Health financing under pressure as civil society calls for urgent action

With global health financing under increasing strain, driven by declining donor funding and tightening national budgets, civil society organizations are warning that urgent action is needed to sustain essential health services and protect progress toward universal health coverage.

On 10 December 2025, the WHO Civil Society Commission, in partnership with Save the Children, convened the first in a series of global dialogues on health financing, bringing together a diverse group of stakeholders from across regions to help shape priorities ahead of the Seventy-ninth World Health Assembly (WHA79).

Opening the discussion, Taru Koivisto, Director, Ministry of Social Affairs and Health, Finland, underscored the stakes: “Health is an investment and strong public health systems are resilience investments that keep societies functioning in times of crisis.”

Reframing health as an economic priority

A central theme of the dialogue was the need to reposition health within economic decision-making.

The Economics of Health for All (EHfA) approach promotes a shift from viewing health as a cost to recognizing it as an investment that contributes to economic stability, resilience and long-term development. 

This shift has practical implications for how governments structure budgets, how finance ministries engage with health policy and how civil society advocates for accountability. As global financing conditions evolve, this is no longer aspirational; it is critical.

Anna Vassall, Unit Head, Health Financing and Economics, World Health Organization, highlighted, “Health should be seen as a core investment that drives inclusive economic development, resilience and poverty reduction.”

Participants broadly supported this direction, emphasizing that health systems are foundational to both social and economic resilience. They also stressed that integrating health into economic policy requires stronger cross-sector collaboration, particularly between the ministries of health and finance.

Strengthening sustainable and domestic financing

The current financing environment is exposing underlying vulnerabilities in health systems, particularly where financing has relied heavily on external support.

Participants emphasized that this moment presents an opportunity to strengthen sustainable, domestically anchored financing, with greater focus on long-term priorities such as prevention and primary health care.

Boniface Mbuthia, Director of Health Financing, Amref Health Africa, stated, “As external funding declines, countries must strengthen domestic revenue and prioritize investments in prevention and primary health care to sustain health systems.”

Discussions also highlighted the importance of maintaining public financing as the foundation of health systems, while improving how re

Youth perspective: long-term consequences

Youth have traditionally been underrepresented in health financing discussions, despite being among those most affected by long-term policy decisions. This dialogue marked an important step in addressing that gap by actively including youth perspectives.

Angela Mei Seiler Torres, InciSioN Global and WHO Youth Council Member, reinforced the importance of intergenerational equity and the need to integrate youth voices into policy and financing discussions, meaningfully stating, “Health financing decisions today will shape the systems that young people inherit tomorrow. That is why youth must be part of these discussions, not only as future leaders, but as stakeholders today.”

Ensuring meaningful youth engagement is essential to designing health systems that are equitable, responsive and sustainable over the long term.

Accountability and equity in focus

Participants emphasized that accountability is essential to ensure that financing commitments translate into tangible improvements in health outcomes. A key message was that commitments must be measurable and transparent.

Civil society organizations called for stronger accountability frameworks, including clearer domestic spending targets, improved tracking of health expenditures, and more robust oversight to ensure that rertance of embedding equity and human rights considerations into financing decisions, so that limited re

These priorities informed the development of concrete recommendations and asks for WHO and Member States.

Setting the agenda ahead of the Health Assembly

The dialogue established a clear direction for future engagement, identifying priority areas for action, including strengthening domestic financing, improving efficiency and governance of health spending, and institutionalizing civil society participation in decision-making processes.

The second dialogue, titled “Financing Health at Home, Why Domestic Leadership Matters,” was held on 15 April 2026, building on these discussions and focusing on practical actions and the development of targeted recommendations for WHO and Member States ahead of the Seventy-ninth World Health Assembly.

As the series progressed toward the Seventy-ninth World Health Assembly, these priorities, from sustainable domestic financing and stronger accountability to meaningful civil society participation, helped shape discussions during a pivotal moment for global health financing.