Global financing for health policy and systems research: a review of funding opportunities

Background: Health Policy and Systems Research is a neglected area in global health financing. Despite repeated calls for greater investment, it seems that there has been little growth. We analysed trends in reported funding and activity between 2015 and 2021 using a novel real-time source of global health data, the Devex.com database, the world's largest source of funding opportunities related to international development. Methods: We performed a systematic search of Devex.com database for HPSR-related terms with a focus on low- and middle-income countries. We included programs, tenders & grants, and contract awards, covering all call statuses (open, closed or forecast). Such funding opportunities were included if they related specifically to HPSR funding or had an HPSR component; pure biomedical funding was excluded. Results: Our findings reveal relative neglect of HPSR, as only approximately 2% of all global health funding calls included a discernible HPSR component. Increases in funding opportunities until 2019 2020. Most identified projects represented small scale opportunities-commonly for consultancies or technical assistance. To the extent that new data were generated, this was either tied to a specific large intervention or was narrow in scope to meet a specific challenge-with many examples informing policy responses to the Covid-19 pandemic. Nearly half of advertised funding opportunities were multi-country, usually addressing global policy priorities like health systems strengthening or development of coordinated public health policies at a regional level. Conclusions: The Covid-19 pandemic has shown why investing in HPSR is more important than ever to enable delivery of effective health interventions and avoid costly implementation failures. The evidence presented here highlights the need to scale up efforts to convince global health funders to institutionalize the inclusion of HPSR components in all funding calls