The poorest seven countries of the former Soviet Union (CIS- ) moved from a centralized system of health-care funding and delivery to a range of institutional and financial arrangements. The different paths chosen have implied different results in terms of available resources, internal efficiency, health-care inequality, and the corresponding incidence of public expenditures. This paper examines the level, composition and allocation of public spending on health, in light of the evolution of the health systems during the transition. The financial constraints experienced by CIS- countries were reflected in the decrease of health-care quality, the collapse of the already inefficient public health activities, and the increased incidence of out-of-pocket expenditures. These factors, alongside the increase in poverty, resulted in a decrease in health-care utilization, suggesting that these countries may experience difficulties in achieving the health-related Millennium Development Goals.

Knowledge Brief  Faced with a large and increasing obesity epidemic, in 2013 Mexico enacted taxes on sugarsweetened beverages (SSBs) and calorie-dense foods of low nutritional value.  The decision to implement this fiscal policy was the result of a long advocacy process in which civil society organizations and government agencies participated.  The taxes were designed to avoid, as much as possible, the substitution of consumption of the taxed goods for other unhealthy foods and beverages not subject to taxation.  The taxes have been successful in increasing both the fiscal revenues and the price of the products taxed. There is evidence that they have reduced consumption, particularly of SSBs.  A debate remains on the size of the impact of the taxes, particularly on health outcomes. Thus it is important to continue monitoring the impact of the taxes through the development of price and volume indicators, based on publicly available data, as well as health outcomes indicators.

IntroductionThe Global Financing Facility (GFF) was launched to accelerate progress towards the Sustainable Development Goals (SDGs) through scaled and sustainable financing for Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition (RMNCAH-N) outcomes. Our objective was to estimate the potential impact of increased resources available to improve RMNCAH-N outcomes, from expanding and scaling up GFF support in 50 high-burden countries.MethodsThe potential impact of GFF was estimated for the period 2017–2030. First, two scenarios were constructed to reflect conservative and ambitious assumptions around resources that could be mobilised by the GFF model, based on GFF Trust Fund resources of US$2.6  billion. Next, GFF impact was estimated by scaling up coverage of prioritised RMNCAH-N interventions under these resource scenarios. Resource availability was projected using an Excel-based model and health impacts and costs were estimated using the Lives Saved Tool (V.5.69 b9).ResultsWe estimate that the GFF partnership could collectively mobilise US$50–75  billion of additional funds for expanding delivery of life-saving health and nutrition interventions to reach coverage of at least 70% for most interventions by 2030. This could avert 34.7  million deaths—including preventable deaths of mothers, newborns, children and stillbirths—compared with flatlined coverage, or 12.4  million deaths compared with continuation of historic trends. Under-five and neonatal mortality rates are estimated to decrease by 35% and 34%, respectively, and stillbirths by 33%.ConclusionThe GFF partnership through country- contextualised prioritisation and innovative financing could go a long way in increasing spending on RMNCAH-N and closing the existing resource gap. Although not all countries will reach the SDGs by relying on gains from the GFF platform alone, the GFF provides countries with an opportunity to significantly improve RMNCAH-N outcomes through achievable, well-directed changes in resource allocation.

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