Given the challenges faced by health systems, an effective dialogue across government agencies responsible for health outcomes is critical. To help facilitate this dialogue, the OECD Joint Network of Senior Budget and Health Officials brings together people from ministries of finance, health and social security agencies.
Over the years, the Network has provided an effective space for government officials to openly discuss challenges and solutions to the fiscal sustainability of health systems. Since 2015, this Network has expanded beyond OECD member countries, in partnership with the World Health Organization, The Global Fund and other international institutions. Regional networks exist in Asia, Central Eastern and South-Eastern Europe, and Latin America and the Caribbean.
- Read our Brochure to learn more about our work
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THE FISCAL SUSTAINABILITY CHALLENGE FOR HEALTH

Source: OECD Health Division projections (forthcoming)
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Health expenditure has typically outpaced economic growth. Latest OECD projections estimate the average annual change in health spending will be twice as high as the change in government revenues from 2023 to 2040
… and two percentage points higher than the potential GDP growth.
To fund this increase, OECD countries would need to dedicate 20% of their revenues to health in 2040, up 5 percentage points from 2018.
Therefore healthcare systems cannot sustain current levels of spending in the long-run without putting signficant strain on government budgets.
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HOW TO ADDRESS THE FISCAL SUSTAINABILITY OF HEALTH SYSTEMS CHALLENGE?
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The OECD Joint Network works across three pillars of health financing to address the fiscal sustainability of health systems challenge:
1. Resource mobilsation - the process through which countries raise funds to finance health services
2. Budgetary governance - the process of formulating the annual budget, overseeing its implementation and ensuring its alignment with public goals
3. Resource allocation - the distribution of finite resources for health among priorities
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UPCOMING PROJECTS OF THE JOINT NETWORK
NEXT FLAGSHIP REPORT – COMING 2024
- The next flagship report of the Joint Network will address the question of how can health and finance minisitries can work together to find the resources to strengthen health system resilience in a fiscally sustainable manner
- The report will bring together analytical work across a range of topics, including the effective management of health expenditure, programme and performance budgeting, medium-term financial planning for health, and long-term projections of health expenditure
APPLYING GOOD BUDGETING PRACTICES TO HEALTH – COMING END 2023
- Applying Good Budgeting Practices to Health draws together more than 10 years of work of the OECD Joint Network of Senior Budget and Health Officials
- Applying Good Budgeting Practices to Health consists of a set of high-level good budgeting practices in the context of the health sector
- These aim to help countries in their design of needed budgeting reforms in the health sector or provide legitimacy to proposed reforms
MEETINGS OF the Joint Network
The meetings of the OECD Joint Network on Fiscal Sustainability of Health Systems provide a valuable space for health and finance officials to increase their understanding of policy responses at the intersection of health policy and public finance. The Joint Network holds annual meetings for OECD member countries in Paris and regional network meetings for members and non-members. The regional meetings are held in partnership with The Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Health Organization.
OECD member countries network:
- 11th meeting, Paris, 9-10 February 2023
- 10th meeting, virtual, 10-11 February 2022
- 9th meeting, virtual, 11-12 February 2021
- Budgetary and Health System Actions to Combat COVID-19: Implications for Upcoming Budgets, Virtual Webinar, 17 September, 2020
- 8th meeting, Paris, 10-11 February 2020
Regional networks:
- 4th Meeting for Central, Eastern and South Eastern European Countries, Brdo, Slovenia, 28 November 2023
- 3rd Meeting for Central, Eastern and South Eastern European countries, Vilnius, Lithuania, 25-26 April 2019 – read the Synthesis note
- 2nd Meeting for Latin America and Caribbean countries, San Jose, Costa Rica, 30-31 January 2019 – read the Synthesis note
- 1st Meeting for Asian countries, Tokyo, Japan 15-16 May 2017 - read the Synthesis note
KEY OUTPUTS AND PUBLICATIONS
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Country case studies on health financing and budgeting practices for health:
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Further reading
CONTACT US
Through the OECD Joint Network of Senior Budget and Health Officials, the OECD Secretariat provides expertise on health budgeting, expenditure and public management to help public sector officials improve the efficiency and effectiveness of health financing. In particular the Secretariat’s experts provide:
- Country reviews of national and subnational health budgeting systems to benchmark with international practices and provide policy recommendations
- In-depth topic specific analysis to support policy design, implementation and review
- Support in the use of spending reviews in the health sector to enable health administrations to prioritise health resources effectively over time
- Training through knowledge workshops and tailored capacity building initiatives
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