Paris: International development financing for health could face significant reductions by 2026, with some of the steepest projected declines expected in programmes targeting malaria, tuberculosis, reproductive health and infectious diseases. The latest OECD projection highlights growing pressure on health-related official development assistance (ODA) from members of the Development Assistance Committee (DAC).

According to the OECD graphic, net bilateral ODA allocated to health is projected to decline across a wide range of health purposes between 2024 and 2026. The estimates compare final reported figures for 2024 with preliminary projected levels for 2026.

Malaria and Tuberculosis Among the Hardest-Hit Areas

The chart shows malaria control experiencing the largest projected reduction, at roughly 60% below its 2024 level. Tuberculosis control follows closely, with a projected decline of approximately 58%.

These reductions could have important consequences for countries that depend heavily on international assistance to maintain disease surveillance, prevention programmes, diagnosis and treatment services.

Malaria and tuberculosis remain major public-health challenges in many low- and middle-income countries. A substantial reduction in external financing could place additional pressure on national health systems and other international funding mechanisms.

Reproductive Health Funding Also Faces a Sharp Decline

Funding related to population and reproductive health is projected to fall by around 55%, according to the OECD chart.

Reproductive-health programmes can include a wide range of services, including maternal health, family planning and other essential healthcare interventions. Reduced development assistance could make it more difficult for vulnerable populations to maintain access to such services, particularly where domestic health budgets are already constrained.

Infectious Disease and COVID-19 Funding

The projection also points to a significant reduction in assistance for infectious disease control, estimated at about 42%.

Funding associated with COVID-19 control is projected to decrease by approximately 40%. The decline partly reflects the extraordinary level of international financing mobilised during the pandemic, when COVID-19 became an exceptional global health priority.

However, infectious-disease preparedness remains important even as emergency pandemic spending decreases. Surveillance systems, laboratories, vaccination programmes and rapid-response capacity continue to require sustained investment.

Broader Health Spending Could Also Decline

The projected reductions are not limited to specific diseases. The OECD chart indicates decreases across several broader categories of health assistance.

Basic nutrition and health education are each projected to decline by roughly one-third. Funding for basic health care is shown falling by around 28%, while general health assistance could decline by approximately 25%.

Assistance for non-communicable diseases is projected to decrease by around 19%, while funding for health personnel development could fall by approximately 17%.

Even basic health infrastructure, which records the smallest reduction shown in the chart, is projected to decline by roughly 12%.

What the Numbers Could Mean for Developing Countries

Health-related development assistance can support programmes that governments may struggle to finance independently. It can help strengthen hospitals and clinics, train healthcare workers, improve disease surveillance and expand access to essential services.

A broad reduction in external health financing could therefore force governments and international organisations to make difficult decisions about priorities. Countries may need to find alternative sources of funding or concentrate limited resources on the most urgent health challenges.

The impact is also unlikely to be identical everywhere. Countries with stronger domestic healthcare financing may be better positioned to absorb reductions, while nations with greater dependence on external assistance could face greater challenges.

A Changing Landscape for Global Health Financing

The OECD projection offers an important warning about the changing environment for international health financing. While some reductions may reflect the winding down of exceptional pandemic-era spending, simultaneous declines across disease-specific and broader health programmes could create new funding gaps.

Maintaining progress against infectious diseases, improving reproductive health, strengthening nutrition and ensuring adequate healthcare infrastructure will require continued coordination between national governments, international institutions and development partners.

The figures shown are projections rather than final 2026 outcomes. The actual level and distribution of health-related ODA could change as governments finalise their budgets and development commitments.

For countries and organisations planning long-term health programmes, the projected decline underlines the importance of sustainable financing and careful prioritisation.