Health System Transformation & Resilience Fund (HSTRF)

Bringing quality care to 1.5 billion people by 2030

Investments in health are one of the most powerful drivers of economic growth and job creation. Health services provide the foundation for stronger societies by enhancing human capital, fueling economies, and creating millions of jobs. Healthy populations are more productive, resilient, and capable of contributing significantly to economic development.

That is why the World Bank Group has set an ambitious goal: to help countries expand health services to 1.5 billion people by 2030. This includes redesigning primary care, scaling national insurance programs, expanding local manufacturing of critical health supplies, supporting regulatory reform, and training healthcare workers-enabling countries to unlock their full economic potential.

The World Bank's Health System Transformation & Resilience Fund (HSTRF) is the World Bank's primary Trust Fund vehicle for achieving the goal and supporting countries to provide quality, affordable health services for 1.5 billion people by 2030.

By pooling contributions from donors and consolidating external financing, the HSTRF reduces duplication and aligns investments with developing countries' national plans so ministries can focus on delivering care. It emphasises country leadership, catalytic and cost-effective financing, streamlined operations and collaboration across sectors.

How HSTRF Works

The HSTRF provides support though three main implentation windows:

The HSTRF brings donor resources for health system transformation and resilience under a single framework, reducing fragmentation among donors, streamlining trust-funded activities with national strategies, and boosting the impact of IDA and IBRD investments by delivering prioritized, integrated, country-tailored solutions.

Regional Priorities

The fund tailors its support to each region:

• In Eastern & Southern Africa (AFE), the COVID-19 pandemic exposed gaps in workforce skills and public health capacity, so the fund focuses on training health workers, strengthening public health institutions, and scaling up innovations through public-private partnerships.
• West & Central Africa (AFW) faces high levels of maternal, newborn and child mortality and vulnerability to epidemics; priorities center on building a high-quality continuum of care for reproductive, maternal, newborn, child and adolescent health and making health systems more resilient to disease outbreaks and climate shocks.
• East Asia & Pacific (EAP) countries juggle a dual burden of infectious and non-communicable diseases while contending with rising climate disasters, so support emphasizes primary-care-centered delivery and climate-resilient, emergency-ready public health architecture.
• In Europe & Central Asia (ECA), ageing populations and high NCD burdens drive efforts to develop long-term care models, bring services closer to people and improve health financing.
• Latin America & the Caribbean (LAC) must tackle extreme inequities, poor access and chronic underfunding; the fund aims to mobilize additional financing, engage the private sector to bridge service gaps and harness digital health innovations.
• Middle East & North Africa (MENA) has some of the world's highest out-of-pocket spending, so priorities involve reforming health financing, taxes and subsidies to create more fiscal space and expand coverage, while strengthening resilience to climate shocks and emergencies.
• The South Asia Region (SAR), home to densely populated settings, focuses on strengthening primary-health-care-based delivery and improving budget efficiency.

Partners

The fund works with a range of partners to mobilize resources and coordinate support. Major donors include Japan, the United Kingdom, the Helmsley Charitable Trust and Switzerland, with pledges nearing US$27 million. Collaboration with initiatives such as the Pandemic Fund, Gavi and the Global Fund ensures that financing for pandemic preparedness, immunization and disease programmes is aligned. A Leaders' Coalition will be convened ahead of the 2025 Universal Health Coverage Forum to champion investment in health.

Results

HSTRF's first year delivered concrete results across its core windows. Tailored regional strategies were developed to guide each region toward expanded health coverage and resilience.

• In Nigeria, one of the world's most climate-vulnerable countries, the fund is weaving climate-smart measures into a new Primary Healthcare Provision Strengthening Program. Clinics and maternity wards are being upgraded to withstand floods and heat waves, community health workers are trained to keep services running during climate shocks, and emergency preparedness plans are being drafted at the national and state levels. These reforms target maternal and child deaths while building resilience.
• In Tanzania, technical assistance and policy dialogue are overhauling the national health insurance system. The fund's support is kick-starting reforms to expand coverage and improve efficiency; a regional advisory group is tackling resource mobilization, multisectoral investment and the transition away from donor dependence.
• In Türkiye, HSTRF is backing plans for a national vaccine-production center and reinforcing public-private partnerships, which would reduce reliance on imports and improve regional supply security.
• Across Small Island Developing States, HSTRF is already showing results. In Saint Lucia, a diagnostic package assesses non-communicable disease care and patient costs at 17 performance-based financing pilot sites, maps care pathways and cancer screening programs, and informs reforms to lower household expenses and make health systems more climate-resilient; similar work is underway in Grenada and Jamaica.

The Pacific Health Systems Flagship Program brought together 60 senior officials from eight Pacific countries for a week-long course combining primary-care reforms and mental-health strategies. At the same time, the Joint Learning Network grew to 40 member countries, enabling practitioners and policymakers to co-produce global knowledge products and share lessons on achieving universal health coverage. These collaborations build leadership, spread innovation and accelerate progress toward universal health goals.