Innovative Financing for Health: What is Truly Innovative?

Atun R, Knaul FM, Akachi Y, Frenk J. Innovative Financing for Health: What is Truly Innovative? Lancet 2012; 380(9858): 2044-49.

Posted: 31 Jan 2013

See all articles by Rifat A. Atun

Rifat A. Atun

Imperial College London

Felicia Knaul

Mexican Health Foundation; Harvard Global Equity Initiative

Yoko Akachi


Julio Frenk

Bill and Melinda Gates Foundation

Date Written: December 8, 2012


Development assistance for health has increased every year between 2000 and 2010, particularly for HIV/AIDS, tuberculosis, and malaria, to reach US$26·66 billion in 2010. The continued global economic crisis means that increased external financing from traditional donors is unlikely in the near term. Hence, new funding has to be sought from innovative financing sources to sustain the gains made in global health, to achieve the health Millennium Development Goals, and to address the emerging burden from non-communicable diseases. We use the value chain approach to conceptualise innovative financing. With this framework, we identify three integrated innovative financing mechanisms — GAVI, Global Fund, and UNITAID — that have reached a global scale. These three financing mechanisms have innovated along each step of the innovative finance value chain — namely resource mobilisation, pooling, channelling, resource allocation, and implementation — and integrated these steps to channel large amounts of funding rapidly to low-income and middle-income countries to address HIV/AIDS, malaria, tuberculosis, and vaccine-preventable diseases. However, resources mobilised from international innovative financing sources are relatively modest compared with donor assistance from traditional sources. Instead, the real innovation has been establishment of new organisational forms as integrated financing mechanisms that link elements of the financing value chain to more effectively and efficiently mobilise, pool, allocate, and channel financial resources to low-income and middle-income countries and to create incentives to improve implementation and performance of national programmes. These mechanisms provide platforms for health funding in the future, especially as efforts to grow innovative financing have faltered. The lessons learnt from these mechanisms can be used to develop and expand innovative financing from international sources to address health needs in low-income and middle-income countries.

Keywords: health, innovative finance, low-income and middle-income countries, health systems

Suggested Citation

Atun, Rifat A. and Knaul, Felicia and Akachi, Yoko and Frenk, Julio, Innovative Financing for Health: What is Truly Innovative? (December 8, 2012). Atun R, Knaul FM, Akachi Y, Frenk J. Innovative Financing for Health: What is Truly Innovative? Lancet 2012; 380(9858): 2044-49.. Available at SSRN:

Rifat A. Atun (Contact Author)

Imperial College London ( email )

South Kensington Campus
London, DC SW7 2AZ
United Kingdom


Felicia Knaul

Mexican Health Foundation ( email )

Periférico sur 4809, El Arenal Tepepan, Tlalpan
El Arenal Tepepan, Tlalpan
Mexico, D.F., 14610
(52) 55 56559011 (Phone)
(52) 55 56559082 (Fax)

HOME PAGE: http://http//

Harvard Global Equity Initiative ( email )

FXB Building, Room 632
651 Huntington Avenue
Boston, MA 02115
United States
(617) 4327938 (Phone)


Yoko Akachi


No Address Available

Julio Frenk

Bill and Melinda Gates Foundation ( email )

P.O. Box 23350
Seattle, WA 98102
United States

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