Publication: Financing for NCDs and Mental Health: Where will the Money Come From?
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2025-02-26
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2025-02-26
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This policy brief reviews the options for increasing funding for NCDs and mental healthfrom the perspective of health ministries, finance ministries, and development agencies.This policy brief complements another policy brief, Financing for NCDs and mental health:making the money work better, that identifies mechanisms for improving the efficiency ofcurrent spending. These recommendations emerged from the International Dialogue onSustainable Financing for Noncommunicable Diseases and Mental Health (June 2024)and related technical background papers.
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“World Health Organization; World Bank. 2025. Financing for NCDs and Mental Health: Where will the Money Come From?. International Dialogue on Sustainable Financing for Noncommunicable Disease and Mental Health. © World Bank. http://hdl.handle.net/10986/42871 License: CC BY-NC 3.0 IGO.”
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Publication Financing for NCDs and Mental Health(Washington, DC: World Bank, 2025-02-26)In the wake of the COVID-19 pandemic, many national governments face significant macrofiscal challenges that make increasing resources for NCDs and mental health more difficult. Hence, the challenge for the coming years is to improve financing for NCDs and mental health in the context of tighter health budgets. This policy brief reviews theoptions for governments to improve and get better value for money in their spending on NCDs and mental health. It also identifies options for ministries of health to use discretionary funds to support increased effective coverage of NCD and mental health interventions. This brief complements another policy brief, Financing for NCDs and mental health: where will the money come from, that identifies mechanisms for increasing financing for these conditions. These recommendations emerged from the International Dialogue on Sustainable Financing for Noncommunicable Diseases and Mental Health (June 2024) and related technical background papersPublication Integrating the Response to NCDS and Mental Health in the Context of Building Resilient Health Systems in Africa(Washington, DC: World Bank, 2024-04-03)From June 6 to 8, 2023, the Ministry of Health of Rwanda organized an event entitled “Integrating the Response to Noncommunicable Diseases (NCDs) and Mental Health (MH) in the Context of Building Resilient Health Systems in Africa” followed by a technical workshop, with the participation of representatives from the governments of Eswatini, Ethiopia, Ghana, Kenya, Lesotho, Rwanda, Uganda, and Zimbabwe. The event and the workshop were prepared by the World Bank Group (WBG), with support from the World Health Organization (WHO) and with collaboration from United Nations Children’s Fund (UNICEF), the African Centres for Disease Control and Prevention (Africa CDC), and other multilateral agencies and nonprofit organizations. The workshop was under funding provided by the Access Accelerated (AA) Trust Fund. The full program of the event is included at the end of this summary report.The rate of noncommunicable diseases (NCDs) in the African Region increased by 67 percent between 1990 and 2017. In 2019 NCDs were responsible for 37 percent of African deaths, and by the year 2030, they will be the main cause of the burden of disease in the Region. The incidence of mental health (MH) challenges increased by 13 percent in the Region since 2017. In addition, Africa is experiencing high rates of suicide and alcohol abuse, especially among young people. Yet, the average per capita expenditure on MH provision in African countries is US$0.46, with only 1.6 health professionals per 100,000 population working in this field. Primary health care and community-based services are essential strategies to support health systems and to avoid the consequences of early mortality and the social and economic losses brought on by the increased incidence of NCDs and MH. The challenges imposed by NCDs require a stronger collaboration among African countries to see how policies developed in different countries could be adaptative to other regional needs and contexts. Countries participating in the workshop shared some achievements and discussed the challenges ahead for the integration of the provision of mental health services and NCDs care at the first level of care.Publication Prevention and Control of Selected Chronic NCDs in Sri Lanka : Policy Options and Action(World Bank, Washington, DC, 2010-10)Strategic decisions to reorient population-based prevention and clinic- and hospital-based care policies toward non-communicable diseases (NCDs) will enable healthier aging and reduce loss of productivity among the working-age population in Sri Lanka. This report aims to stimulate policy dialogue for NCDs and to provide an evidence base to facilitate decisions. Its focus is mainly on chronic NCDs-that is, cardiovascular disease (CVD), diabetes, and asthma/chronic obstructive pulmonary disease (COPD), and to a lesser extent cancer-and their major modifiable risk factors (tobacco use, unhealthy diet, lack of exercise, and harmful alcohol use). This is not to detract, though, from the importance of injuries and mental health since both are major issues that carry a huge burden, as supported by evidence in this report. Several major areas for policies and actions emerged from the analysis of Sri Lanka's health sector organization and capacity as well as its NCD orientation. Some areas are not specific to NCDs but, rather, will strengthen the health sector generally while leading to better NCD prevention and control. These areas include: (i) increasing financial resources for NCD prevention and control, (ii) increasing access to NCD drugs, especially for the poor, (iii) addressing social determinants, (iv) focusing on specific NCDs, (v) addressing under nutrition and over nutrition, (vi) creating an intensified national NCD program, strengthening and reorganizing NCD prevention and curative care services, (vii) moving services closer to clients and improving efficiency, (viii) further decentralizing and devolving health service delivery, (ix) human resource development for NCD prevention and control, (x) creating a national NCD surveillance system, and (xi) developing public-private partnerships and aligning service delivery.Publication Health in All Policies as a Strategic Policy Response to NCDs(World Bank, Washington, DC, 2014-02)The aim of Health in All Policies (HiAP) is to bring diverse sectors together to find shared solutions; it focuses on identifying 'win-win' or 'cobenefits' such that policy measures contribute not only to improved health outcomes but also to outcomes desired by other sectors, such as education, environment, welfare, agriculture, and transportation. HiAP can be applied to NCD prevention and control from three different entry points: risk factors or conditions, population groups (including life course), and sectors. (HiAP) is a relatively new concept and policy practice that attempts to incorporate consideration into the policy decision-making process of how public policies and programs affect community health and well-being. It represents a way of working across sectors that aim to find solutions for complex, interrelated, and persistent problems. With the global epidemic in non-communicable diseases (NCDs), HiAP offers a potential approach and a pathway to secure coordinated action on social determinants of health that relate to NCDs and result in health inequalities. Promising examples can be seen globally for action on both specific NCD risk factors as well as in a more systemic approach to policy decision making.Publication Chronic Emergency : Why NCDs Matter(World Bank, Washington, DC, 2011-07)'Chronic emergency: why non communicable diseases (NCDs) Matter' examines the magnitude of the challenge posed by NCDs in middle- and low-income countries, and makes the case for elevating the challenge as a priority item to address on the agenda of decision-makers. NCDs are on the rise in all middle- and low-income country regions. By 2030, NCDs are expected to account for three quarters of the disease burden in middle-income countries, up from two-thirds today and approaching the level of high-income countries. In low income countries, the NCD share of the disease burden will increase even more quickly and will approach the levels currently found in middle-income countries. At the same time, many low-income countries will continue to contend with substantial communicable disease burdens, thus facing a double burden of disease. Further, compared to their higher-income counterparts, many developing countries will face elevated NCD levels at earlier stages of economic development and with a much compressed timeline to address the challenge. The overall economic and social cost of NCDs vastly exceeds their direct medical costs. NCDs affect economies, health systems, and households and individuals through a range of drivers such as reduced labor productivity, higher medical treatment costs, and lost savings. These drivers aggregate into significant socioeconomic impacts, including in the areas of: country productivity and competitiveness; fiscal pressures; health outcomes; and poverty, inequity and opportunity loss. Despite the magnitude of the NCD challenge, there is considerable space for action. While most countries will not be able to treat their way out of the NCD challenge because of the immense costs such a strategy requires, they can target NCD risk factors and promote healthier lifestyles through focused prevention efforts while also facilitating strategic adaptation measures to mitigate the impact of NCDs on economies, health systems, and households and individuals.
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The CCDR also outlines a path to net zero emissions by 2050 (referred to as “with mitigation” measures, “decarbonization,” or, simply, “net zero 2050”), highlighting associated development co-benefits.Publication Guinea-Bissau Country Climate and Development Report(Washington, DC: World Bank, 2024-10-23)Guinea-Bissau is endowed with a wealth of natural resources, with the highest natural capital per capita in West Africa (US3,874 dollars per capita), which could be leveraged for sustainable and resilient growth. However, Guinea-Bissau faces significant development hurdles, such as high poverty rates, political instability, and economic challenges, including an over-reliance on cashew nuts. Rural poverty has increased, and the nation's infrastructure, education, and health care systems are underdeveloped. Climate change poses a severe threat, potentially impacting agriculture, fisheries, and infrastructure. Without adaptation, it could lead to a significant cut in real GDP per capita (minus 7.3 percent by 2050) and increase in poverty (with up to over 200,000 additional poor by 2050, that is, 5 percent of the expected population, in the worst scenario). The country's low greenhouse gas emissions are expected to rise, mainly due to agriculture and land-use changes, with deforestation being a major contributing factor. Although Guinea-Bissau is a low emitter, it has high mitigation ambitions, targeting a 30 percent reduction in greenhouse gas emissions by 2030. The Nationally Determined Contribution outlines significant climate actions, with initiatives focused on forest conservation, sustainable agriculture, and community development. However, the country's political instability, institutional weaknesses, and limited financial resources pose challenges to implementing these climate commitments, which depend heavily on external funding. The financial sector's underdevelopment and vulnerability to external shocks limit its ability to support green investments, though reforms could enhance resilience. Guinea-Bissau must consider its climate financing as development financing and vice-versa, engage the private sector, and integrate climate goals with national development plans to ensure a sustainable future. Concessional climate financing is vital due to the underdeveloped financial sector and the government’s limited borrowing capacity. Addressing Guinea-Bissau's vulnerability to climate change and its structural issues requires a cohesive approach that integrates development and climate strategies. This could involve improving governance, diversifying the economy, protecting natural capital, developing human capital, and investing in sustainable agriculture and infrastructure. The transition to a more sustainable and inclusive development pathway that supports economic growth is possible, but requires focusing on key strategic sectors, enhancing institutional capacity, and creating the conditions to mobilize finance. As a highly vulnerable country, there are myriad needs in the different sectors; however, to be more efficient and effective, Guinea-Bissau should prioritize actions in a few sectors, especially actions on biodiversity, agriculture, and social protection. Low carbon development, especially in energy and forestry sectors, could provide cost-efficient solutions and attract climate finance, including from the private sector, which will support the overall development agenda.Publication Mongolia Country Climate and Development Report(Washington, DC: World Bank, 2024-10-22)Mongolia’s development prospects are uniquely challenged by both the impacts of climate change and the global shift toward a low-carbon economy. The country’s efforts toward decarbonization pose significant challenges given the structurally high-emission intensity of its economy. While challenging, climate action also presents Mongolia with opportunities to achieve important development benefits. The effects of climate risks and the shift away from coal will have diverse impacts across different regions, communities, and socioeconomic levels. The report assesses the critical interconnections between Mongolia’s development ambitions and climate change action and identifies ways to transition to a more economically diversified, inclusive, and resilient development path. It highlights key climate and transition risks affecting Mongolia’s future development and presents a pathway to enhance climate mitigation and adaptation. The report also makes a case for strengthening policies to enhance resilience to climate change and ensure a just transition, particularly for the most vulnerable. The report is structured as follows: section 1 gives introduction. Section 2 delves into the linkages between development and climate in Mongolia and presents model-based findings on the economic and poverty impacts of climate change under different scenarios. Section 3 covers four in-depth sectoral analyses. The first two mainly focus on adaptation to climate change in the agriculture and water sectors. The third considers prospects for the extraction sector, while the fourth sectoral analysis focuses on decarbonizing power and heat generation. Section 4 shifts the focus to how the government can boost resilience for climate-vulnerable populations. Section 5 outlines options for mobilizing private and public financing and private investments to support the green transition. Section 6 examines the existing institutional and governance structure for climate action and presents recommendations to improve its effectiveness, and section 7 concludes with a framework for prioritizing the policy actions outlined in this report.Publication Comoros Country Climate and Development Report(Washington, DC: World Bank, 2025-06-18)The Union of the Comoros (The Comoros) has significant vulnerability to climate change-related risks but has considerable opportunities to strengthen preparedness and resilience against these challenges. According to the Notre Dame Global Adaptation Index, the Comoros is the 29th-most vulnerable country to climate change and the 163rd most ready to adapt (out of 191). The Comoros archipelago is exposed to many natural hazards that adversely affect the country’s natural capital, people, and physical infrastructure. In 2014, the economic cost of climate-related disasters was estimated at 5.7 million dollars annually, equivalent to 9.2 percent of Gross Domestic Product (GDP). Between 2018 and 2023, as many as 11 tropical depressions or cyclones impacted the country, with Cyclone Kenneth causing the greatest damage, equivalent to 14 percent of GDP, resulting in total economic growth falling from 3.6 percent in 2018 to 1.9 percent in 2019. More than 345,000 people (40 percent of the population) were affected by the cyclone, with 185,000 people experiencing severe impacts and 12,000 people displaced. However, there is an opportunity for the country to grow more robust and shock-responsive, and to establish pre-positioned funding mechanisms to enhance future crisis response efforts. For the Comoros, adaptation and climate-resilient development are the key climate change focus areas, with the country projected to face 836 million dollars 2050 in additional costs due to climate-related impacts. Current plans to adapt to the impacts of climate change in the Comoros include efforts to improve water management, strengthen coastal protection, and develop climate-smart agriculture practices. Given the country’s reliance on its natural resource base for economic growth and mobility, protection of these resources from climate change will be essential for promoting resilient growth and development. In addition to growing the adaptive capacity of the country’s natural resource sectors, strategic economic diversification will be important to help minimize future climate impacts, and development activities will need to be undertaken in such a way as to attract low-carbon co-benefits. The Union of the Comoros is committed to addressing climate change through its Nationally Determined Contribution (NDC) and national priorities. 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Prepared by the World Bank, the International Finance Corporation (IFC), and the Multilateral Investment Guarantee Agency (MIGA), CCDRs integrate country perspectives, climate science and economic modeling, private sector information, and policy analysis to assess how countries can successfully grow and develop their economies and create jobs despite increasing climate risks and while achieving their climate objectives and commitments. Each CCDR starts from the country’s development priorities, opportunities, and challenges, and is developed in close consultation with governments, businesses, and civil society, ensuring the recommendations reflect national priorities. By combining evidence on adaptation, resilience, and emissions pathways, CCDRs highlight where climate action can reinforce development and job creation, and where targeted policies are needed to manage risks and smooth labor market transitions. Taken together, these elements can help create local jobs, ensure economic transitions are just and inclusive, and equip workers and firms to navigate the disruptions and opportunities of a changing climate and changing technologies.