The key to advancing towards universal health coverage (UHC) for most lower-middle income countries is often health financing. This is the case with Timor-Leste, a nation confronting its post-COVID-19 era health challenges and looking to chart a way to stronger, more efficient, and more equitable health financing that can provide quality health services for its population.
In July 2025, Timor-Leste’s Ministry of Health, Ministry of Finance, and the World Bank organized the Health Financing for Universal Health Coverage in Timor-Leste: A Learning and Sharing Forum in Dili. Senior government officials, development partners, civil society, and technical experts came together to consider improving the efficiency of health spending, expanding fiscal space through better domestic resource mobilization, addressing critical shortages in medical specialists, and strengthening service delivery at both primary and secondary levels.
Aligning health and funding
“A key takeaway for me was the critical need to align health sector priorities with the national budgeting framework. We are now actively exploring ways to incorporate performance-based budgeting principles into next year’s health funding allocations,” Elson Martinho da Costa, National Director of Management Efficacy and External Mobilization, Ministry of Finance, said about the forum.
Indeed, this is what Timor-Leste must do to progress towards UHC—ensuring the country’s health systems are supported by systematic budgeting that will sustain efforts to achieve all its health priorities.
“The forum significantly enhanced our understanding of how health financing interlinks with broader fiscal management. I realized that boosting efficiency in health expenditure is not solely about increasing funds but fundamentally about ensuring every dollar effectively benefits our citizens,” Mr da Costa said.
New analytics were the jumping points
Jobs are at the heart of the World Bank’s development mission today, and healthcare is one of five sectors identified as having the greatest potential for in-country job creation. Discussions during the various forum sessions were based on the findings of four new analytical reports developed by the World Bank with support from the Australian government. These reports covered public financial management for health, health expenditure efficiency, human resources for health, and service delivery indicators.
“I value the insights on expanding fiscal space for health. The forum emphasized that sustainable financing must rely on improved domestic resource mobilization and smarter spending strategies rather than solely on external assistance,” Mr da Costa noted.
He added: “The discussions highlighted that improving health outcomes demands close coordination between the finance and health sectors. Moving forward, our ministry (finance) will strengthen partnerships with the Ministry of Health to improve budget execution and enhance accountability.”
