Where and how to invest
An investment case is designed to answer a question that ministries of finance ask every day: if resources are limited, where should governments invest to achieve the greatest impact? By translating health priorities into economic terms, investment cases provide evidence on the costs of inaction and the returns that can be achieved through targeted interventions.
As Dr André Zida, AFIDEP’s Senior Research & Policy Analyst, noted during his presentation, "An investment case is not an end in itself; it is a tool to support policy dialogue, resource mobilization and decision-making." The real value of the process lies not in producing a report, but in helping governments make informed choices about where and how to invest.
"An investment case is not an end in itself; it is a tool to support policy dialogue, resource mobilization and decision-making."
The persistent gap between evidence and action
This distinction is important because many countries have successfully developed investment cases yet continue to struggle to translate their findings into financing commitments and implementation. Reports are completed, stakeholders are engaged, and recommendations are made, yet securing financing and implementing proposed interventions often remains a challenge.
Webinar participants noted that investment cases are particularly valuable because they speak the language of finance, framing health priorities in economic terms. Rather than focusing solely on disease burdens, they demonstrate how investments in prevention can reduce healthcare costs, improve productivity, and strengthen economic growth.
Country experiences shared during the webinar highlighted both the promise and the challenges of this approach.
Country experiences, lessons from implementation
Uganda
In Uganda, the discussion centered on the country's experience developing an NCD investment case and the challenges of translating evidence into financing decisions. Dr. Frank Mugabe, Principal Medical Officer in the Non-Communicable Diseases (NCD) Department at Uganda's Ministry of Health, explained that the investment case, developed with support from WHO and UNDP, examined the economic burden of NCDs, the costs and impacts of interventions, and the expected returns on investment. The process focused on key risk factors, including tobacco use, alcohol consumption, and physical inactivity, and quantified both the direct and indirect costs associated with NCDs.
With the investment case now complete, Uganda has begun engaging the Ministry of Finance and other stakeholders. However, Dr. Mugabe noted that securing government buy-in remains a challenge. He observed that existing resource allocation mechanisms do not always adequately consider the growing burden of NCDs. Reflecting on Uganda's experience, he highlighted the need for stronger advocacy to ensure that evidence generated through investment cases translates into policy and budgetary action.
Somalia
For Somalia, the conversation focused on the realities of financing NCDs within a health system that remains heavily dependent on external support. Dr. Khalid Mohamud, Health Financing Specialist at the Ministry of Health, Somalia, noted that Somalia has not yet completed an NCD investment case but views it as a critical tool for advancing the country's financing agenda. As he explained, “When you look at our health system, it's almost entirely donor-funded, which is around 90%, compared to the government contribution, which is about 7%.” He added that “noncommunicable diseases receive very little of that money.”
"When you look at our health system, it's almost entirely donor-funded, which is around 90%, compared to the government contribution, which is about 7%.”
To reduce reliance on external funding, Somalia is exploring domestic financing options, including health taxes and levies on sectors such as telecommunications and aviation. Mohamud emphasized the importance of engaging the Ministry of Finance early on and ensuring that evidence reaches decision-makers before budget formulation begins. He described investment cases as “the most powerful tool that we can use” in negotiations with finance ministries and in building “a case for domestic financing mechanisms for health.”
Conclusion
As African countries grapple with rising NCD burdens amid constrained fiscal space and declining development assistance, investment cases offer a valuable tool for mobilizing resources and informing spending decisions. Their effectiveness is strengthened when ministries of finance are engaged early in the process and when their development is aligned with national planning and budgeting cycles.
Yet, as the webinar discussions highlighted, producing investment cases is only the first step. Their true value lies in influencing budgets, unlocking domestic financing, and guiding sustained investment in NCD prevention and control.
Closing Africa's NCD financing gap will require political commitment, stronger collaboration between health and finance sectors, and deliberate efforts to integrate evidence into planning and budgeting processes. Ultimately, evidence alone does not close financing gaps, it will depend on the investment decisions governments make and the political commitment to act on what the evidence shows.
This webinar is part of the Financing Accelerator Network for NCDs (FAN) Learning and Exchange Series. Explore the other webinars in the series:
