Sustaining coverage in the face of health financing cliffs: meeting report, Geneva, Switzerland, 4-5 March 2025

This meeting report summarizes discussions from a technical consultation convened by the Alliance for Health Policy and Systems Research and the WHO Department of Health Financing and Economics in March 2025 on sustaining essential health service coverage amid growing health financing constraints. The report examines the impact of declining external assistance, fiscal pressures and debt burdens on health systems, particularly in low- and middle-income countries that remain heavily dependent on external funding for programmes such as HIV, tuberculosis and malaria. Drawing on country experiences and expert discussions, the report analyses the risks posed by “health financing cliffs” and explores policy responses to protect essential services and vulnerable populations.

The publication outlines discussions on domestic resource mobilization, coordination between ministries of health and finance, integration of health financing into broader economic planning and the role of private sector engagement. Participants emphasized the need for stronger country ownership, improved tracking of financing flows, enhanced analytical capacity and more effective alignment between external funding and national priorities. The report also identifies priorities for future research, policy support and knowledge-sharing to strengthen sustainable health financing and support more resilient, equitable and country-driven health systems during financing transitions.