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[Comment] Navigating health financing cliffs: a new era in global health
An era in global health, inaugurated in 2000 by the UN Millennium Declaration,1 has passed. This era saw large increases in domestic spending on health and official development assistance for health,2 the creation of new global health institutions, such as the Global Fund and Gavi, and impressive progress in child mortality and infectious disease epidemic control.3 The sudden passing of this era, triggered in early 2025 by rapid reductions in development assistance for health (by US, European, and other large external funders), has exacerbated existing pressures on domestic health spending (which decreased between 2021 and 2022 per capita across all countries for the first time since 20002) and led to dramatic health financing cliffs.
An era in global health, inaugurated in 2000 by the UN Millennium Declaration,1 has passed. This era saw large increases in domestic spending on health and official development assistance for health,2 the creation of new global health institutions, such as the Global Fund and Gavi, and impressive progress in child mortality and infectious disease epidemic control.3 The sudden passing of this era, triggered in early 2025 by rapid reductions in development assistance for health (by US, European, and other large external funders), has exacerbated existing pressures on domestic health spending (which decreased between 2021 and 2022 per capita across all countries for the first time since 20002) and led to dramatic health financing cliffs.
