Emmergency./ PHOTO; Pexel
The World Health Organization (WHO) has released new guidance to help countries respond to the growing impact of severe global health financing cuts that are threatening essential health services across low- and middle-income countries (LMICs).
The document, titled “Responding to the health financing emergency: immediate measures and longer-term shifts,” outlines practical steps governments can take to mitigate both immediate disruptions and the long-term consequences of reduced external aid.
It also provides a framework for countries to strengthen domestic financing systems to sustain essential health services.
According to the WHO, external health aid is projected to decline by between 30% and 40% in 2025 compared to 2023 levels.
The drop, described as the sharpest in more than a decade, has already disrupted critical services in many LMICs.
Data collected by WHO from 108 countries in March 2025 showed that cuts have reduced essential services, including maternal care, vaccination programmes, epidemic preparedness, and disease surveillance, by as much as 70% in some regions.
The report also found that more than 50 countries have experienced job losses among health and care workers, with several suspending or downsizing health worker training programmes due to limited budgets.
“Sudden and unplanned cuts to aid have hit many countries hard, costing lives and jeopardizing hard-won health gains,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General.
WHO notes that the current situation compounds long-standing financial challenges, including high debt burdens, inflation, economic instability, and rising out-of-pocket spending.
Many governments already face systemic budget constraints and heavy dependence on foreign assistance for health.
The guidance urges policymakers to view health spending as an investment in national stability and resilience rather than a cost to be contained.
It recommends a balance of short-term measures to cushion the immediate effects of reduced aid and long-term reforms aimed at achieving sustainable domestic financing.
“But in the crisis lies an opportunity for countries to transition away from aid dependency towards sustainable self-reliance, based on domestic resources. WHO’s new guidance will help countries to better mobilize, allocate, prioritize, and use funds to support the delivery of health services that protect the most vulnerable,” said Ghebreyesus.
Key policy recommendations include:
- Prioritize the health services accessed by the poorest.
- Protect health budgets and essential health services;
- Improve efficiency through better procurement, reduced overheads, and strategic purchasing;
- Integrate externally-funded or disease-specific services into comprehensive PHC-based delivery models; and
- Use health technology assessments to prioritize services and products that have the greatest health impact per dollar spent.
Country leadership and global
WHO emphasized that country leadership and international solidarity will be essential for managing the transition. Several countries have already moved to strengthen domestic financing.
Kenya, Nigeria, and South Africa have all increased or proposed increases in national health budgets. Nigeria, for example, raised its health allocation by US$200 million to offset funding shortfalls, with specific increases for immunization, epidemic response, and priority health programmes.
In Ghana, the government lifted the cap on excise taxes earmarked for the National Health Insurance Agency, resulting in a 60% budget increase.
The country also introduced “The Accra Reset,” a framework to reimagine global governance and financing partnerships in health and development.
Uganda, meanwhile, has outlined policies to integrate services and improve efficiency in service delivery.
The new WHO guidance builds on the organization’s ongoing commitment to support countries in achieving universal health coverage through stronger, more resilient systems anchored in primary health care.
It also aligns with World Health Assembly resolutions on strengthening global health financing and promoting the “economics of health for all.”
WHO and its partners have pledged to continue providing technical support, financial analytics, and opportunities for peer learning through initiatives such as the upcoming UHC Knowledge Hub, a joint platform with the Government of Japan and the World Bank set to launch in December 2025.
Through these measures, WHO aims to ensure that despite shrinking global aid, countries can sustain essential services, protect vulnerable populations, and continue progressing toward universal health coverage.
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