Innovative financing instruments for global health 2002–15: a systematic analysis

Development assistance for health (DAH), the value of which peaked in 2013 and fell in 2015, is unlikely to rise substantially in the near future, increasing reliance on domestic and innovative financing sources to sustain health programmes in low-income and middle-income countries. We examined innovative financing instruments (IFIs) -financing schemes that generate and mobilise funds-to estimate the quantum of financing mobilised from 2002 to 2015. We identified ten IFIs, which mobilised US8·9 billion (2·3% of overall DAH) in 2002-15. The funds generated by IFIs were channelled mostly through GAVI and the Global Fund, and used for programmes for new and underused vaccines, HIV/AIDS, malaria, tuberculosis, and maternal and child health. Vaccination programmes received the largest amount of funding (2·6 billion), followed by HIV/AIDS (1080·7 million) and malaria (1028·9 million), with no discernible funding targeted to non-communicable diseases.