World Bank-IMF Annual Meetings 2024: health financing gap impact access to health in African countries

Wemos and partners attended the World Bank and International Monetary Fund Annual Meetings, from 16-21 October 2024. As part of the Civil Society Policy Forum, we organized a session titled ‘How does health financing affect access to healthcare?’, featuring insights from case studies in Mozambique, Uganda, and Côte D’Ivoire. We also connected with World Bank staff and representatives from global and regional financial institutions. These engagements were important opportunities to strengthen partnerships and advocate for more inclusive and equitable health financing policies worldwide.

Session: ‘How does health financing affect access to healthcare?’

The question of how healthcare will be financed in the world is becoming more and more relevant. Currently, many low- and middle-income countries are struggling to allocate sufficient funds to healthcare. High debt servicing and fiscal consolidation measures are shrinking national healthcare budgets, pushing governments to increasingly rely on external funding and private investments. While the World Bank has committed to expanding access to health services for 1.5 billion people, and global health initiatives are conducting fundraising rounds (‘replenishments’), these efforts alone cannot fully address the growing funding gaps.

During our session, experts in health financing discussed these challenges and shared country experiences. Below are the key takeaways from their presentation:

• Moderator Matthew McConnel (Human Rights Watch) opened the session with the latest developments in healthcare financing worldwide. He highlighted that out-of-pocket spending has been on the rise since the beginning of Covid-19, alongside the government’s declining spending on healthcare. This trend disproportionally impacts people with low income, forcing many of them to skip essential services because they simply cannot afford them.
• Denis Bukenya (People’s Health Movement Uganda), shared insights on how privatization policies have undermined access to healthcare in Uganda, emphasizing the need for systemic reforms to address the root causes of underinvestment in public health.
• Camila Barretto (GI-ESCR), presented a report from Côte D’Ivoire, where underfunding for public health led to commercialization of health services, including the surge of illegal private health centres. The report highlighted how this practice has exacerbated inequalities and discrimination in access to healthcare.
• Andes Chivangue (N’weti), discussed findings from our joint project ‘Equitable health financing for a strong health system in Mozambique’. He highlighted that high levels of debt servicing take up an important percentage of the country’s budget, compromising resources for health. He presented options to increase Mozambique’s budget for health, such as predictable support from international donors.

World Bank officers from Mozambique and countries that work with the World Bank attended the session and showed interest in the topics discussed.

Connecting with key global stakeholders for better financing for health systems

Being at the Civil Society Policy Forum provided us with a valuable opportunity to engage with various global health stakeholders. Our participation facilitated meaningful in-person discussions on ways to strengthen health financing in Africa. It confirmed the added value of working in partnerships to have an impactful participation in global forums. Attendees expressed strong interest in our work around the fiscal space for health in Mozambique, particularly the solutions to increase funding for public healthcare.

Participants also expressed the need for more collaborative research and comparative studies on how health financing influences access to healthcare in various countries. It could give more insights into the root causes of financing gaps and help identify evidence-based solutions to strengthen the healthcare system and make sure everybody has access to it.

The event provided a valuable platform to exchange ideas, share insights and foster connections with key stakeholders. It reaffirmed the importance of dialogue between the World Bank Group and civil society to find equitable and sustainable solutions for global health challenges.

Watch our session’s recording here, on ‘Day 4: Oct 25’, video ‘How Does Health Financing Affect Access to Healthcare?’