Commissioned by the Trust, Accountability, and Inclusion Collaborative – Funders for Participatory Governance (TAI), this brief examines the growing crisis in global health financing and its connection to sovereign debt. Produced under the Fund Fiscal project, it aims to mobilize donor interest in equitable, accountable, and effective fiscal policies that expand fiscal space and strengthen public systems.
Progress toward Sustainable Development Goal 3 is stalling as low- and middle-income countries face shrinking health budgets, rising debt servicing costs, and limited fiscal space. In 2023 alone, countries in the Global South paid a record $1.4 trillion in debt repayments, with many now spending more on debt service than on new development financing. Without addressing the structural debt pressures constraining public investment, efforts to achieve universal health coverage and pandemic preparedness risk falling further out of reach.
The brief outlines why debt reform and fiscal justice are central to safeguarding health systems and advancing equitable development.
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