Health financing priorities are moving from commitments towards implementation as fiscal pressures intensify and concerns persist over whether existing pledges are improving health systems and access to care. More than 130 participants joined a global dialogue convened by the WHO Civil Society Commission and Save the Children on 15 April 2026, ahead of the Seventy-ninth World Health Assembly. The discussion focused on translating civil society priorities into action and influencing health financing decisions. Attention now extends beyond the Assembly towards implementation, stronger accountability, more effective use of existing resources, greater investment in primary health care and continued engagement ahead of the 2027 High-Level Meeting on Universal Health Coverage.
Turning Financing Commitments into Delivery
The central challenge is no longer identifying health financing priorities, but ensuring that existing commitments are implemented. Improving financing requires both additional resources and more effective use of the money already available. Three routes can expand fiscal space for health: increasing overall tax revenues, assigning a greater share of national budgets to health and improving expenditure management and efficiency. Together, these measures address public revenue, the share allocated to health and the effectiveness of expenditure.
Budget prioritisation is a political decision that depends on domestic leadership. However, additional allocations alone do not guarantee that funding reaches services or supports health priorities. Weak budget execution, fragmented funding and poor alignment between budgets and health needs continue to reduce the impact of spending. Greater attention to primary health care can direct resources towards more cost-effective services.
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Debt pressures create a further constraint. In many low- and middle-income countries, debt repayments now exceed government spending on health, limiting the fiscal space available for domestic health financing. These conditions strengthen the focus on combining revenue mobilisation with reprioritisation and better management of available resources. The issue therefore extends beyond how much money is raised to how reliably budgets are executed, how funding streams are coordinated and whether expenditure supports agreed health priorities.
Accountability Links Funding to Results
Participants identified accountability as central to converting financing commitments into outcomes. Concerns centred not only on the level of funding, but also on how resources are allocated, managed and spent. Financing decisions should reflect human rights and equity so that access to health is not restricted through selective choices about who receives care.
Transparency is necessary for effective oversight. Civil society organisations need clear information on where money originates and how it is used if they are to scrutinise financing decisions. Public access to financing data therefore forms part of calls for stronger accountability mechanisms and closer tracking of allocations, execution and expenditure.
Weak public financial management and fragmented financing can prevent resources from reaching frontline services. Better spending is therefore a parallel priority to increased financing. This includes clearer links between budgets and health priorities, stronger execution and improved coordination across funding arrangements.
Participants also called for more inclusive governance, including meaningful involvement of young people. Young people remain largely absent from national budget processes despite their roles as contributors, innovators, taxpayers, caregivers and future leaders. Their exclusion affects representation, effectiveness, equity and long-term sustainability. Greater community involvement in decision-making can make spending more responsive, transparent and efficient, while investment in youth health was identified during the dialogue as a high-return priority.
Priorities Set Direction for Further Action
The dialogue established immediate and medium-term priorities centred on delivery and accountability. The emphasis shifted from seeking increased resources alone towards ensuring that funds are allocated, executed and tracked effectively. A survey was shared with members of the WHO Civil Society Commission to gather feedback and align proposed recommendations with country and community realities.
Member States were urged to protect essential health services and invest an additional 1% of gross domestic product in primary health care. They were also asked to establish clear domestic spending targets and improve efficiency. Priorities directed towards the World Health Organization included institutionalising civil society participation and strengthening data transparency and accountability mechanisms.
These proposals informed consolidated recommendations ahead of the Seventy-ninth World Health Assembly. Continued engagement with civil society organisations through the WHO Civil Society Commission further refined the priorities before recommendations were presented to WHO leadership and Member States.
Participants expressed broad support for stronger domestic health financing, improved efficiency and accountability and formal participation by civil society. Financing decisions were also linked with equity and universal health coverage. Attention now extends towards the 2027 High-Level Meeting on Universal Health Coverage, where progress on health financing commitments is expected to be monitored and reviewed. Maintaining momentum and implementing the priorities identified through the consultation therefore remain central to the next phase.
Health financing priorities now centre on converting commitments into visible improvements through stronger domestic funding, efficient expenditure and transparent accountability. The proposed measures combine additional investment in primary health care with clearer spending targets, better budget execution and closer tracking of how resources are used. Civil society and youth participation form part of the governance approach alongside efforts to protect essential services and advance equity and universal health coverage. Following the Seventy-ninth World Health Assembly, attention is shifting towards implementation and the review of health financing commitments at the 2027 High-Level Meeting on Universal Health Coverage.
Source: World Health Organization
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