Since the launch of the OECD Joint Network of Senior Budget and Health Officials in 2011, health systems have been confronted with a range of challenges that put increasing pressure on public budgets for health. New challenges are ahead that will affect the funding available for health systems, and in the words of some analysts, we could be entering a period of ‘permacrisis’.

This context underlines the need for health systems to be better prepared and to find the funds necessary to strengthen resilience whilst maintaining fiscal sustainability. An essential building block in this regard is applying a robust budgetary framework for health. Such a framework should meet several key objectives, notably safeguarding the fiscal sustainability of health systems, promoting the efficient use of resources, whilst delivering high quality and equitable health services that are accessible to all.

This publication shows that good budgeting practices are a cornerstone of well-functioning health systems. They are a precious instrument for public authorities to retain control and stewardship over expenditure whilst respecting health policy objectives.

The analysis is not purely theoretical. Rather, it is based on an exchange of policy experiences during the meetings and workshops of this OECD Joint Network. In that sense, this publication should be seen as the product of a co-creation process between the participants of the OECD Joint Network and the OECD staff, built on a constructive communication between health and finance officials of member states as well as the OECD staff.


Jo De Cock,

Chair of the OECD Joint Network of Senior Budget and Health Officials

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