The World Health Organization (WHO) has issued new guidance to help countries mitigate the immediate and long-term impacts of sharp reductions in external health funding, which are severely affecting essential health services in many low- and middle-income countries (LMICs). The report, titled “Responding to the health financing emergency: immediate measures and longer-term shifts,” outlines practical policy options to help countries manage financing shocks while building sustainable and resilient national health systems.
According to WHO projections, global health aid is expected to decline by 30–40% in 2025 compared to 2023. This drop is already disrupting critical services such as maternal and child health care, vaccination programs, emergency preparedness, and disease surveillance. WHO’s survey of 108 LMICs revealed that in some cases, service disruptions have reached as high as 70%, while more than 50 countries have reported job losses among health workers and cutbacks in training programs.
WHO Director-General Dr. Tedros Adhanom Ghebreyesus highlighted that while these unplanned cuts threaten lives and progress made in global health, they also present an opportunity for countries to move toward self-reliance and sustainable financing based on domestic resources. He emphasized that WHO’s new guidance is designed to help governments allocate and prioritize funds more efficiently to protect vulnerable populations and essential services.
The guidance calls for urgent policy actions that prioritize health spending even during economic crises, framing it as an investment in social stability and resilience rather than a financial burden. It recommends that countries safeguard budgets for essential services, improve spending efficiency through better procurement and management, and integrate externally funded disease programs into broader, primary health care-based delivery models. Additionally, it stresses the use of health technology assessments to ensure the most cost-effective interventions are prioritized.
Several countries have already begun implementing measures aligned with WHO’s recommendations. Kenya, Nigeria, and South Africa have increased or are planning to increase their health budgets, with Nigeria adding US$200 million to cover aid shortfalls. Ghana has removed a cap on excise tax allocations for its national health insurance agency, boosting its health budget by 60%, and launched the “Accra Reset” framework to reimagine global health financing. Uganda has also initiated reforms to integrate health services and improve long-term efficiency.
This new guidance reinforces WHO’s commitment to helping all countries strengthen their health systems and achieve universal health coverage through robust primary health care. It supports global mandates on strengthening health financing and promoting equitable access to care. WHO and its partners will continue to provide technical and analytical assistance through initiatives like the forthcoming Universal Health Coverage (UHC) Knowledge Hub, developed in collaboration with Japan and the World Bank, which will be launched in December 2025 to help countries navigate the ongoing health financing crisis.
