Urgent calls for debt relief as governments are forced to cut health and education funding by UNICEF, OHCHR, Columbia University, agencies 4:06pm 28th Jul, 2026   July 2026    The Debt Crisis is undermining the Right to Education    The Global South is being forced to choose creditors over children, highlights Ilan Kapoor, Professor of Critical Development Studies at York University, Toronto.    "The world claims to regard education as a universal right. Its financial system tells a different story. ⁠New figures released by UNESCO show that 113 countries with a total population of 6.1 billion now spend more on servicing debt than educating their people.    In low-income countries, debt payments are nearly four times education expenditure. In 18 of the most heavily indebted countries, governments spend at least five times more on debt than on education.    These are not merely signs of strained public finances. They reveal a stark political hierarchy.    Creditors possess enforceable claims on government revenues. Children possess declarations, development goals and promises. When the two collide, creditors are paid first.    The consequences are visible in overcrowded classrooms, deteriorating school buildings, teacher shortages, unaffordable school fees and children leaving education prematurely. Yet these outcomes are generally described as funding gaps or failures of domestic governance, as though governments had freely decided to neglect their schools.    In reality, many governments are operating inside an international financial order that sharply restricts what they can choose.    The ⁠World Bank reports that developing countries transferred $741bn more to external creditors in principal and interest between 2022 and 2024 than they received in new financing. This was the largest net debt outflow in at least 50 years. In 2024 alone, low and middle-income countries paid a record $415bn in interest.    In other words, the financial flows are frequently moving in the opposite direction from the one suggested by the language of development assistance.    Poorer countries are commonly portrayed as beneficiaries of Western generosity. But vast amounts of public wealth are travelling from debtor countries to bondholders, commercial banks, multilateral institutions and wealthier creditor governments.    Money that could hire teachers, provide school meals or build classrooms is instead leaving the country.    This is particularly perverse because education is not simply another item of government consumption. It is an investment in a society’s future capacities. Cutting it may make debt payments easier today, but it will weaken productivity, public revenues and social resilience tomorrow.    Debt contracts are treated as binding obligations whose breach can trigger credit downgrades, capital flight, lawsuits and exclusion from financial markets. The right to education, by contrast, carries no comparable machinery of enforcement.    No ratings agency downgrades creditors when a country cannot afford enough teachers. No financial penalty is imposed on bondholders when debt service forces children out of school. Markets do not panic when classrooms collapse.    The system disciplines governments for failing creditors, not for failing children.    UNESCO has proposed expanding debt-for-education swaps. Under these arrangements, a creditor cancels or restructures part of a country’s debt in exchange for government investment in agreed educational programmes.    Such initiatives can produce tangible gains. A 2023 agreement with France helped Ivory Coast finance more than 30 schools in underserved areas. A German agreement with Egypt supported school feeding and basic services, while an earlier Spain-Peru programme funded education projects across vulnerable regions.    These programmes are worthwhile. But they are not a solution to the larger debt crisis. Debt swaps typically cover only a small fraction of what countries owe. They are negotiated selectively, depend on creditor consent and may add new layers of external monitoring to domestic spending.    Most importantly, they leave untouched the principle that creditors are entitled to repayment unless they voluntarily concede otherwise.    The question becomes how to persuade creditors to permit a little more education, rather than why the claims of creditors should take priority in the first place.    That question is especially urgent because education aid is also falling. UNESCO projects that international assistance for education could decline by as much as 30 percent between 2023 and 2027.    Debtor countries are therefore being squeezed from both sides: aid is retreating while debt payments continue.    The familiar recommendation that developing countries should mobilise more domestic resources is inadequate. Progressive taxation and reduced corruption matter. But additional revenues will not transform education systems if they are immediately diverted towards debts contracted at high interest rates, or made more expensive by currency depreciation.    Nor can the problem be solved by demanding ever more austerity. Education budgets consist largely of recurring expenditure, especially teachers’ salaries.    When governments are instructed to freeze public-sector wage bills, they cannot solve teacher shortages or expand access, however often international institutions proclaim education a priority.    A more serious response would begin with large-scale debt cancellation for countries in distress, automatic suspension of payments during economic and climate emergencies, far cheaper concessional financing and a fair multilateral mechanism for restructuring sovereign debt.    At present, debt negotiations are fragmented among private creditors, bilateral lenders and international institutions. Debtor governments must bargain with powerful financial actors while trying to avoid being punished for seeking relief.    A binding United Nations framework for sovereign debt could establish shared rules, require both borrowers and lenders to act responsibly and prevent holdout creditors from obstructing restructuring. It could also make social rights central to assessments of what a country can genuinely afford to repay.    The world needs to move towards the idea that debt repayment cannot come at any human cost. A debt is not sustainable when paying it requires dismantling the institutions on which a society’s future depends".    http://www.unesco.org/en/articles/transforming-education-summit-unesco-mobilizes-leaders-113-countries-spend-more-debt-payments http://www.unesco.org/gem-report/en/aid-education http://giescr.org/en/our-work/on-the-ground/we-join-civil-society-submission-to-un-special-rapporteur-on-debt-crisis-undermining-the-right-to-education    June 2026    Breaking Barriers: Understanding Educational Exclusion in Crises – Global estimates 2026    The latest global estimates from Education Cannot Wait (ECW) reveal that 258 million school-aged children and adolescents across 87 countries have their education affected by crises. Of these, 93 million are entirely out of school, while millions more remain enrolled but struggle to learn under conditions that undermine their progress and increase their risk of dropping out.    The report provides new evidence on where needs are greatest, who is being left behind and the barriers preventing children from accessing and completing their education. It finds that educational exclusion is highly concentrated, with 182 million crisis-affected children – including 74 million out-of-school children – living in the world's 20 most severe crisis contexts.    Drawing on the latest available data, the report highlights the urgent need to invest not only in access to education, but also in foundational learning, retention and progression. Without decisive action, learning losses will continue to deepen, putting an entire generation at risk.    http://www.educationcannotwait.org/resource-library/breaking-barriers-understanding-educational-exclusion-in-crises-global-estimates http://www.thenewhumanitarian.org/opinion/2025/11/24/aid-cuts-kids-caretakers-are-clear-about-what-save-education http://www.unicef.org/press-releases/global-funding-cuts-could-force-6-million-more-children-out-school-coming-year http://giescr.org/en/our-work/on-the-ground/we-joined-over-190-organisations-in-global-call-to-protect-education-financing http://www.ei-ie.org/en/item/32736:funding-the-future-education-unions-students-and-civil-society-mobilise-to-boost-global-education-financing http://www.ei-ie.org/en/item/32765:privatisation-threatens-young-childrens-rights-unions-and-partners-call-for-urgent-public-investment-in-early-childhood-education    http://www.ohchr.org/en/statements-and-speeches/2025/09/dhc-al-nashif-open-ended-intergovernmental-working-group-optional http://campaignforeducation.org/focus-area/financing-education/ http://www.cesr.org/financing-the-right-to-education-for-peace-equality-and-a-rightsbased-economy http://www.sos-childrensvillages.org/news/education-day2025 http://www.unhcr.org/what-we-do/build-better-futures/education http://www.warchild.net/intervention-cwtl/ http://plan-international.org/publications/still-we-dream/ http://www.unicef.org/press-releases/nearly-quarter-billion-childrens-schooling-was-disrupted-climate-crises-2024-unicef http://www.unicef.org/press-releases/not-new-normal-2024-one-worst-years-unicefs-history-children-conflict http://www.prio.org/comments/1152    June 2026    UNICEF Executive Director Catherine Russell remarks at the Annual Session of the UNICEF Executive Board. (Extract):    "I’d like to highlight an issue that has deeply concerning implications for whether children can realize their right to essential services and care – the fiscal burden of servicing huge and unsustainable debt.    “Today, nearly 400 million children live in countries where debt burdens are outpacing investment in health, education, and nutrition. In 37 countries, home to approximately 1.1 billion children, governments now spend more servicing debt than they do on health. This means less available resources for children’s vaccines, medicine, and primary health care.    “The consequences are profound. These countries account for an estimated 3.2 million under-five deaths, and 96 million stunted children each year.    “In other words, children are suffering and dying because their governments are spending increasingly high levels of their revenue to service their debts – resources that could otherwise be used on essential services.    “How the world responds to this debt crisis is one of the most consequential questions for children everywhere. The choices made now – on debt restructuring, on fiscal space, on what gets protected, and what gets cut – will shape the trajectory of an entire generation.    “Three decades ago, we saw some success in debt reduction. Debt relief initiatives helped create fiscal space for investments in child survival, education, and development. This created a fresh start for some fragile states. However, many countries eventually experienced a return to the high risk of debt distress due to global commodity price drops, climate shocks, and new borrowing.    “Debt sustainability is often discussed in financial terms. But for children, it is ultimately about whether schools remain open, whether health workers are paid, whether nutrition programmes continue, and whether governments can invest in the next generation.    “In this sense, debt is not only a financial issue. It is a child-rights issue. And protecting children's rights requires protecting investments in children.    “UNICEF will continue to work with governments, international financial institutions, development banks, and partners – including the Vatican – to ensure that children remain at the center of the conversation on debt restructuring, fiscal policy, and development financing."    http://www.unicef.org/press-releases/unicef-executive-director-catherine-russell-remarks-annual-session-unicef-executive    May 2026    Cutting debt servicing costs for the world’s poorest countries could free up $900bn a year for development, a new report to the UN secretary general outlines.    Prepared by advocacy group Development Finance International (DFI), the analysis warned that the world is facing “the worst ever debt-provoked development crisis”.    The G77 developing countries spend a total of $8tn a year servicing their debts, the report showed – equating to an average of 35% of government spending. Six billion people are living in countries where spending on debt service is higher than the annual health budget.    The UN secretary general, Antonio Guterres, has previously called for global action on debt relief to free up resources to spend on meeting the sustainable development goals (SDGs). Specifically, he suggested debt restructuring for the hardest-hit countries; and halving borrowing costs for countries that need to borrow from financial markets.    In the new report, based on data from the International Monetary Fund (IMF), DFI modelled, country-by-country, the benefits of implementing such a plan.    In total, it found that halving borrowing costs for the 33 countries paying the highest interest rates, plus reducing repayments to 10% of government revenue for others – including those regularly hit by climate crises – could free up as much as $3tn a year to be spent on development.    What it suggests may be a more realistic plan, which excludes wealthier developing countries such as China, could still free up $917bn a year – allowing countries to more than double their social spending.    On average, the savings would be worth 9% of annual GDP for beneficiary countries. “If the international community can deliver comprehensive debt relief to countries which need it, and reduce the debt service burdens of many more, it will provide the fiscal space needed to fund the current SDGs,” the report said, adding, “the question is whether the world will find the political will to achieve these objectives, and relieve the suffering of billions of the world’s citizens.”    The report showed that the burden on developing countries is now greater than in the run-up to the Make Poverty History campaign in 2005, when    the UK government used its leadership of the G8 summit in Gleneagles to secure pledges of debt relief.    Today’s situation is more complex, with less direct bilateral lending from governments, and more private sector lending.    The IMF warned recently that the growing significance of private sector investors such as hedge funds as lenders puts developing countries at greater risk of higher interest rates and currency shocks – including as a result of the ongoing conflict in the Middle East.    These inflows of finance, “tend to be more volatile than bank flows and are increasingly sensitive to global risk conditions”, the IMF warned.    Higher borrowing costs as a result of the Iran war, which has restricted oil supplies and pushed up inflation, are expected to increase the burden on developing countries in the coming months.    Max Lawson, head of inequality policy at Oxfam, said: “Why should paying debts to rich bankers in London or New York be more important than feeding hungry people or getting kids in school? Global south governments were already on their knees, and are now facing a huge new food crisis caused by the Iran war. They need massive debt relief and they need it now.”    http://www.development-finance.org/en/news/894-5-may-oslo-debt-relief-could-allow-g77-to-double-social-climate-nature-spending http://www.theguardian.com/global-development/2026/may/06/cut-borrowing-costs-for-poorer-countries-to-free-up-900bn-for-development-report http://blogs.lse.ac.uk/inequalities/2026/06/02/does-the-design-of-the-international-monetary-system-sustain-inequality/ http://wir2026.wid.world/insight/exorbitant-privilege/    People in poverty continue to pay the high price of a debt crisis not of their making, by Olivier De Schutter - UN Special Rapporteur on extreme poverty and human rights:    The international financial system is failing to address the catastrophic debt crisis that is engulfing developing countries and causing misery for hundreds of millions of people, the UN’s poverty expert said today.    “The debt crisis is not just a fiscal issue; it is a full-blown human rights crisis,” said the UN Special Rapporteur on extreme poverty and human rights, Olivier De Schutter, on the International Day for the Eradication of Poverty.    “In the poorest countries of the world people are struggling to eat, access health services or send their children to school, while their governments shell out billions of dollars to pay back loans to wealthy creditors.    “Making a bad situation worse, countries with the highest levels of debt also tend to be those most vulnerable to climate change, but are being forced to prioritise debt repayments over addressing the severe consequences of the climate crisis.”    The expert warned that rocketing interest rates since the Covid-19 pandemic were sinking countries in the Global South further into debt.    In 2023, a record 54 developing countries allocated 10% or more of government revenue to paying off the interest on their debt, leaving “little room for countries to spend on poverty-busting public services such as education or social protection”. 3.3 billion people live in countries that spend more on interest payments than on either education or health. Interest rates demanded from developing countries are also much higher than those paid by rich countries. African countries borrow money at almost four times the rate paid by the United States, despite the astronomical level of US debt.    “This perverse scenario has been playing out in the Global South for years, accelerating the freefall into poverty seen since the pandemic,” De Schutter said.    “Creditors have responded too little, too late. The G20’s ‘Common Framework’, agreed in 2020 to bring international financing institutions (IFIs), individual states and private lenders together to speed up debt restructuring, is simply not working.”    De Schutter called for immediate debt relief for countries in crisis and urgent reform of the international financial system to align with human rights.    “Banks and hedge funds have become huge players in the world of sovereign debt and should not be exempt from their human rights responsibilities. It is abhorrent that debt repayments to the world’s richest corporations are being paid at the expense of children’s education or healthcare. Governments must introduce legislation to compel private creditors under their jurisdiction to participate in debt relief for low income countries.    “Comprehensive reform of the international financial architecture, as advocated by the recently agreed Pact of the Future, is also needed. The current system within the IFIs, characterised by unequal representation between high and low-income countries, unfavourable lending conditions, and unfair debt restructuring is trapping too many countries in a cycle of poverty.”    The Special Rapporteur lamented the conditions attached to bailout packages from IFIs which, with their demands for austerity measures, sale of state assets and, at times, surcharges already denounced by UN human rights experts, make it near impossible for states to comply with their human rights obligations and lock countries into unsustainable growth patterns that have only worsened poverty and inequality.    “With Pakistan recently agreeing to its 24th bailout from the International Monetary Fund, which hinged on the country accepting what the Prime Minister called ‘conditions beyond imagination’, it is clear that people in poverty will continue to pay the high price of a debt crisis that is not of their making,” the expert said.    “The solution to the debt crisis is neither to stimulate economic growth at all costs, nor to impose austerity policies. It is to cancel or restructure debt, and to focus on public investment, particularly in social protection, that will restore the prospect of long-term prosperity.”    Global financial architecture needs urgent reform to uphold equality and human rights    The global financial system must be rebuilt on the principles of equality, solidarity, and human dignity that underpin the United Nations Charter, a UN expert told the UN General Assembly.    The Independent Expert on the promotion of a democratic and equitable international order, George Katrougalos, presented his report to Member States, calling for bold and comprehensive reforms to create a fairer and more inclusive financial architecture.    The expert underlined that the current system continues to reflect the disproportionate influence of the global North. Katrougalos said that the report is not about assigning blame but about promoting reforms for fairer and more inclusive global financial governance, through open and forward-looking dialogue.    “Although international financial institutions claim neutrality, their policies prioritise market liberalisation, deregulation, and fiscal discipline over social equity,” he noted.    “They directly affect how much a country can invest in education, health, and social protection, and how it can respond to crises while maintaining its dignity and independence,” the expert said, warning that austerity and structural adjustment policies have often weakened labour protections, curtailed access to public services, and eroded democratic participation.    The expert underscored that economic policy cannot be treated as neutral or detached from human rights obligations. Financial institutions, as specialised intergovernmental organisations, are bound by the UN Charter and international law, including universal human rights treaties.    Yet, despite frequent references to human rights, climate action, or social inclusion in policy statements, these commitments rarely result in binding measures or transparent accountability.    He noted that, in 2023, developing countries transferred an estimated US$ 263 billion to the wealthiest 1 percent in the global North, while many low- and middle-income countries devoted nearly half of their national budgets to servicing external debt.    The report calls for a realignment of the Bretton Woods institutions around democratised governance, stronger accountability, and the integration of human rights into all aspects of financial decision-making. It urges the General Assembly to seek an International Court of Justice advisory opinion on the legal obligations of the International Monetary Fund and the World Bank to respect fundamental human rights.    Katrougalos said reform is both urgent and possible. “A democratic and equitable international order is not merely an aspiration but an obligation,” he said. “Only by placing people before profit and dignity before debt can we build a fairer, more sustainable global economy.”    http://www.ohchr.org/en/press-releases/2025/10/global-financial-architecture-needs-urgent-reform-uphold-equality-and-human http://www.srpoverty.org/2024/10/17/statement-international-financial-system-not-fit-for-purpose-to-address-catastrophic-debt-crisis-un-poverty-expert/ http://www.ohchr.org/en/documents/thematic-reports/a79142-report-independent-expert-effects-foreign-debt-and-other-related http://www.ohchr.org/en/special-procedures/ie-foreign-debt/annual-thematic-reports http://www.undp.org/press-releases/development-gains-reverse-high-debt-servicing-bears-disproportionate-impacts-women-55-million-jobs-risk http://www.lse.ac.uk/granthaminstitute/news/overlooking-nature-is-no-longer-an-option-for-fiscal-policy-and-debt-sustainability-analyses http://www.ohchr.org/en/statements-and-speeches/2025/02/asg-brands-kehris-current-international-debt-architecture-unfair    http://www.ohchr.org/en/press-releases/2025/02/fair-and-effective-tax-policies-needed-advance-economic-social-and-cultural http://www.cesr.org/leading-voices-call-for-a-new-development-human-rights-centered-approach-to-sovereign-debt-at-paper-series-launch/ http://iej.org.za/category/resourcing-for-rights-realisation/resourcing-for-rights-realisation_debt-justice/ http://www.ipsnews.net/2025/01/developing-countries-choked-debt-year-breaking-free/ http://debtjustice.org.uk/press-release/lower-income-country-debt-payments-hit-highest-level-in-30-years http://debtjustice.org.uk/news http://cafod.org.uk/campaign/the-new-debt-crisis http://tinyurl.com/y45jmkdd http://www.eurodad.org/g20_imf_world_bank_fail_debt_crisis    Oct. 2025    Urgent calls for debt relief as study shows health and education cuts in developing world    Top economists are demanding urgent action on debt relief in Washington this week, as analysis from the campaign group Debt Justice shows struggling governments are cutting back on health and education.    As finance ministers and central bankers gather for the International Monetary Fund (IMF) and World Bank annual meetings, influential experts including the Nobel laureate Joseph Stiglitz, and leading economists Mariana Mazzucato and Jayati Ghosh, are urging them to “turn debt into hope”.    They are calling for the urgent replenishment of the IMF and World Bank’s debt relief funds, and changes to the way the institutions work, to ensure more countries can receive debt cancellation.    “Bold action on debt means more children in classrooms, more nurses in hospitals, more action on climate change, more jobs, more trade, and less need for aid,” they say in a letter to global policymakers published this week.    The signatories, who have been involved in producing important recent reports on debt relief, including for the UN secretary general and the pope, said African governments spend an average of 17% of their revenues on servicing debts.    “A cap of 10% in 21 countries could unlock enough money to provide clean water and sanitation to roughly 10 million people, as well as avert at least 23,000 under-5 deaths each year,” they argue.    Other signatories to the letter include the former South African finance minister Trevor Manuel, and former Italian prime minister Paulo Gentiloni.    Analysis by the UK-based Debt Justice shows declining health and education spending in countries whose debts the IMF considers to be “sustainable”.    Debt Justice looked at a group of 11 countries, including Sierra Leone, Mozambique, Kenya and Pakistan, which have long-term IMF programmes, and where the Washington-based lender classifies them as at risk of not being able to repay – but that do not qualify for debt relief.    The research finds that over the course of their IMF programmes, health spending per person in this group of countries has been cut by 18% on average in real terms with education spending reduced by 10%.    Heidi Chow, the executive director of Debt Justice, said: “By denying debt relief for countries that need it, the IMF is acting as a debt collector for rich and powerful creditors, while harming millions of people in debtor countries. Forcing countries to pay debts in full is leading to deepening crises in health, education and vital public services.”    Debt Justice is calling on the IMF to review how it decides when countries are entitled to debt relief, and assess the impact of spending cuts on development goals.    http://debtjustice.org.uk/press-release/imf-denials-of-debt-relief-triggering-drastic-health-and-education-spending-cuts-in-lower-income-countries http://data.one.org/2025-debt-open-letter    June 2025 (Columbia University-Initiative for Policy Dialogue, Caritas)    A new report by world-leading experts on debt and development calls for urgent action and systemic reforms to tackle the escalating debt and development crises affecting billions worldwide.    “The Jubilee Report: A Blueprint for Tackling the Debt and Development Crises and Creating the Financial Foundations for a Sustainable People-Centered Global Economy,” is authored by Pope Francis’ Jubilee Commission — a group of over 30 leading global experts led by Nobel laureate and Columbia University Professor Joseph Stiglitz and Columbia University School of International and Public Affairs Professor Martín Guzman.    The report follows Pope Francis’ repeated calls for global debt relief, which are now being carried forward by Pope Leo XIV, and brings together for the first time a combination of sound economic expertise with the moral responsibility to act.    The report powerfully shows that the debt crisis plaguing our global financial system is also fueling a development crisis. Fifty-four developing countries now spend 10% or more of their tax revenues just on interest payments.    Across the developing world, average interest burdens have nearly doubled in the past decade. This diverts resources away from essential investments in health, education, infrastructure, and climate resilience -depriving millions of life-saving care, nutrition and employment. This does not have to be the case: Solutions exist that are both economically sound and beneficial to all.    As global market uncertainty grows and refinancing options diminish for debt-distressed nations, this report charts a bold and practical path forward, arguing that, through shared responsibility we can avoid a lost decade for development and climate action and instead support economic recovery and long-term development.    The report presents a moral and practical vision: that global finance should serve people and the planet — not punish the poor to protect profits.    http://ipdcolumbia.org/publication/jubilee-debt-development-blueprint/ http://www.caritas.org/2025/06/why-the-jubilee-report-calls-for-a-rethink-of-global-debt/ http://ipdcolumbia.org/wp-content/uploads/2025/06/Jubilee-Report-7.17.pdf http://www.caritas.org/2025/07/church-groups-say-more-action-needed-on-global-debt-crisis/ http://www.oxfam.org/en/research/private-profit-public-power-financing-development-not-oligarchy    June 2025    United Nations Secretary-General launches report to break “the cycle of debt distress”. (UN News)    The United Nations Secretary-General has presented new recommendations–Confronting the Debt Crisis: 11 Actions to Unlock Sustainable Financing–that aim to break the cycle of debt distress and lay the foundation for unlocking long-term, affordable financing that supports sustainable development.    With two-thirds of low-income countries now at high risk of—or already in—debt distress, the report highlights a growing crisis: soaring debt service costs are crowding out vital investments in education, health, and climate resilience.    “The current global debt system is unsustainable, unfair and unaffordable, with many governments spending more on debt payments than on essentials like health and education combined,” said the Secretary-General. “These 11 immediately actionable proposals can help resolve the debt crisis, empower borrower countries, and create a fairer system.”    Prepared by the UN Secretary-General’s Expert Group on Debt, the report reinforces the commitments put forward in the FfD4 Outcome Document and makes the case that an end to the debt crisis is entirely feasible—if opportunities are seized.    http://www.un.org/sustainabledevelopment/blog/2025/06/ffd4-press-release-sg-report-2025 http://news.un.org/en/story/2025/06/1165051 http://unctad.org/publication/world-of-debt http://www.ohchr.org/en/special-procedures/ie-foreign-debt/annual-thematic-reports    Mar. 2025    Debt crisis threatens progress in the response to AIDS    The significant health progress made over the past decade in Central, Eastern, Southern and West Africa—where many countries were on track to ending their AIDS epidemics—is now at risk of being reversed due to inadequate financing. One of the major causes of the funding shortfall is rising debts.    In 2020, as the Covid-19 pandemic halted economies and overwhelmed emergency rooms, many African countries borrowed from creditors to provide emergency services to their citizens. But four years later, the terms of those loans are forcing governments to make debt payments at the expense of health and other social services. Nearly two thirds of people living with HIV reside in countries that have not received significant debt relief post-Covid.    In West and Central Africa, debt to GDP ratios increased by 9 percent between 2018 and 2023. Countries such as Burkina Faso, Burundi, the Republic of the Congo, Cote d’Ivoire, Ghana, Liberia, Senegal and Sierra Leone have seen significant rises in their debt burden, now reaching at least 15% of GDP.    In East and Southern Africa, the situation is even more dire: in Angola, Kenya, Malawi, Rwanda, Uganda and Zambia, governments spend over 50 percent of their tax revenues on debt servicing. Many of these debts are from external private creditors seeking unreasonable profits – for example, one creditor in Zambia would make a 110 percent profit if the country paid back its debts. (As context, even highly profitable companies like Apple do not have profits that surpass 48 percent.)    Despite Zambia successfully reaching a debt restructuring deal with official creditors, effectively getting some debt relief last year, it’s still slated to pay two-thirds of its budget towards debts over the next two years largely due to not yet reaching a deal with private-creditors.    On the ground, crises are already proliferating; hospitals lack essential medicines and equipment. Labor unions and health activists have rallied across Lusaka demanding debt cancellation.    “Countries are facing life and death decisions,” said Charles Birungi, who leads UNAIDS’ work on macroeconomic and fiscal policy. “Do I pay for hospitals, medicines and education – or do I pay my debt? What if paying my debt means that my hospitals go without drugs?”    Two recent UNAIDS reports focusing on Eastern and Southern Africa and on Western and Central Africa outline that the future of funding for the HIV response in many African countries, as well as broader health and social welfare, rests on innovative measures to ensure governments can invest their own tax revenue for citizens.    “Progress is being made in the fight against HIV in both regions,” said one of the report authors and development finance specialist Gail Hurley. “Of course there were setbacks, including those related to Covid-19, but external funding and strong political commitment has provided a solid foundation to build on. Countries now need partial or even whole scale debt relief in order to achieve global health goals.”    Debt relief is especially critical for countries that want to move away from relying on international donors to finance their HIV responses. In East and Southern Africa, for instance, most HIV financing comes from two donors: the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to fight AIDS, Tuberculosis and Malaria (which is also heavily supported by the US government). But without debt relief, countries cannot invest tax revenue in health systems.    Based on extensive consultation with economists and policy experts, UNAIDS has called for lenders and international institutions to re-negotiate debt payments to comprise at least less than 15 percent of respective countries’ annual budgets.    Such a policy for the heavily indebted countries of Angola, Burundi, Ethiopia, Kenya, Madagascar, Malawi, Mozambique, South Sudan, United Republic of Tanzania, Uganda, Zambia and Zimbabwe would free up $41 billion a year for health, education and social welfare.    The strategy has a precedent: the Heavily Indebted Poor Countries (HIPC) Initiative, launched in 1996 by the IMF and World Bank, aimed to ensure that states did not struggle under an unmanageable debt burden. It took a similar approach and relieved 37 countries of more than $100 billion in debt.    UNAIDS also recommends that governments increase tax revenue through measures like raising the income tax of the ultra-wealthy, wealth taxes, reducing tax exemptions and clamping down on tax-dodging. Amnesty International estimates that Zambia, for example, loses over USD 4.5 billion annually through tax evasion and tax avoidance.    Another option not included in the reports but recommended by UNAIDS’s partner WHO is a ‘health tax’ on products that lead to or exacerbate health issues, including sugary beverages, tobacco and alcohol.    In 2023, WHO called on all countries to increase taxes on alcohol and sugary drinks (and has previously suggested taxes on tobacco). These monies could then be re-invested in health systems.    But UNAIDS cautions that even raising tax revenue will not be enough to address funding gaps unless it goes hand in hand with debt reduction. Without swift changes to enable African governments to invest in health, Birungi fears what the future could hold. “What happens if we wake up tomorrow and the donors are gone?” he asked. “Will we go back to the 80s and 90s when people were dying in massive numbers?”    http://www.unaids.org/en/resources/presscentre/featurestories/2025/march/20250320_debt-crisis http://www.theguardian.com/global-development/2026/jul/21/trumps-hiv-funding-cuts-having-severe-and-devastating-impact-around-the-world http://news.un.org/en/story/2026/07/1168033 http://www.srpoverty.org/2025/01/17/financing-social-protection-floors-contribution-of-the-special-rapporteur-to-ffd4/ http://reliefweb.int/report/world/human-cost-public-sector-cuts-africa-april-2025 http://actionaid.org/publications/2025/human-cost-public-cuts-africa
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