Since 2019, the UK’s strong reputation in global health has been undermined by a series of deep cuts and a distracting departmental reorganisation. 2024 may, however, represent a turning point, with new Foreign and Development Ministers, both with a strong track record on development, the implementation of a new development white paper, and a possible election which may bring a new government with new priorities. In this paper, we summarise the challenges and opportunities in global health on which the UK will need to act if it wishes to restore its reputation. We review UK global health aid expenditure data up to 2022, current UK global health policies, and major external global trends. We find that in 2018, the UK reported spending £2.17 billion (0.1 percent of Gross National Income (GNI)). By 2022, this fell to £1.73 billion (0.07 percent of GNI). If the UK had continued at 0.1 percent of GNI level, it would now have an additional £844 million to spend on global health annually. Bilateral programmes, Foreign Commonwealth & Development Office-managed aid programmes, and reproductive health programmes were particularly hard hit by the cuts. We identify three global trends that the UK must accommodate: an acute-on-chronic health financing crises in low- and middle-income countries; changing demographics, burden of disease, and increasing global threats; and the inadequacy of global health architecture. Finally, we recommend a five-point plan for the UK government to take forward: 1) Champion debt relief and “health taxes” to increase resources for health; 2) Support countries to strengthen health system efficiency; 3) Prioritise limited UK financing on key, measurable objectives in a few low-income countries. 4) Conduct a multilateral aid review that focuses on developing country priorities; and 5) Direct UK health system strengthening funding through the World Bank and long-term bilateral programmes.
