Lamola tells UN health financing is a test, not an excuse

South Africa has called for stronger protection of health financing for women, children and adolescents, warning that falling development assistance, rising debt and limited fiscal space are threatening hard-won global health gains.

International Relations and Cooperation Minister Ronald Lamola made the call in New York on Tuesday, representing President Cyril Ramaphosa, who chairs the Global Leaders Network. He was speaking at a high-level GLN event on financing for women, children and adolescents’ health during a time of austerity, held on the margins of the 81st United Nations General Assembly.

The event was co-hosted by South Africa, Spain, Tanzania and the Partnership for Maternal, Newborn and Child Health. It brought together political leaders, health ministers, global health leaders and strategic partners to discuss practical, country-led ways to sustain investment in the health of women, children and adolescents.

Lamola said the GLN, a network of 12 sitting heads of state and government, has worked since its launch in 2023 to keep the health of women, children and adolescents high on the political agenda, to help countries turn commitments into action and to protect health financing.

“We recognise that maternal, child and adolescent mortality cannot be reduced without sustained investment,” he said. “We also recognise that universal health coverage and economic development cannot be achieved without protecting the resources for women, children and adolescents’ health.”

He said the global health financing environment has become increasingly difficult, with official development assistance falling by just over 23% in 2025. That decline has placed additional pressure on procurement systems and health workforces in low- and middle-income countries, undermining efforts to ensure equitable access to essential maternal and child health commodities.

“Rising debt burdens and shrinking fiscal space make it harder for countries to adjust to the sudden cuts in official development assistance,” Lamola said.

He pointed to the scale of the wider financing challenge, noting that more than 3,3 billion people now live in countries that spend more on interest payments than on schools and hospitals, with more than 750 million of them in Africa.

Against that backdrop, he said the GLN has pursued an action-oriented agenda focused on closing financing gaps, protecting existing gains and keeping health-related Sustainable Development Goal accelerators alive. This includes a six-part webinar series on domestic resource mobilisation that brought together more than 900 participants from over 40 countries, among them ministries of health and finance, development finance institutions, the private sector, academia and civil society.

Lamola said the discussions showed that countries are willing to explore new approaches to health financing. “We were blown away by the innovations so many of our members had already implemented,” he said.

The GLN also identified underutilised opportunities, including debt-for-health swaps, and highlighted the importance of knowledge exchange between countries.

Lamola said the network has since moved from dialogue to implementation through its Financial Diplomacy Series, which brings ministries of health and finance together with investors and technical partners to develop financing plans for country health programmes. In just five months, four GLN members, Liberia, Kenya, Sierra Leone and South Africa, have developed business cases. Representatives from the four countries met investors and partners in New York on Monday to take those cases further into financing plans.

“This clearly shows the political commitment to support countries to mobilise resources for women, children and adolescents,” Lamola said.

He also highlighted the Public-Private Partnership Health Accelerator, an initiative developed by South Africa and Botswana to help close financing gaps by bringing together the private sector, the diaspora, philanthropies, Southern and global foundations and development partners. The initiative was recognised as an official G20 legacy project during South Africa’s G20 Presidency.

Lamola said it demonstrates the potential for partnerships to mobilise additional resources for health in low- and middle-income countries.

Looking ahead, he said the GLN’s message is both simple and urgent: countries must protect the resources needed to sustain essential health services.

“We cannot protect the health and rights of women, children and adolescents unless we protect the financing that sustains essential services and sexual and reproductive health and rights,” he said.

He called on governments to protect and increase allocations to women’s, children’s and adolescent health and to track expenditure against outcomes. He also urged development partners to align their financing and technical assistance with national plans.

“Together, we can protect essential services, use every available resource more effectively and ensure that women, children and adolescents remain at the centre of health financing decisions.”

World Health Organisation Director-General Dr Tedros Adhanom Ghebreyesus told the gathering that global progress in maternal and child health needs to be protected. He noted that maternal mortality has fallen by 40% over the past 25 years, while child mortality has more than halved. But he warned that progress has slowed and that preventable deaths continue at an unacceptable scale.

“We meet in a time of austerity, but austerity is not an excuse. It’s a test. A policy without a budget is a press release. A commitment without financing is a promise already broken,” Ghebreyesus said.

He called on leaders to protect health spending during periods of fiscal pressure, saying women, children and adolescents should not be first to bear the consequences of funding cuts. He also called for financing for sexual and reproductive health services, particularly in humanitarian settings, and urged governments and partners to show progress through measurable results.

“The measure of our leadership will not be what we pledged in New York. It will be whether the woman in labour tonight sees the morning,” he said.

United Nations Population Fund Executive Director Dr Diene Keita also highlighted the continuing financing gap affecting women’s health, saying millions of women and girls are being affected as official development assistance contracts. She said investment in women and girls generates broad social and economic returns, and welcomed countries taking greater ownership of their health agendas. Keita highlighted efforts to strengthen investment in frontline health workers, including midwives, and called for greater financing for contraception and maternal health services.

The GLN event formed part of South Africa’s high-level programme during UNGA81, as the country continues to advance multilateral cooperation and country-led approaches to development and global health financing.

This report is based on the South African Government News Agency’s account of the event, which is a summary of proceedings rather than a full transcript.

Source: SAnews (South African Government News Agency), South Africa calls for protection of women and children’s health financing