Financial innovation is a key, underused tool that can be mustered to strengthen humanitarian outreach in crisis settings, while also strengthening public health systems over the long term, according to a new report published by The Geneva Health Forum.

“New sources of financing are developing, breaking with the traditional vision of charitable action financed by grants from humanitarian agencies and fundraising,” the report states. 

“Blending funds, implementing insurance systems, micro-levies and ‘sin’ taxes, regionalizing production, volume guarantees, co-investing and co-pay mechanisms, derisking, and the variability of licensing systems are all avenues worth exploring.” 

The report was the product of a GHF-organized event at the Geneva AidEx conference in October 2025 – an international gathering focused on humanitarian aid, disaster response, and development innovation. 

The session brought together a select group of health leaders to examine how alternative financial tools can help bridge the gap between emergency response and health system strengthening in developing countries.

The panel featuring experts from the global public and private sectors, reflected a cross-section of public, philanthropic, and market-shaping perspectives.

Rethinking financial innovation in fragile contexts

“Faced with major turbulence in humanitarian aid, with a sharp decline in traditional funding, there is an urgent need to rethink economic models to strengthen the sustainability of health systems in fragile and low-resource contexts,” said Bridie Layden, senior director of The END Fund and moderator of the panel discussion that forms the backbone of the report. 

A “collaborative philanthropic fund”, The End Fund recruits private capital to support innovative programmes fighting Neglected Tropical Diseases (NTDs). 

Layden cautioned against treating innovation as an end in itself: “The term innovation remains vague,” she warned. “What we really want to explore …is how certain financial tools can help us bridge the gap between emergency humanitarian response and the building of sustainable health systems.”

Clarifying what ‘innovation’ really means

Innovative financing tools push beyond traditional grants provided by bilateral donors, NGOs and philanthropies. They range from blended funds and insurance models to micro-levies and co-investment mechanisms. Innovative finance can be particularly meaningful in  offering, for instance: 

• Liquidity to health systems for urgent needs when donor funds are promised – but not yet tangibly available.  
• Insurance schemes that derisk private sector production of needed health products – ensuring more rapid response in times of need.  
• Seed capital in the form of low-interest loans, equity, or guarantees for investments in new product development and health infrastructure that can both directly improve systems as well as leveraging more investments from the private sector.  

The report showcases good practice examples of such innovative tools aired at the panel. It emphasizes adapting and scaling proven mechanisms rather than introducing complexity for its own sake.

Gavi financial facility provides ready cash for vaccine procurement  

One such model is Gavi, the Vaccine Alliance’s International Finance Facility for Immunization (IFFIm). 

The Finance Facility  “transforms future commitments from public donors into immediately available liquidity,” in the words of Jack Nichols, Gavi senior legal counsel.

“Financial innovation is based on how it advances our mission, not on the novelty of the structure,” he added.

The mechanism was created in 2006 by Gavi to streamline the rollout of vaccination programmes in the more than 90 low-and-middle income countries worldwide that receive Gavi support. 

Effectively, IFFIm issues “vaccine bonds” on international markets and investors buy the bonds, providing immediate funds. The money thus raised are transferred to Gavi, allowing it to fund the purchase and distribution of vaccines according to a systematic timetable. Later, when government pledges arrive, they are used to repay investors with interest.

The IFFIm is, in short, “a mechanism for making an organization’s liquidity available to meet needs at the right time,” said Nichols. 

Insurance de-risks private sector production scale-up

MedAccess offers an example of another critical niche instrument – insurance for the rollout or scale up of new health products. 

The non-profit organization protects private sector manufacturers against the risk of low sales and market slack, enabling them to scale up production of critical medicines and diagnostics in settings where product demand is not yet well defined.   

By enabling more production at scale at a faster pace, the scheme also helps keep prices down and expand access to medical innovations, said Jonathan Hutchins, CEO of MedAccess. He described how MedAccess work to de risk the rapid rollout of new generation BASF bednets and highly sensitive HIV diagnostics such as the Hologic HIV assay yielded savings of $35 million and $45 million respectively.  

And in seven years of operation, MedAccess has provided 15 insurance guarantees without any ever needing to be called in for payment. 

“The idea is to use public money more imaginatively, to unleash the potential of the private sector to achieve impact,” Hutchins said. 

Micro-levies and seed finance to catalyze stronger health infrastructure

MedAccess is just one example of a project initially funded by British International Investment, the UK’s development finance company responsible for investing in low- and middle-income countries.  

BII invests capital in the form of loans, equity, or guarantees in private companies and public infrastructure projects that alleviate poverty and yield economic benefits in emerging economies. And that includes infrastructure for health facilities as well as the energy, water and laboratory systems that support operations.  

By de-risking investments, the capital also helps mobilize additional private finance to amplify impacts. 

Another tactic, a micro-levy on airline tickets, led to the creation of UNITAID in 2006 and has sustained its core funding for nearly two decades.  

The solidarity tax on airline tickets, implemented by Brazil, Chile, France, Norway and the United Kingdom, is collected by national treasuries and then transferred to UNITAID. 

It has proved to be a stable and predictable source of revenue with a low cost of collection. 

UNITAID, in turn, has become an innovator in the testing of new and innovative health products, and in their subsequent procurement and scale up. Over the past two decades, UNITAID has partnered with both the private sector and global health agencies like WHO and UNICEF to roll out or expand access to some 100 new innovations – all lifesaving health products that together reach over 320 million people every year. 

Most of all, UNITAID operates as a vital link between the world of pharma innovation and developing countries that to facilitate market access to cheaper, more accessible, and easier to deliver health products, says Matthew Lindley Senior Resource Mobilization Manager, Unitaid. 

“Timetables and performance indicators between donors, institutions, and investors are rarely aligned and often diverge, and that’s when friction and delays arise,” he noted at the AIDEX event. 

Evaluation of impacts

Along with the schemes themselves, impact evaluation is a critical lubricant for the innovation ecosystem. Systematic assessment of the impacts using defined metrics can make new medicines and devices more “readable” and stimulate capital inputs from the private sector and mainstream investors.  

“Local innovation exists, but it doesn’t connect with capital: our role is to build this bridge,” said Carolina Batista, head of Global Health Affairs at the Swiss-based Baraka Impact Finance. The firm provides purpose-built analytical tools to investors assess the potential financial and market impact of new health products – and estimate future yields. 

Baraka also works with health product entrepreneurs to define key performance indicators (KPIs) that reflect the social and financial value of new medicines and devices they have created. These KPIs demonstrate how each dollar invested produces both a measurable social return and a lasting impact on local healthcare systems. 

Building a shared language across sectors

Along with the successes, many barriers remain. Panelists highlighted the operational challenges of deploying innovative finance in the health sector, with its wide diversity of stakeholders and actors. 

“Timetables and performance indicators between donors, institutions, and investors are rarely aligned and often diverge, and that’s when friction and delays arise,” UNITAID’s Lindley observed. 

The underlines the need to build active collaborations and mutual trust between finance and health communities.

Layden, as moderator, summed it up saying: “The challenge is not necessarily to create financial tools, but to adapt and learn from existing ones, and build a common language between finance and health.”

Added Hutchins: “The idea is to use public money more imaginatively, to unleash the potential of the private sector to achieve impact.”

The report also emphasized the importance of local leadership and inclusion, noting that: “including local stakeholders from the project design stage is essential to ‘decolonizing’ health finance.”

The report concludes with ten key messages that frame both the potential and the limits of innovative finance in global health. Among those, three stand out:

• Innovative financing can complement, but not replace, official development assistance:
• Financial innovation is only valuable if it strengthens the public health mission and equity. 

And finally, “trust between stakeholders — donors, investors, and local partners — is as valuable as financing itself.”

First in a series on current issues in global health, published in collaboration with the Geneva Health Forum. Upcoming next week: Unlocking private sector engagement to build resilient health systems. 

Image Credits: WHO/L. Mackenzie , Geneva Health Forum , Geneva Health Forum.