As global health financing pressures intensify, the focus is shifting from commitments to delivery. There is growing concern that existing pledges are not translating into tangible improvements in health systems. Civil society organizations are calling for concrete action to ensure financing results in stronger systems and better access to care.
On 15 April 2026, more than 130 participants joined the second global dialogue convened by the WHO Civil Society Commission and Save the Children to advance priorities in the lead-up to the Seventy-ninth World Health Assembly.
Ravi Ram, Co-Chair of the WHO Civil Society Commission, emphasized that the dialogue series focuses on ensuring that civil society perspectives translate into implementation, with a clear objective of influencing decisions at the Health Assembly.
Turning commitments into action
The dialogue underscored that the key challenge is no longer defining priorities but ensuring commitments are delivered in practice.
Opening the technical framing, Hélène Barroy, Senior Public Finance Expert at the World Health Organization, highlighted that improving health financing is not only about mobilizing additional resources, but also about using existing resources more effectively. As she explained, “Fiscal space is not only about introducing new taxes or raising new revenues, but also about using existing resources in the best way.”
Hélène highlighted three main ways to expand fiscal space for health: increasing overall tax revenues, reprioritizing national budgets to allocate a greater share to health, and enhancing expenditure management and efficiency.”
On budget prioritization, she emphasized that this is fundamentally a political decision, noting, “Fiscal space for health is also a political choice. Domestic leadership really matters.”
At the same time, she highlighted that inefficiencies within health spending continue to limit impact, including weak budget execution, fragmented funding, and misalignment between budgets and health priorities. Prioritizing primary health care, she noted, can help shift resources toward more cost-effective services.
At the same time, the debt crisis is placing increasing pressure on countries’ fiscal space. In many low- and middle-income countries, debt repayments now exceed government health spending, creating a structural constraint on domestic health financing.
Bridging the gap between funding and results
Participants emphasized that accountability is essential to ensure that commitments translate into real outcomes.
Country and civil society perspectives highlighted that the challenge is not only the level of financing, but inefficiencies in how resources are allocated and spent.
Labila Sumayah Musoke, Board Member at Medicus Mundi International and the Initiative for Social and Economic Rights, Uganda, said that financing decisions must be grounded in human rights and equity, warning, “Health is not a privilege. We cannot choose who accesses health and who does not access health.”
Musoke also stressed the importance of transparency, noting, “We cannot really hold governments accountable if we do not know where the money is coming from and how it is being used.”
Hendry Peter Samky, Health Financing Expert at the Benjamin William Mkapa Foundation, said that the issue is not only how much is spent, but how well it is used, stressing, “It is not only about increasing financing, but about spending it better.” He noted that weak public financial management and fragmented financing often prevent resources from reaching frontline services
Elevating youth in health financing
Participants also highlighted the importance of inclusive governance, including meaningful youth engagement.
Balkiss Abdelmoula, Member of the WHO Youth Council and Junior Doctors Network, said that youth remain largely excluded from financing decisions, noting, “Young people… remain largely absent from national budget processes… This is not only a gap in representation, but also a challenge to effectiveness, equity and long-term sustainability.”
She stressed that youth are already active contributors: “Youth are not just beneficiaries of health systems. They are contributors, innovators, taxpayers, caregivers and future leaders.” She called for a “move from tokenism to transformation when it comes to youth engagement.”
Abdelmoula added that inclusive decision-making improves outcomes, noting, “When communities are involved in decision making, spending becomes more responsive, transparent and efficient.” She emphasized that “investing in youth health is one of the highest return investments a country can make.”
Clear priorities for action
The dialogue converged on clear priorities to guide immediate and medium-term action. These reflect a shift from advocating for increased resources to ensuring accountability for how resources are allocated, executed and tracked. A survey was also shared with Civil Society Commission members gathering feedback to ensure that proposed recommendations reflect country and community realities.
For Member States:
- protect essential health services and invest an additional 1% of GDP in primary health care
- establish clear domestic spending targets and improve efficiency.
For WHO:
- institutionalize civil society participation
- strengthen data transparency and accountability mechanisms.
These priorities informed consolidated recommendations ahead of the World Health Assembly.
From dialogue to decision at the Seventy-ninth World Health Assembly
The dialogue marked a clear shift from discussion to action.
The priorities identified through the consultation process were further refined through continued engagement with civil society organizations via the WHO Civil Society Commission and informed recommendations presented to WHO leadership and Member States in the lead-up to the Seventy-ninth World Health Assembly.
The dialogue reinforced broad support for strengthening domestic health financing, improving efficiency and accountability, institutionalizing civil society participation, and ensuring that health financing decisions advance equity and universal health coverage. It also underscored the importance of maintaining momentum beyond the Health Assembly and building toward the 2027 High-Level Meeting on Universal Health Coverage, where progress on health financing commitments is expected to be monitored and reviewed.