Net official development assistance (ODA) by member countries of the Development Assistance Committee (DAC) is projected to fall again by 6.9% in 2026, driven by cuts by major donors. The health sector is seeing the deepest cuts, falling to its lowest levels in almost two decades. As the world grapples with more frequent and widespread health crises, this decrease in aid for health threatens to have broad implications for the world at large.
Bilateral ODA for health is projected to decline again, falling to its lowest levels in almost two decades
DAC countries’ net bilateral ODA for health and population services (hereafter “health”) in 2024 was the third-largest sector by volume (USD 17.6 billion) after humanitarian aid and aid for government and civil society.
ODA for health is projected to decline by 29-46% from 2024 to 2026, equivalent to a reduction of USD 5-8 billion. Not only is this 63% below the 2022 COVID-19 peak, but it reverts to levels not seen since 2008. This decrease is expected to continue beyond 2026, as major providers continue to implement multi-year cuts that are planned until at least 2028.
Contributions to multilateral organisations, which are key actors in the global health architecture, are projected to decline further by 3.4% in 2026. This is the third consecutive year of decreases and the second-longest downturn in the history of multilateral ODA.
Cuts are concentrated in the regions that rely the most on aid for health
Countries in Sub-Saharan Africa, including Malawi, South Sudan, Mozambique, Lesotho and Uganda, rely heavily on external financing to support their health systems. With prominent donors, particularly from the G7, projected to drastically cut ODA, these countries have limited fiscal space to absorb these cuts, with potentially drastic impacts on public health as a result.
Reproductive health and infectious disease control hardest hit by cuts
Within the health sector, population and reproductive health, including HIV/AIDS and other sexually transmitted disease control, faces the largest cuts in terms of volume. The cuts are over ten times higher than the next most-impacted sector (general health). These cuts are likely to have a disproportionate impact on women.
Funding for the control of communicable diseases, including malaria and tuberculosis, face the largest percentage decrease in funding (60% and 57% respectively). With outbreaks of infectious diseases becoming more frequent and widespread, these dramatic decreases raise doubts as to recipient countries’ ability to respond to future health crises.
Reduced health aid also reduces global health security
Funding pandemic preparedness, prevention and response (PPR) is essential to respond to disease outbreaks and minimise disruptions to essential health services during outbreaks. Spending on PPR was more than 30 times lower per capita in low-income countries (LICs), where the highest risks occur, than in advanced economies. Almost 80% of PPR financing for LICs comes from external sources, including ODA.
The risk is most acute where outbreaks frequently occur. In the Democratic Republic of the Congo and Uganda, which are facing an active Ebola outbreak, health aid is projected to fall by 46.6% and 53.5% respectively. As recent outbreaks show, the global health system is only as strong as its weakest link. This drastic reduction in health aid should therefore raise considerable concerns for the state of the global health system as a whole.
