Debt-to-health as a mechanism to expand fiscal space for maternal newborn and child health investments

Despite longstanding global commitments to maternal, newborn, and child health (MNCH), progress remains insufficient to achieve the 2030 Sustainable Development Goals. This paper explores the potential of debt-to-health (D2H) swaps as a mechanism to address financing gaps in MNCH that have been exacerbated by recent reductions in global health funding. Drawing on recent multilateral commitments and historical lessons from debt-for-development swaps, this paper argues that MNCH is uniquely positioned to benefit from such mechanisms due to well-established investment frameworks, political will, and institutional infrastructure. It proposes a model leveraging the Global Financing Facility to facilitate and scale D2H agreements, thereby unlocking fiscal space for national MNCH priorities.