Many countries have achieved substantial health gains through a combination of domestic investment and international support. However, changing economic conditions, evolving disease burdens, and reductions in external financing can create challenges for sustaining progress.

As countries transition, governments must make difficult decisions about financing, service delivery, workforce planning, and institutional capacity. Without a clear understanding of these dynamics, health systems may struggle to adapt to changing realities.

There is therefore a need for evidence that helps policymakers anticipate transition risks, identify opportunities, and develop strategies that support long-term sustainability.