Unhealthy finances: the global health funding crisis and its human cost

Global health financing has long been dominated by donor-led, disease-specific programmes that, while saving lives, have also fragmented public health responses, reinforced unequal power relations, and undermined the sustainability of national health systems.

In recent years, structural failings have been compounded by Covid-19-era debt burdens and the diversion of health budgets as well as by the dramatic contraction of global health funding in 2025. 

The shrinking of donor commitments and the shifting of burdens onto already-stretched domestic budgets is forcing a reckoning with the model itself - with profound consequences for the populations that depend on these systems. Who should pay for health in low- and middle-income countries, how, and on whose terms? 

This DLD Conversation brings together perspectives from history, health policy research, and humanitarian practice to examine the consequences of the current financing crisis for public health and development in the Global South, and to explore what more equitable and sustainable alternatives might produce better health outcomes and broader economic gains. 

Speakers: 

• Toby Green is Professor of Precolonial and Lusophone African History and Culture at King's College London and a Fellow of the British Academy. A historian of Africa and global inequality, he is a prominent commentator on the Covid-19 pandemic and its unequal impact across the majority world. His 2023 book The Covid Consensus offers a critical examination of the pandemic response and its consequences, including the impact of post-pandemic austerity and donor retreat on health systems across Africa. He has presented The Covid Consensus at parliament, presented at a side-panel on pandemic poverty at the 2023 UN High Level Political Meeting, and organised a conference on Africa's experience of the Covid-19 pandemic response at the Royal United Services Institute.
• Kara Hanson is Professor of Health System Economics at the London School of Hygiene and Tropical Medicine. Her research focuses on health financing and the private health sector in low- and middle-income countries. She chaired the Lancet Global Health Commission on Financing Primary Health Care and has published widely on strategic purchasing and health system performance, and the role of the private sector in healthcare market regulation. Professor Hanson frequently advises national governments and international organisations on health systems and financing. She is Past President of the International Health Economics Association and Director of the NIHR Global Health Research Programme.
• Tess Hewitt is a Health Policy Advisor and Global Fund Focal Point for Médecins Sans Frontières (MSF). Previously she worked with MSF projects in Latin America and South Sudan, focusing on HIV, TB, malaria, climate change, victims of sexual violence and displaced populations. She holds a MSc in Public Health and a MSc in International Public Policy. Tess previously worked with various organisations including the Commission for Environmental Cooperation, UNICEF, the Overseas Development Institute, the UK Foreign Office, and the Department for Health and Social Care.

Please note that this event is in-person only at the Brunei Gallery Lecture Theatre, SOAS. A recording of the event will later be published on SOAS DLD's YouTube channel.

Header image credit: Marcelo Leal via Unsplash.