Global Leaders Network convenes to address health financing crisis

Official development assistance fell to USD 174.3 billion in 2025, marking a 23.1 percent drop from 2024 and the largest annual decline in global health financing on record, according to data presented at the United Nations. Co-hosted by the Governments of South Africa, Spain, and Tanzania alongside the Partnership for Maternal, Newborn, and Child Health, the Global Leaders Network for Women’s, Children’s and Adolescent Health convened on September 22, 2026, to address the crisis. High debt-servicing costs and a record USD 8.9 trillion in external debt across low- and middle-income countries have severely constrained public budgets, threatening decades of health gains for women, children, and adolescents.

Record Debt and Declining Aid Threaten Health Budgets

The convergence of falling international assistance and soaring external debt has severely restricted the capacity of governments in low- and middle-income countries to fund essential public health services. In 2023, an estimated 260,000 women died from preventable causes linked to pregnancy and childbirth. The following year, approximately 4.9 million children under the age of five died from preventable conditions that could be averted with basic healthcare access and low-cost interventions.

Global Leaders Network members emphasized that the crisis cannot be resolved solely through replacement aid. Instead, governments must prioritize the protection, allocation, and efficient use of domestic resources for women’s, children’s, and adolescent health.

We know that issues of women, children, adolescent health and well-being can’t be solved by ministers of health alone. They need head of state support, they need minister of finance support, and there are always political choices to be made about what we protect when the resources are scarce.

Helen Clark, Chair of the Board of Partners for the Partnership for Maternal, Newborn and Child Health

Calls for Primary Healthcare Protection in 2027 Budgets

During the high-level session, international agency representatives urged national governments to safeguard primary healthcare foundations, including midwives, community health workers, vaccines, nutrition services, and clinics, when drafting their 2027 budgets.

A policy without a budget is a press release. A commitment without financing is a promise already broken.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

Helga Fogstad, Director of the UNICEF Health Programme, called on leaders to direct domestic resources toward interventions with the highest impact, ensuring reliable supplies of essential medicines and adequate compensation for frontline healthcare workers. Diene Keita, Executive Director of the United Nations Population Fund, added that investments in maternal care and family planning yield strong economic and social returns.

Nigeria Model Demonstrates Domestic Financing Impact

Session participants examined country-level strategies that successfully translate health commitments into practice. Under its Health Sector Renewal Investment Initiative, Nigeria has transitioned away from fragmented donor-led programs in favor of unified country ownership and enhanced resource alignment.

Nigeria has committed nearly $3 billion in domestic health financing over a five-year period, supplementing $2 billion in support from the United States. This domestic investment has facilitated the revitalization of more than 4,000 primary health centers and the retraining of 80,000 frontline health workers. Consequently, the country recorded a 34 percent increase in deliveries attended by skilled birth attendants and a 22 percent reduction in maternal mortality among women utilizing those facilities.

The discussions highlighted an ongoing tension between the push for greater national ownership of health systems and the persistent requirement for international solidarity to protect vulnerable populations.