Aligning Financing Mechanisms for Health with Nationally-Determined Priorities

Decades of depending on external financing for health at national, regional, and global levels have skewed what gets funded, how, and by whom. The current financing architecture distorts health agendas at all levels, reinforces dependency over partnership, and weakens countries' voices in designing the mechanisms that finance their health systems.

To align financing mechanisms for health across national, regional, and global levels, reforms should be based on subsidiarity, not substitution. Health priorities must be nationally determined through robust, inclusive, and accountable decision-making processes. They should be financed by maximizing the resources that can be readily and sustainably mobilized domestically. When (or if) additional financial resources are required and requested by countries, external financing mechanisms should be designed to provide support in a manner that aligns with those nationally determined priorities and available resources.