Sustainability, transition from external financing and health system strengthening technical working group

All countries face several critical pressures on their health systems. Some of these are particularly salient for countries that are currently or will soon be ‘transitioning’ to much lower levels of external financial support.

A common guiding principle is to maintain or even increase effective coverage for priority health services, including those currently supported with external funds.  

This does however not mean simply channelling government revenues to pay for a previously donor-funded programme. Rather, transition provides an opportunity for countries to assess how governance, financing and service delivery are configured to ensure the sustainability of effective coverage for priority interventions.  

Hence, health system strengthening (HSS) is at the core of the response to transition if progress towards UHC is to be sustained.  It also emphasizes the importance of sustainability in the transition process, which should also extend to those countries that are not imminently facing declines in donor assistance.

The UHC2030 working group on sustainability and transition from external funding works towards building a consensus on the sustainability objective in relation to transition from external funding – to mean - sustained or increased effective coverage of quality priority interventions and outcomes for UHC and develop a collaborative agenda taken forward by different actors in support of this.

Download: Terms of reference

The membership of the group brings together country representatives, WB/WHO health system and disease experts, bilateral partners, global health initiatives, GFF, OECD, BMGF, academia think tanks and civil society. Country interest and participation in the group has been strong, with 15 countries actively engaging in the group, either through direct participation or country consultation.

The working group has held three face-to-face meetings – see below links for final reports and other documentation. The working group has developed a mapping of policies, definitions and ongoing work by working group members related to transition from aid. A country consultation paper on sustainability and transition has also been commissioned and a data set on key indicators on UHC context and transition timelines in all low income and middle income countries. The WG has also developed a paper on perspectives from health programs on sustainability and transition.

In 2018 the working group developed the UHC2030 statement on sustainability and transition from external funding. Statement was presented to the UHC2030 Steering Committee in June 2018 and launched following a wide consultation process. The statement serves as a basis for advocacy, political influencing- informing transition related coordination processes both at national and global levels.  The statement includes ten recommendations/principles directed at governments of countries experiencing transition from external funding and the broad range of development partners working in these contexts.

Read: Launch of the Statement on sustainability and transition from external financing

Participant list

For further information please contact: 

Maria Skarphedinsdottir, WHO and UHC2030 Core Team: skarphedinsdottirm@who.int