George, AshaKinney, MaryLawn, Joy2025-10-302025-10-302025George, A. S. et al. (2025) Behind the billions: policies, politics and power of the Global Financing Facility for women’s, children’s, and adolescents’ health. Global health action. [Online] 18 (1), 2554021.https://doi.org/10.1080/16549716.2025.2554021https://hdl.handle.net/10566/21339The landscape of global health financing has shiftedprofoundly in recent years – with redirection of donor aid to national security spending, economic shocks from the COVID-19 pandemic, and rising debt burdens – placing immense pressures on low- and middle-income countries (LMICs) to self-finance theirhealth systems . Sudden major donor cuts to global health amplify the need to transform health financing to more sustainable and equitable models that protect vulnerable populations, especially women, children, and adolescents . Many LMICs, and notably those in sub-Saharan Africa, are off track or haveslowed down in progressing towards the Sustainable Development Goals targets for ending preventable maternal, neonatal and child deaths by 2030. This requires urgent action and increased investment. Concurrently, global health initiatives (GHIs), including the Global Financing Facility (GFF), are also beingreimagined to better support countries on their path towards Universal Health Coverage . The GFF launched in 2015 with a compelling mission: to close financing gaps for women’s, children’s, and adolescents’ health through smarter, more sustainable investments . Framed as a ‘country-led’ mechanism that could both mobilize and coordinate domestic and external financing, the GFF promised to move beyond traditional aid models by catalyzing investment cases tailored to each country’s priorities. A decade since its inception, there remains relatively little peer-reviewed research about how the GFF operates in practice, how its promises of country leadership and catalytic financing are realized, and what lessons can be drawn for the future of global health financing .enGlobal Financing Facilitywomen andhealthwomen and childrenUniversal Health CoverageArticle