The 4th Meeting of the Collaborative Agenda on Fiscal Space, Public Financial Management and Health Financing focused on public revenues, which are central to financing progress towards universal health coverage (UHC). Mobilizing fiscal space through domestic revenues has therefore gained importance in the post-2015 global health agenda. However, weaknesses and rigidities in public financial management (PFM) systems often constrain the efficient use of such revenues, making PFM reform central to the UHC agenda. Motivated by this, WHO’s Department of Health Systems Governance and Financing convened a series of meetings in Montreux, Switzerland, on Fiscal space, PFM and Health Financing policy since 2014 to share knowledge and provide guidance to country related reforms. The first meeting was held in December 2014, building on existing work and dialog on these issues with partner agencies. A follow-up was held in April 2016, to discuss key issues aimed at enhancing productive dialog as countries seek to move towards UHC. In November 2017, the third meeting centred on the practical issues countries face in implementing PFM policies and reforms to institutionalize and sustain progress towards UHC.

This fourth meeting took a more granular approach towards specific health sector PFM and fiscal space issues, including unpacking the links between generic fiscal space and health-specific measures, budget formulation and execution issues in health, and their interrelations with payment systems for health service providers. The specific objectives of the meeting were:

• Provide participants with an update on conceptual developments on fiscal space
• Offer a deep-dive on budget formulation and execution issues for the health sector
• Look at PFM reform from a health service provider perspective
• Define the future PFM/health work agenda with partners