WHO Issues Guidance to Face Health Funding Shortfalls

The World Health Organization (WHO) issued new guidance this week to help countries manage sudden reductions in external health funding, a challenge that is disrupting essential services worldwide. The guidance comes as low- and middle-income countries face projected cuts of 30% to 40% in foreign aid this year, threatening services such as maternal care, vaccination, and disease surveillance.

“Sudden and unplanned cuts to aid have hit many countries hard, costing lives and jeopardizing hard-won health gains,” says Tedros Adhanom, Director General, WHO. “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 guidance, titled Responding to the Health Financing Emergency: Immediate Measures and Longer-Term Shifts, outlines strategies for countries to mobilize and allocate domestic resources, prioritize essential services for the poorest populations, improve efficiency, and integrate externally funded programs into broader primary health care models. The organization emphasizes using health technology assessments to target spending toward interventions with the greatest impact per dollar and calls for political and fiscal prioritization of health as a core investment.

Several countries are already taking action. Nigeria has increased its health budget by US$200 million to offset aid shortfalls, while Ghana lifted the cap on excise taxes allocated to its national health insurance, increasing the budget by 60%. Kenya, South Africa, and Uganda have also introduced measures to sustain service delivery and improve efficiency. WHO plans to provide technical support through initiatives such as the UHC Knowledge Hub, in partnership with Japan and the World Bank.

In Mexico, public health financing remains below international recommendations despite a planned 5.9% increase in the 2026 health budget to MXN$965 billion (US$53.3 billion). The rise primarily benefits IMSS and IMSS-Bienestar, while other agencies, including ISSSTE, PEMEX, and the Ministry of National Defense (SEDENA), face reductions. The Ministry of Health plans to reduce programs from 27 to 16, with similar consolidations at ISSSTE and IMSS.

“Next year’s health budget appears likely to remain very challenging,” says Héctor Valle, Executive President, FUNSALUD, noting that Mexico’s per-capita health investment is low compared with other Latin American and OECD countries, leaving households exposed to high out-of-pocket costs. The government has also proposed increasing special taxes on sugary drinks and cigarettes, though opposition parties have called for greater transparency in managing these funds.

Economic pressures have already constrained spending. In the first quarter of 2025, Mexico’s public health expenditure fell 14.3% from the same period in 2024, the lowest first-quarter level since 2010, according to the Ministry of Finance and Public Credit. Experts caution that sustained underinvestment could undermine health outcomes and limit the country’s ability to respond to future crises. WHO notes that reduced government spending on health often signals that essential services, including nutrition and emergency aid, are not treated as a priority.

The combined pressures of declining international aid and domestic fiscal constraints underscore the need for strategic health financing. WHO’s guidance aims to assist countries in navigating these challenges, strengthening primary health care, and ensuring that essential services remain accessible to the most vulnerable populations.