Financing Global Health 2025, Q&A with Dr. Angela Apeagyei

In 2021, total development assistance for health (DAH) reached a record $80 billion due to the COVID-19 pandemic, when the world was unified in pouring resources into health systems to protect all populations.

Since then, DAH has steadily declined: it plummeted by 51% from the 2021 peak to $39 billion in 2025, marking the lowest in 15 years. If current policies remain unchanged, total DAH is forecasted to decline by another 8% to $36 billion by 2030.

Lead author Dr. Angela Apeagyei, Assistant Professor at IHME, presents FGH 2025 findings in this Q&A video.

Video transcript

This transcript has been lightly edited for clarity

What is the relevance of IHME's Financing Global Health Report in the current global health funding context?

What IHME’s Financing Global Health report brings to our understanding of development assistance for health that is unique is its comprehensiveness. We bring in data on bilaterals, private philanthropies, and NGOs, and a number of other efforts that track development assistance for health do not cover all these different aspects, so that’s very unique. For this year, especially given the recent aid cuts, IHME has leveraged its ability to pull data from all sources, and also leverage contacts at key global health institutions, to generate estimates that incorporate the most up-to-date information regarding the announced cuts and their impact on the aid that will be available, in order to produce timely and relevant development assistance for health estimates for policymakers and other relevant stakeholders.

How do you produce the estimate for the Financing Global Health report?

Our production process for the Financing Global Health reports annually involves two main pipelines: one pipeline that essentially generates development assistance for health estimates for each of 17 international development agencies we cover, and the second pipeline that reconciles these estimates to ensure that we have accounted for any multiple transfers across agencies. This year, in particular, we have developed estimates for 2025, which is the current year, and this is not something we have typically done in the past.

To get the estimates for 2025, we gathered all media reports of aid cuts, preliminary budgets, and allocation announcements from foreign assistance donors, where those were available. And we applied these announced cuts, as appropriate, to 2024 estimates and beyond.

What are the key findings of the Financing Global Health report?

There are three main findings from the report. One, development assistance for health (DAH) is dropping further in 2025. DAH peaked at around US$80 billion in 2021 and fell to about $50 billion in 2024. In 2025, based on announced budget cuts to bilateral aid, we are expecting aid to decrease further to global DAH of about $39.1 billion.

And that’s 21% less than the development assistance for health that was provided in 2024. And this is levels that are a comparison to what was last seen in 2009. Two, multilateral development banks’ – such as the World Bank’s – role as a disbursement entity for aid will increase in importance. This is partly because the current aid cuts have not impacted them, or don’t seem to have impacted them as much, at least for the ones that have been announced.

And so our analysis is showing that the multilateral banks will have an increased share in the total DAH disbursed. Lastly, near-time forecasts for DAH suggest that stagnation: We are not foreseeing, in the near term, any significant increase in DAH availability, and are forecasting DAH to reach about $36.5 billion in 2030.

Who will be the most affected by the cuts to the Development Assistance for Health?

Unfortunately, initial analysis suggests that low-income countries, that are typically most dependent on aid, will be most affected – due to various reasons, these same countries are those that are least likely able to independently fill the gap left through their own government resources.

What can be done to mitigate the predicted contraction of Global Development Assistance for Health?

I can think of three potential pathways. So, if the countries commit more of their own resources to their health sectors going forward, essentially increasing domestic resources for health. An increase in efficiency – so, countries endeavoring to do more with limited resources that will be currently available. Or, the last option will be to cut services, which may not be ideal but may become necessary in some instances.