Kurowski, ChristophSchmidt, MartinKumar, AnuragMieses, JulioGabani, Jacopo2024-11-082024-11-082024-11-08https://hdl.handle.net/10986/42385This paper presents the most recent trends in government health spending (GHS) across 63 low- and lower-middle-income countries, offering critical insights as nations approach the decisive period for achieving the Sustainable Development Goals (SDGs). After the pandemic-induced surge, sustained declines in GHS per capita followed. While these declines might appear to be a logical consolidation, the resulting modest growth in GHS per capita and decreases in health’s share of overall government spending between 2019 and 2023 pose significant challenges to the sustainability of government investment in health—compounded in many countries by contracting or stagnant government expenditure projected through 2029. These shifts cannot be ignored as countries need to restart progress toward Universal Health Coverage and other health-related SDGs after the COVID-19 setback, alongside building resilience to climate change and enhancing pandemic preparedness. Increasing the priority of health in spending is a key policy option, but it will not be sufficient on its own. Effective responses also require improving spending efficiency and addressing broader fiscal challenges. Without decisive action, many countries have little chance of achieving the health SDG.en-USCC BY-NC 3.0 IGOGOVERNMENT HEALTH SPENDINGUNIVERSAL HEALTH COVERAGESDGPANDEMIC PREPAREDNESSWorking PapersWorld Bank10.1596/42385