The future of global health spending amidst multiple crisis

The deteriorating macroeconomic conditions—alongside consequences of the war in Ukraine and competing national priorities—will significantly constrain public and aid spending on health in 2023 and beyond. 

 Health systems in many countries are still reeling from the fallout of the pandemic. Yet, the concerning reality is that many Low and Middle Income Countries (LMICs)—where unmet health needs are largest—are projected to see health spending drop or plateau. A World Bank report estimates that 41 governments will spend less on health between now and 2027 than they did in the pre-pandemic period. The global economic downturn is also squeezing aid budgets, even while external assistance is urgently needed to support LMICs.

Against this backdrop, the prevailing development finance architecture is being revisited, with ideas proposed to expand financing—both volumes and instruments—to meet urgent global challenges. 

This CGD note summarizes the implications of the macroeconomic context and broader financing outlook for domestic and external health spending and proposes a “menu” of policy options to keep health spending on track and blunt negative impacts on health systems and population health around the world. It draws on findings from recent research and a private roundtable discussion (under Chatham House rules) with leading health and finance experts, convened by CGD in October 2022.