By Hatice Beton, Roberto Durán-Fernández, Dennis Ostwald and Rifat Atun
LONDON, Jun 19 2025 – As G7 leaders of the world’s wealthiest nations wrapped up their summit in Kananaskis June 16, a critical issue was absent from the agenda: the future of global health financing.

Amid escalating geopolitical tensions, trade conflicts and cuts to development aid, health has been sidelined – less than five years since COVID-19 devastated lives, health systems and economies.

With the fiscal space for health shrinking in over 69 countries, it’s time to recognise that health financing is no longer solely a public sector concern; it is a fundamental pillar of economic productivity, stability, and resilience.

A glimmer of hope has emerged from South Africa, the current G20 Presidency host, and from the World Health Organization (WHO). A landmark health financing resolution, adopted at last month’s World Health Assembly calls on countries to take ownership of their health funding and increase domestic investment.

While this is a promising step, the prevailing discourse continues to rely on outdated solutions which are often slow to implement and fall short of what is needed.

Invest Smarter, Not Just More, in Health

Recent trends among G20 countries show that annual healthcare expenditure is actually declining across member states. In 2022, health expenditure dropped in 18 out of 20 G20 nations, leading to increased out-of-pocket expenses for citizens.

While countries like Japan, Australia, and Canada demonstrate a direct correlation between higher per capita health expenditure and increased life expectancy, others, such as Russia, India, and South Africa, show the opposite.

This disparity underscores a crucial point: the quality and efficiency of investment matters more than quantity. Smart investment encompasses efficient resource allocation, equitable access to affordable care, effective disease prevention and management, and broader determinants of health like lifestyle, education, and environmental factors.

Achieving positive outcomes hinges on balancing health funding – the operational costs – with sustainable health financing – the capital costs.

Private capital is already moving into health, what’s missing is coordination and strategic alignment

Despite the surge in healthcare private equity reaching USD 480 billion between 2020 and 2024, many in the sector remain unaware of this significant shift. Recent G20 efforts have focused on innovative financing tools, but what’s truly needed are systemic reforms that reframe health as a core pillar of financial stability, economic resilience, and geopolitical security, not just a public service.

This year’s annual Health20 Summit at the WHO, supporting the G20 Health and Finance Ministers Meetings, addresses this need by launching a new compass for health financing: a groundbreaking report on the “Health Taxonomy – A Common Investment Toolkit to Scale Up Future Investments in Health.”

Why do we need an investment map for health?

The answer is simple: since the first ever G20 global health discussions under Germany’s G20 Presidency in 2017, there has been no consistent effort to rethink or coordinate investments. G20 countries still lack a strategic dialogue between governments, health and finance ministries, investors and the private sector.

Market-Driven, Government-Incentivised: The Path Forward

Building on the European Union’s Green Taxonomy, the health taxonomy aims to foster a shared understanding and common language among governments, companies, and investors to drive sustainable health financing. Investors, Asset Managers, Venture Capitalists, G20 Ministries of Health and Finance, Multilateral Development Banks (MDBs), and International Organisations broadly agree that a market-driven taxonomy is both credible and practical.

Governments can have greater confidence knowing it has been tested with investors and is grounded in market realities.

The Health Taxonomy report identifies a key barrier to progress: the fundamental confusion between health funding and health financing: Health financing refers to the system that manages health investments, such as raising revenue, pooling resources and purchasing services. In contrast, health funding refers to the actual sources of money.

Increasing health funding alone will not improve health outcomes if the financing system is poorly designed. Conversely, a well-developed health financing framework won’t succeed without sufficient funding. Both are essential and must work together.

The health taxonomy has the potential to serve as a vital tool for policy planning sessions, strategic boardroom discussions and investment committees, thereby enabling health to be readily integrated into existing portfolios and strategies. It could also support more systematic assessments of health-related risks and economic impacts, including through existing processes like the IMF’s Article IV consultations and other macroeconomic surveillance frameworks.

The report urges leading G20 health and finance ministers to rethink and align on joint principles for health funding and financing.

The next pandemic could be more severe, more persistent, and more costly. Failure to invest adequately in health before the next crisis is a systemic risk our leaders can no longer afford to ignore.

Hatice Beton is Co-Founder, H20Summit; Roberto Durán-Fernández; PhD, is Tec de Monterrey School of Government, Former Member of the WHO’s Economic Council; Dennis Ostwald is Founder & CEO, WifOR Institute (Germany); Rifat Atun is Professor of Global Health Systems, Harvard T.H. Chan School of Public Health

IPS UN Bureau

By Stephanie Hodge
UNITED NATIONS, Jun 19 2025 – Ten years ago, I lost more than a job.

When my post was abolished, there was no warning, no closure, no golden parachute—just a quiet erasure. Overnight, I went from a UN professional with decades of service to an invisible statistic in a system that eats its own.

I wasn’t just de-linked from my role—I was cut off from my health insurance, my professional identity, my community, and the safety net I thought I’d built after a lifetime of service.

What’s the real cost of that? Let me try to count it.

The Financial Toll

Over ten years, I’ve conservatively lost between $1.7 and $2.4 million USD—not in stock options or startup fantasies, but in the very basic elements of working life:

• Salary: Gone. A UN professional with my experience (at the P5/D1 level) typically earns around $120,000–$150,000 a year. That’s over $1.2 million in wages lost—and that’s before accounting for inflation.
• Pension: For every year you’re out of the UN system, your pension erodes. I’ve lost another $300,000+ in employer and personal contributions to retirement.
• Health Insurance: When you lose your job, you lose your healthcare. For ten years, I’ve covered out-of-pocket care for my dependent—including during health emergencies. I’ve spent $50,000–$200,000 USD just trying to keep her well and safe.
• Missed Opportunities: I should have been leading evaluations, directing global programs, mentoring the next generation. Instead, I was just trying to survive. Lost networks, lost credibility, lost consulting income. Easily another $200,000–$400,000 in forgone earnings.

The Emotional Toll

The numbers don’t tell the whole story. They don’t reflect what it’s like to wake up every morning wondering if your work ever mattered. They don’t show the moments I had to choose between groceries and another round of lab tests for my mother. They don’t capture the professional shame, the panic, the quiet disbelief that no one came looking.

It’s not just a system failure. It’s a human one.

Why Reform Can’t Wait

You can’t claim to be a values-based organization while discarding your own people in silence. And yet that is what too many international agencies do—cutting technical posts under the guise of restructuring, while retaining bloated management layers and generalist positions with no clear public value.

We need a reset. Here’s where to start:

1. Guarantee Transitional Support for Abolished Posts

Abolition should never mean abandonment. Staff whose posts are cut must be offered:

• Transitional pay and benefits (healthcare continuation, pension bridging)
• Career re-entry guarantees within a defined period
• Support for relocation, re-skilling, and reference protections

2. Protect Technical Expertise

Organizations must stop privileging coordination over content. The future depends on knowledge—gender, climate, health, evaluation, biodiversity, education. We need fewer PowerPoint czars and more people who’ve actually done the work.

Create:

• Technical career tracks with promotion potential
• Fixed-term roles with mobility protections for those in niche or field-based posts
• Internal pools for technical surge deployment

3. Build Accountability into Human Resource Systems

Too often, posts are abolished due to politics, personal vendettas, or vague restructurings. There must be:

• Transparent criteria for abolishment
• Independent review panels for contested decisions
• Data tracking on who is let go and why—disaggregated by gender, nationality, race, and contract type

4. Rebalance Power and Purpose

The system is top-heavy and risk-averse. It’s time to rebalance:

• Elevate field voices, not just headquarters control
• Fund delivery and results—not endless strategy papers
• Measure success by impact, not institutional expansion

Rebuilding, Not Returning

I’ve spent the last decade slowly rebuilding. Consulting, evaluating, speaking truth to power. I’ve advised governments, walked the garbage-strewn backstreets of Jakarta, listened to stories from herders in Mali and coral farmers in Seychelles. My skills didn’t vanish. My value didn’t die.

But I’ve had to fight for every contract. Every inch of ground.

And I’ve come to understand this: abolition doesn’t end a career—it reveals what the system never saw in the first place.

To Those Who’ve Been Abolished

If you’ve lost your job, your anchor, your sense of place—this is for you. You are not expendable. You are not a line in a budget or a casualty of “restructuring.”

You are the system’s conscience, even if it forgot your name.

We are still here. We are still needed.

And we are not done.

Stephanie Hodge is an international evaluator and former UN advisor who has worked across 140 countries. She writes on governance, multilateral reform, and climate equity.

IPS UN Bureau