NOTE: Germany has reported only semi-aggregated data for part of the BMZ data for this release (approximately EUR4 billion), due to an internal transition of their IT systems. Granular data on recipients, sectors, and policy markers were not available for submission to the OECD at the time of publication. Therefore, any data including Germany is preliminary.

How is ODA to global health evolving?

ODA to the health sector from 2020-2024 experienced significant volatility. Total ODA peaked at US$37 billion in 2021, driven by exceptional pandemic-related assistance. The 2021 surge reflected an 8% increase from 2020, primarily due to bilateral grants for COVID-19 vaccine donations and health system assistance. However, most of the increased funding was reallocated from other development priorities rather than constituting truly additional resources.

Following the 2021 peak, global health ODA declined sharply to US$25 billion in 2023—a 36% decrease. Bilateral ODA fell from US$16 billion in 2021 to US$12 billion in 2023, while core multilateral contributions dropped from US$10 billion to US$3 billion during the same period. 2024 figures show a modest recovery to US$27 billion, though funding remains below pandemic-era levels.

Who are the top donors to global health?

The US dominated global health ODA in absolute terms, contributing US$15 billion, nearly seven times more than the UK, the second-largest donor at US$2.2 billion. While the US provided the largest absolute amount, it also prioritized global health more than other major donors, allocating 23% of its total ODA to the sector, followed by Luxembourg at 14% and the UK and Australia at 13%.

What are the key debates and topics surrounding global health?

Reform of the global health architecture: Reductions in ODA and shortfalls in replenishments of key global health institutions (GHI) including Gavi (US$9 billion) and the Global Fund (US$11.4 billion, against an US$18 billion ask) have accelerated long-overdue reform debates on global health architecture. There is now, broad consensus that greater country ownership including domestic resource mobilisation is fundamental to sustainable health systems that delivers quality care. GHIs and regional bodies have a key and catalytic role in helping countries deliver on this commitment- coordinating cross-border solutions to transnational challenges while deliberately building the capacities and structures that underpin genuine national ownership. Proposals such as the Accra Reset are gaining traction precisely because they are oriented towards what countries and regions actually need.

Climate and health: From advocacy to implementation: The climate and health nexus has shifted from a niche advocacy issue to a central pillar of global health diplomacy. Mean annual temperatures exceeded 1.5°C above pre-industrial levels for the first time in 2024, and the Lancet Countdown 2025 confirms that climate change is increasingly claiming lives and overwhelming health systems- particularly in the most vulnerable LMICs. At COP30, many countries integrated health into their Nationally Determined Contributions, signalling growing political recognition. The debate has shifted from whether to invest in climate-resilient health systems to how to finance and implement such investments at scale. With traditional health ODA shrinking, unlocking climate finance as a complementary pathway to fund health system resilience has become a critical priority.

Digital innovation and AI: Promise, governance, and equity: AI and digital health have emerged as the defining frontier debate in global health. AI diagnostics, large language models, and data-driven tools hold genuine promise for addressing health workforce shortfalls in resource-constrained settings. However, significant governance questions persist: how to ensure AI is developed with low-income countries, and how to protect data sovereignty and avoid replicating existing power asymmetries through technology. In an era of shrinking ODA, AI’s potential to increase efficiency can only be realised if the underlying health system foundations are in place.

Pandemic Preparedness: From commitment to implementation: The COVID-19 pandemic underscored the critical need for robust systems to detect, prevent, and respond to global health threats. The 2025 adoption of the WHO Pandemic Agreement, the first legally binding international instrument on pandemic preparedness, marked a significant milestone with critical implementation debates ongoing in a context of weakened multilateral engagement, including around pathogen sharing, equitable access to medical countermeasures, and enforcement. Pandemic preparedness requires sustained investment in public health infrastructure, research, and workforce development if the agreement's ambitions are to translate into genuine resilience.