WHO’s health financing recommendations builds on the World Health Report 2000 and extensive conceptual and empirical work in two decades which followed. All health financing systems are organized around the functions of revenue raising, pooling of revenues, and purchasing of services, together with decisions on benefit design. WHO has well-developed guidance for each of these sub-functions, building on nineteen desirable attributes of health financing systems as defined in the Health Financing Progress Matrix.

Government plays a critical role in progress towards UHC, in terms of funding, delivery, and regulation, and its capacity can be severely limited in FCAS, with external actors often playing a more significant role, both in terms of funding but also in terms of policy conditionalities.

Following an extensive review of the literature, published as WHO Health Financing Working Paper no. 13, and a synthesis of evidence together with policy recommendations published as WHO Health Financing Guidance no. 7. The three overarching recommendations are:

• Safeguarding the financing of critical health system functions in FCAS is a priority given the increased risks to population health security. These include population-based interventions such as disease surveillance, ensuring safe medication, water and sanitation systems, and other common goods for health. This message is as valid for external funders as it is for national governments given the increased reliance on external humanitarian and development funding in such settings.
• Health financing policy in FCAS should be guided by a set of principles to avoid the development of schemes or sub-systems inconsistent with UHC. Multiple, uncoordinated actors, often external, can lead to the development of unsustainable interventions due to high cost or complexity, which neglect to invest in the foundational elements essential for a resilient health system. In contrast, coordinated actions which use and support domestic systems where possible, or otherwise mirror critical public functions, can strengthen health system resilience. Examples of coordinated action include ensuring the pooling of funds, using a common pay scale for health workers salaries, and ensuring that funding for critical inputs required for service delivery takes priority.
• Cash and voucher assistance (CVA) can play a critical role in protecting human welfare in FCAS by supporting vulnerable households to meet both health and non-health needs. However, given the agreed interagency policy to suspend user fees for essential health care services in humanitarian and complex emergencies, unconditional or unrestricted cash transfers should not inadvertently contribute to a fee-charging culture for priority services, which would undermine progress towards universal health coverage. This can be achieved by ensuring that CVA modalities are viewed as complementary to support for the systems required to deliver essential health services.