Sustaining coverage in the face of health financing cliffs

As countries face growing health financing cliffs due to declining external aid and mounting domestic fiscal pressures, the risk of reversing hard-won health gains is increasing—especially in low- and middle-income countries. To respond to this urgent challenge, the Alliance for Health Policy and Systems Research and WHO’s Department of Health Financing and Economics convened a technical meeting in March 2025. Bringing together national policy-makers, development partners and experts, the meeting explored strategies to sustain essential health service coverage, identified country needs for data and policy support, and co-developed a research and learning agenda to guide future financing transitions. Key discussions highlighted the importance of aligning external funding with national priorities, integrating health financing into broader economic governance, and addressing the tension between immediate responses and long-term reform.