries to fight Covid-19
Together with 143 civil society organisations, we call on the major funders in global health to prioritise international funding that supports recruitment of health workers in resource limited contexts. In a letter, we ask the funders to commit and contribute to pooled and adequate funding for long-term investments in the health workforce.
Uganda’s human resources for health: paradoxes and dilemmas
Advocacy brief including recommendations