WHO issues guidelines to address drastic global health funding cuts

The World Health Organization (WHO) today published new guidance for countries on how to counter the immediate and long-term effects of sudden and severe cuts in external funding, which are disrupting the provision of basic health services in many countries.

The new guidelines, entitled “Responding to the health financing emergency: urgent measures and long-term developments”, provide a range of policy options for countries to deal with sudden financial shocks and to strengthen efforts to mobilize and implement sufficient and sustainable financing for national health systems.

External health aid is projected to decline by 30% to 40% in 2025 compared to 2023, causing immediate and severe disruption to health services in low- and middle-income countries (LMICs). WHO survey data from 108 LMICs collected in March 2025 shows that funding cuts have reduced key services – including maternal care, immunization, health emergency preparedness and response, and disease surveillance – by up to 70% in some countries. More than 50 countries have reported job losses among health and care workers, along with major disruptions in health worker training programs.

“Sudden and unplanned aid cuts have hit many countries hard, costing lives and jeopardizing hard-won health gains,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But in the crisis lies an opportunity for countries to move away from aid dependence towards sustainable self-reliance, based on domestic resources. The new WHO guidelines will help countries better mobilize, allocate, prioritize and use resources to support the provision of health services that protect the most vulnerable.”

This year's funding cuts exacerbated years of persistent health financing challenges for countries, including mounting debt burdens, inflation, economic insecurity, high out-of-pocket spending, systemic underfunding from the budget and heavy reliance on foreign aid.

Fast action driven by efficiency and fairness

New WHO guidelines call on policymakers to make health a political and fiscal priority in national budgets even during periods of crisis, viewing health spending not just as an expense to be contained, but as an investment in social stability, human dignity and economic resilience.

The guidelines highlight the need for countries to mitigate the current impact of cuts in foreign aid to health and to adapt to a new era of reduced aid. Key policy recommendations include:

• give priority to health services accessed by the poorest;
• protect health budgets and basic health services;
• improve efficiency through better procurement, reduced overhead and strategic purchasing;
• integrate externally funded or disease-specific services into comprehensive PHC 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 solidarity are key

Several countries have already taken decisive steps to strengthen their health systems and protect basic health services:

• Kenya, Nigeria and South Africa have allocated additional budgetary resources for health or are awaiting parliamentary approval for an increase;
• Nigeria increased its health budget by US$200 million to make up for the aid shortfall, with increased allocations for immunization, epidemic response and priority programmes;
• Ghana lifted the cap on excise duties for its national health insurance agency, resulting in a 60% budget increase. The country also launched the “Accra Reset”, a bold framework for reimagining global health and development governance, financing and partnerships; and
• Uganda has outlined a clear policy agenda for the integration of health services and programmes, with the aim of improving efficiency and sustaining service delivery.