All countries face several critical pressures on their health systems. Some of these are particularly salient for countries that are currently or will soon be ‘transitioning’ to much lower levels of external financial support.

A common guiding principle is to maintain or even increase effective coverage for priority health services, including those currently supported with external funds.  

This does however not mean simply channelling government revenues to pay for a previously donor-funded programme. Rather, transition provides an opportunity for countries to assess how governance, financing and service delivery are configured to ensure the sustainability of effective coverage for priority interventions.  

Hence, health system strengthening (HSS) is at the core of the response to transition if progress towards UHC is to be sustained.  It also emphasizes the importance of sustainability in the transition process, which should also extend to those countries that are not imminently facing declines in donor assistance.

The UHC2030 working group on sustainability and transition from external funding works towards building a consensus on the sustainability objective in relation to transition from external funding – to mean - sustained or increased effective coverage of quality priority interventions and outcomes for UHC and develop a collaborative agenda taken forward by different actors in support of this.

Download: Terms of reference

The membership of the group brings together country representatives, WB/WHO health system and disease experts, bilateral partners, global health initiatives, GFF, OECD, BMGF, academia think tanks and civil society. Country interest and participation in the group has been strong, with 15 countries actively engaging in the group, either through direct participation or country consultation.

The working group has held three face-to-face meetings – see below links for final reports and other documentation. The working group has developed a mapping of policies, definitions and ongoing work by working group members related to transition from aid. A country consultation paper on sustainability and transition has also been commissioned and a data set on key indicators on UHC context and transition timelines in all low income and middle income countries. The WG has also developed a paper on perspectives from health programs on sustainability and transition.

In 2018 the working group developed the UHC2030 statement on sustainability and transition from external funding. Statement was presented to the UHC2030 Steering Committee in June 2018 and launched following a wide consultation process. The statement serves as a basis for advocacy, political influencing- informing transition related coordination processes both at national and global levels.  The statement includes ten recommendations/principles directed at governments of countries experiencing transition from external funding and the broad range of development partners working in these contexts.

Read: Launch of the Statement on sustainability and transition from external financing

Participant list

The working group is chaired by

Midori Habich former Minister of Health Peru

Kara Hanson, Professor of Health System Economics London School of Hygiene and Tropical Medicine.

Maria Skarphedinsdottir, UHC2030 Core team, providing the secretariat


Mark Blecher Chief Director of Health and Social Development Treasury South Africa

Ms Triin Habicht Senior Adviser to the Ministry of Health Estonia

Dr. Aquina Thulare Technical Specialist, Health Economics National Health Insurance Department of Health South Africa

Ms Regina Ombam Head, Strategy Development National Aids Control Council Kenya

Daniel Osei, Head of Budget, Ministry of Health Ghana

UHC2030 hosting organizations

Toomas Palu Advisor Global Coordination Health Nutrition and Population WB

Somil Nagpal Senior Health Adviser WB

Agnes Soucat Director Health Governance and Financing WHO

Joe Kutzin Coordinator Health Financing WHO

Susan Sparkes Technical Officer Health Systems Governance and Financing WHO

Dr Anshu Banerjee Director Global Coordination WHO

Brian Tisdall Team Leader Polio Transition WHO

Huang Xiao Xian Technical advisor WHO EPI team

Nishikiori Nobuyuki  Global TB program WHO

Diana Weil Coordinator Global TB program WHO

Gilles Forte Coordinator Essential Medicines and Health Products WHO

Dr. Zubin Shroff Alliance for Health Policy and System Research WHO

Tom O’Connell Health System Governance and Finance WHO

Development partners

Matthias Reinicke Health Sector Adviser Europe Aid EC

Dan Peters Senior Program Officer Development Policy and Finance BMGF

Joanna Keatinge Health Advisor DFID

Lisa Fleisher Public Finance Advisor USAID

Susanna Baker Chief Health Finance and Economics Office of HIV/AIDS

Paul Rueckert Health Adviser GIZ

Dr Shin-ichiro Noda Center for Global Health and Medicine Japan

Arjun Vasan Senior Health Economist US Treasury

Michael Borowitz Head Strategic Investments and Partnerships GF

Mr. Matthew Macgregor Portfolio Manager GF

Santiago Cornejo Senior Specialist Immunization Financing GAVI Alliance

Nertila Tavanxhi Technical Adviser UNAIDS

Tim Poletti Health Adviser Permanent Mission of Australia to UN

Maria Eugenia Bonilla-Chacin Senior Economist Global Financing Facility

Piera Tortora Advisor on Development Finance OECD

Anderson Stanciole Health Financing Advisor UNFPA

Academia and Civil society

Sara Bennett, Professor John Hopkins Bloomberg School of Public Health

Mr. Mohamed Gad, Technical Analyst Imperial College UK

Gavin Yamey Director Center for Policy impact in Global Health Duke University

Osundu Ogbuoji Senior Policy Associate Duke Global Health Institute

Kalipso Chalkidou Director Global Health Policy Centre for Global Development (CDG)

Mr. Michael Chaitkin, Senior Program Officer Results for Development

Oanh Khuất Thị Hải, Executive Director, Centre for Supporting Community Development Initiatives 

Craig Burgess, Senior Technical Advisor, JSI Research and Training Institute

For further information please contact: 

Maria Skarphedinsdottir, WHO and UHC2030 Core Team: