World Bank Spring Meetings, 2026

For the mental health crowd, here are some observations:

1. “Shocks” was the term of the week. Whilst there is always an economic shock just happened, happening, or about to happen, people who watch these things closely think this time is different. The main difference is that these economic shocks are coinciding with “large, simultaneous, fast and unexpected” cuts to aid. And, agencies such as WHO, UNICEF, WFP, and USAID have previously been ‘shock absorbers’ plugging additional gaps in public services that economic shocks create. An IMF predicted 4.3% drop in GDP across Africa comes at a time of 18-20% in ODA to the continent and is compounded by 30-40% cuts in multilateral agencies. This means that despite IFIs having healthy balance sheets and being willing to act as shock absorbers, government budgets will be under huge pressure. For mental health, this means one thing: effective budget advocacy,  integrated across sectors and ministries, becomes even more essential if we want mental health funding to survive the shocks. 

The economic forecast compounds the debt crisis that is yet to be formally recognised, but it is very much present, and debt negotiations are likely to become more common. Mental health is an excellent option for all involved in debt-for-development swaps, where sovereign debt is reduced and, in return,  the savings are committed to specific development goals. Given the direct impact improving mental health prevention and support can have on productivity, and the relatively high opportunity for mental health system investment and running costs to be paid in local currencies. Mental health advocates need to identify specific opportunities and make the case for mental health clear. 

2. The funding squeeze hasn’t reached the international financing institutions. They remain well-capitalised and, in many cases, are looking for opportunities to deploy resources. But for these opportunities to be translated into real investment in mental health, realised, the right language must be used, and the right outcomes must be emphasised. There is an essential advocacy effort required to educate and motivate IFIs on why mental health is the investment they are missing. Impacts of productivity and employment, and improving other investments such as health or education, need to be clearly articulated in the language IFIs speak. 

Human capital is still the approach for social sector investment as far as the World Bank is concerned. The new human capital report highlights moving beyond traditional settings to homes, neighbourhoods, and the workplace for mental health interventions and effects, in a way that takes a social determinants approach, and even recommends cash transfers to improve mental health outcomes. In fact, the 2026 Human Capital report has mental health throughout and feels like a real step forward in how the Bank sees mental health as a cross-cutting issue. 

3. The future of aid goes hand-in-hand with the future of the global health sector; both are being widely discussed at the moment, and both discussions have serious implications for mental health. At the Springs, the focus was on aid. Defenders of aid tend to be more liberal, so discussions urged governments to turn away from a Realpolitik approach to aid which has emerged, and recognise that aid has never been only about serving the national interest.

The general consensus amongst experts this week (though it should be said these were all pro-aid people) is that governments will continue to invest public money abroad. But in an era of fiscal pressure, the purpose of that investment must be clear, and how it is deployed must be more disciplined. Being clear about what aid is for, and what it is not, is the best way to defend it. We mental health advocates must take note of this. We cannot rely on pathos and general claims about mental health when dealing with IFIs and those controlling aid, and we cannot be fragmented. IDA (the huge fund within the World Bank that gives grants and concessional loans to low-income countries for mostly social sector impact) is an example of a great opportunity for mental health, where we need to employ these tactics. 

We, as a coordinated mental health community, should be aware of the financial pressures that governments are and will be under, and use mental health’s strengths and what makes it unique to secure finance that will help mental health systems increase and improve. To do this, we need to speak the language of IFIs and understand their approach, however different that might be from what we are used to.