WHO issues guidance to address drastic global health financing cuts

世卫组织发布指南应对全球卫生筹资大幅削减

The World Health Organization (WHO) today released new guidance for countries on ways to counter the immediate and long-term effects of sudden and severe cuts to external funding, which are disrupting the delivery of essential health services in many countries.

世界卫生组织（世卫组织）今天为各国发布了新的指南，指导如何应对外部资金突然严重削减的直接和长期影响，这些资金正在扰乱许多国家基本卫生服务的提供。

The new guidance, called “Responding to the health financing emergency: immediate measures and longer-term shifts”, provides a suite of policy options for countries to cope with the sudden financing shocks, and bolster efforts to mobilize and implement sufficient and sustainable financing for national health systems.

新指南名为“应对卫生筹资紧急情况：即时措施和长期转变”，为各国应对突如其来的筹资冲击提供了一套政策选择，并加强了为国家卫生系统调动和实施充足和可持续筹资的努力。

External health aid is projected to drop by 30% to 40% in 2025 compared with 2023, causing immediate and severe disruption to health services in low- and middle-income countries (LMICs). WHO survey data from 108 LMICs collected in March 2025 indicate that funding cuts have reduced critical services – including maternal care, vaccination, health emergency preparedness and response, and disease surveillance – by up to 70% in some countries. More than 50 countries have reported job losses among health and care workers, along with major disruptions to health worker training programmes.

预计2025年外部卫生援助将比2023年下降30%至40%，导致中低收入国家的卫生服务立即受到严重干扰。世卫组织2025年3月收集的108个低收入国家的调查数据表明，在一些国家，资金削减使关键服务——包括孕产妇护理、疫苗接种、卫生应急准备和应对以及疾病监测——减少了高达70%。50多个国家报告了卫生和护理人员的失业，以及卫生人员培训方案的严重中断。

“Sudden and unplanned cuts to aid have hit many countries hard, costing lives and jeopardizing hard-won health gains,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “But in the crisis lies an opportunity for countries to transition away from aid dependency towards sustainable self-reliance, based on domestic resources. WHO’s new guidance will help countries to better mobilize, allocate, prioritize and use funds to support the delivery of health services that protect the most vulnerable.”

世卫组织总干事谭德赛博士表示：“突然和计划外的援助削减对许多国家造成了沉重打击，造成了生命损失，并危及来之不易的健康成果。”“但危机中蕴藏着各国从援助依赖过渡到基于国内资源的可持续自力更生的机会。世卫组织的新指南将帮助各国更好地动员、分配、优先排序和使用资金，以支持提供保护最弱势群体的卫生服务。”

This year’s funding cuts have compounded years of persistent health financing challenges for countries, including rising debt burdens, inflation, economic uncertainty, high out-of-pocket spending, systemic budget underfunding and heavy reliance on external aid.

今年的资金削减加剧了各国多年来持续存在的卫生筹资挑战，包括债务负担上升、通货膨胀、经济不确定性、高额自付费用、系统性预算资金不足和严重依赖外部援助。

WHO’s new guidance urges policy-makers to make health a political and fiscal priority in government budgets even during times of crisis, seeing health spending as not merely a cost to be contained, but an investment in social stability, human dignity, and economic resilience.

世卫组织的新指南敦促政策制定者即使在危机时期也要将卫生作为政府预算中的政治和财政优先事项，认为卫生支出不仅仅是需要控制的成本，而是对社会稳定、人类尊严和经济弹性的投资。

The guidance emphasizes the need for countries to cushion the immediate impact of reductions in foreign assistance for health, and to adapt to a new era of reduced assistance. Key policy recommendations include:

该指南强调，各国需要缓冲外国卫生援助减少的直接影响，并适应援助减少的新时代。主要政策建议包括：

prioritize the health services accessed by the poorest;

优先考虑最贫困人口获得的卫生服务；

protect health budgets and essential health services;

保护卫生预算和基本卫生服务；

improve efficiency through better procurement, reduced overheads and strategic purchasing;

通过更好的采购、减少管理费用和战略采购来提高效率；

integrate externally-funded or disease-specific services into comprehensive PHC-based delivery models; and

将外部资助或针对特定疾病的服务整合到基于PHC的综合交付模式中；和

use health technology assessments to prioritize services and products that have the greatest health impact per dollar spent.

使用卫生技术评估来优先考虑每一美元支出对健康影响最大的服务和产品。

Several countries have already taken decisive action to strengthen their health systems and protect essential health services:

一些国家已经采取果断行动，加强其卫生系统和保护基本卫生服务：

Kenya, Nigeria and South Africa have allocated additional budget funds to health, or are awaiting parliamentary approval for increases;

肯尼亚、尼日利亚和南非已经向卫生部门分配了额外的预算资金，或者正在等待议会批准增加资金；

Nigeria increased its health budget by US$ 200 million to offset aid shortfalls, with increased allocations for immunization, epidemic response, and priority programmes;

尼日利亚增加了2亿美元的卫生预算，以弥补援助缺口，增加了对免疫、流行病应对和优先方案的拨款；

Ghana lifted the cap on excise tax earmarked for its national health insurance agency, resulting in a 60% budget increase. The country also launched “the Accra Reset”, a bold framework to reimagine global governance, financing and partnerships in health and development; and

加纳取消了指定用于其国家健康保险机构的消费税上限，导致预算增加60%。该国还启动了“阿克拉重置”，这是一个大胆的框架，旨在重新构想卫生和发展领域的全球治理、融资和伙伴关系；和

Uganda has outlined a clear policy agenda for integration of health services and programmes, aiming to improve efficiency and sustain service delivery.

乌干达概述了整合卫生服务和方案的明确政策议程，旨在提高效率和持续提供服务。