Across Africa, ministries of health are being asked to deliver more at a time when fiscal space is shrinking, donor funding is declining, and health needs are growing. Recognising that these challenges cannot be addressed by the health sector alone, CABRI, with technical support from ODI Global and financial support from the Global Fund, has launched a new Network of Health and Finance Officials. The Network brings together officials from ministries of health (MoH) and ministries of finance (MoF) across 22 African countries, with the aim to grow the Network further in the medium term.
A country-owned, demand-driven peer-learning platform
The launch, in January 2026, marked the start of a country-owned, demand-driven platform aimed at increasing resources for the health sector and improving value for money through stronger collaboration between health and finance authorities. Rather than creating parallel structures or prescribing reforms, the Network is designed to respond to the real, day-to-day problems officials face as they navigate tight budgets, competing priorities, and complex public financial management (PFM) systems.
CABRI and its partners will facilitate discussions, provide technical inputs, and help convene peers, but countries themselves will set the agenda. Priorities will be identified collectively, based on where officials believe collaboration between health and finance can unlock the greatest gains.
What can ministries of finance do differently?
At the launch, Tom Hart, Senior Research Fellow at ODI Global, reflected on how ministries of finance can support more efficient health spending, particularly in contexts where increasing the health budget share may not be feasible. 10 areas were suggested that ministries of finance, ministries of health and their partners can explore to improve the quality of health spending across three themes: improved budgeting and prioritisation of health spending; improved budget execution and procurement; and stronger public financial management frameworks for health spending.
Country experiences: from spending reviews to emergency shocks
Officials from ministries of finance and health shared concrete experiences that echoed and enriched ODI’s input.
Dr. Mashudu Bidzha, Acting Chief Director: Health and Social Development in South Africa’s National Treasury, highlighted the role of institutionalised spending reviews as a tool for identifying efficiencies in a constrained fiscal environment. With donor funding declining and limited scope to raise new taxes, collaboration between the MoH and MoF has been essential to ensuring that savings are politically and technically feasible. A key lesson was that spending reviews work best when they are genuinely co-owned by both ministries.
Hyeladzira Gawnvwa, Resource Coordination and Health Financing Lead, SWAp Coordination Office, Federal Ministry of Health Nigeria, underscored the challenge of translating ambitious health plans into budgets that reflect fiscal realities. Without early engagement with the MoF and a clear understanding of resource constraints, plans risk becoming “wish lists.” Joint spending reviews and improvements to the chart of accounts were highlighted as practical areas where collaboration could yield better information and better decisions.
Officials from Tanzania drew attention to the disruptive impact of recurrent emergencies—from pandemics to donor withdrawals—which can quickly derail carefully prioritised budgets. For them, the question is not only how to plan well, but how to build systems that are resilient to shocks. Mauritius, meanwhile, emphasised the importance of embedding high-level policy commitments into national health plans while maintaining a degree of independence from donor priorities.
What countries want the Network to focus on
To help shape the Network’s immediate agenda, participants were asked to rank priority areas through a live Zoom poll. The highest-ranked priorities centred on navigating donor transitions and aid cuts, improving the translation of health priorities into credible, funded budgets; identifying efficiencies through spending reviews and better expenditure analysis; and strengthening budget execution to ensure that approved resources actually reach frontline services. The poll results reinforced the message that officials are seeking solutions that can be implemented within existing systems, rather than wholesale reforms that may take years to materialise.
From launch to action
The launch of the Network of Health and Finance Officials signals a shift from abstract debates about health financing toward a more grounded conversation about how budgets actually work—and how they can work better. In July 2026, the first in-person meeting of the Network will take place. By bringing health and finance officials into the same room, around the same table, and focused on shared problems, the Network aims to help countries do what is increasingly necessary: deliver more health for the money they have.